As we begin to reflect on policy changes and how they impacted people during covid, It’s of utmost importance that we assess what enhanced our wellbeing and what did not. We know that a significant determinant of health, especially in children, is access to healthy food and permanent food security. One of the many policies during Covid was… Read More »
Currently, a significant portion of value-based care payments has focused on primary care-based models. Whether Medicare Advantage, Medicare Shared Savings Programs, Direct Primary Care, or other value-based programs, they all center on primary care clinicians and services. Though there are a few unique specialty-based models such as BPCI, the vast majority are not. These models have had a… Read More »
For many of us, certain technologies, including telemedicine, are viewed in a highly positive light as a methodology to increase access in a consumer-centric manner. However, there are concerns that such technology will potentially increase health disparities because of the lack of broadband access, hardware, and functional literacy. As a result of the pandemic, access to office-based visits… Read More »
The recent approval of Medicare to extend insurance reimbursement for the new Alzheimer’s drug, only when taken as part of randomized clinical trials, highlights the various issues surrounding the FDA approval of Aducanumab for treatment. This approval process for trial usage only accentuates the necessity for further investigation into this new drug that received an expedited review and… Read More »
There is considerable discussion regarding aligning incentives to lower the total cost of care, and even more specifically, on the importance of diagnostic testing, the value it might bring, its accuracy, and the shared decision-making when ordering tests. Therefore, aligning incentives around appropriate diagnostic testing is critical to both diagnostic excellence and affordability of healthcare. Additionally, an important… Read More »
As clinicians, we spend a significant amount of our time attempting to diagnose what is ailing those we treat. And we have an armament of tests to select from and an extensive list of differential diagnoses, ranging from the probable, to the extremely rare yet, potentially fatal. Understanding the effectiveness of our diagnostic tests is important from multiple… Read More »
As consolidation and integration of physician practices occur, especially within organizations that can wrap capabilities around ambulatory clinical care, we must examine the potential benefit to those we serve. This ideal is also the premise for a clinically integrated network where payment models are designed to allow for enhanced capabilities available to smaller groups of clinicians. These enhanced… Read More »
There has been considerable debate concerning the value of the Medicare Hospital Readmissions Reduction Program. The program was designed to deduct up to 3% of Medicare payments for hospitals with higher-than-expected thirty-day all-cause readmission rates, after index admissions, for six conditions and procedures. One of the primary concerns regarding the program was the disproportionate impact on teaching and… Read More »
There has been a great deal of focus on whether nonprofit hospitals bring value to the communities they serve in proportion to their tax-exempt status. The argument is that the tax dollars are necessary and properly utilized for community benefit; therefore, a tax-exempt status requires community benefit in replacement of payments. The measure used as a metric for… Read More »
For those in the value-based payment (VBP) world, we are constantly asking the question; “Is what we are doing impactful and adding value to quality, service, and costs, to those we serve?” A recent study in Health Affairs analyzed 20 years of commercial VBP studies and found mixed results. And from this information, it’s possible to formulate a… Read More »