Centering The Patient in Value-Based Care Benefits

HIT Consultant | September 6, 2024

Forty years ago, at the height of the AIDS epidemic, HIV researchers and physicians discovered that simply treating the symptoms of the disease was not enough to provide lasting improvement for patients. Other factors like unstable living conditions, drug use, the public stigma over AIDS and HIV – known today as social determinants of health – all require attention in addition to a traditional treatment plan. This holistic view of the patient and caring for their symptoms, treatments, and the environment around them is what we know today as Value-Based Care (VBC). From this perspective, one could say VBC has been part of our healthcare ecosystem for decades.

Medicaid Accountable Care Organizations may increase care engagement and quality among pregnant and postpartum patients

Medical Xpress | Septe, 2024

A new study has found that Medicaid ACOs in Massachusetts were associated with increases in prenatal and postpartum office visits, postpartum depression screenings, and timely postpartum care. Despite recent declines in nationwide maternal mortality, the United States continues to experience a significant maternal health crisis, in part shaped by inequitable access to quality health care for too many pregnant and postpartum people, particularly those who are covered by Medicaid.

The ‘Holy Grail’ of Palliative Care Payment Through ACOs

Hospice News| September 11, 2024

As opportunities to provide palliative care through Accountable Care Organization (ACO) relationships continue to arise, operators will likely need to understand the varying types of reimbursement that exist in that arena. ACOs are groups of physicians, hospitals and other health care providers who come together voluntarily to give coordinated high-quality care to their Medicare patients. Hospices and palliative care providers can collaborate with ACOs by becoming members of those organizations themselves, or by contracting with them through a preferred provider network. Community-based palliative care’s track record of reducing costs and hospitalizations could make providers of those services attractive to ACOs, according to Edo Banach, partner at Manatt Health, a division of the law firm Manatt, Phelps & Phillips, LLP.

Why ACOs and Other Risk-Bearing Providers Must Prioritize Contract Management

Healthcare IT Today | September 11, 2024

Healthcare providers are continuing to form and invest in Accountable Care Organizations (ACOs) as a means of improving care quality and reducing costs. Some of the largest ACOs serve upwards of hundreds of thousands of patients, while, overall, 13.7 million Medicare beneficiaries are being cared for by ACOs this year, according to the Centers for Medicare & Medicaid Services (CMS). A key component of the healthcare industry’s push towards value-based care, ACOs place a heavy emphasis on delivering preventive care to patients to reduce costs, which may be particularly impactful for those experiencing chronic conditions. Approximately 90% of the nation’s $4.5 trillion in annual healthcare expenditures goes toward people with chronic and mental health conditions, such as heart disease, cancer, and diabetes, according to the U.S. Centers for Disease Control and Prevention (CDC).