Tag Archives: healthcare payments

Did the Medicare Bundled Payment Model Decrease Care Quality?

As we continue to focus on value-based payment models, we must always be aware of possible unintended consequences. The Medicare Bundled Payment for Care Improvement Advanced Model (BPCI-A) is a model that has had broad participation since its inception in 2018. It has shown reductions in overall Medicare payments per episode and improvements in clinical outcomes. The question… Read More »

Pricing of Aducanumab Brings Out Flaws in Drug Payment Models

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 »

The Value of Radiology Services in Value-Based Care

Radiology services play an essential role in value-based care. Yet, some believe that such services fall into the category of cost; however, if we change our perspective, we can consider such activities may elevate the overall value we deliver. In fact, diagnostic radiology can have a clinical benefit because it can help to refine differential diagnoses, define and… Read More »

Are Physician Payments Being Calculated Correctly?

In examining healthcare expenditures, various factors influence costs. Although we focus a tremendous amount on overutilization, variation, and waste, unit prices are also an essential factor. For example, drug costs constitute a significant focus concerning unit pricing. However, there are other numerous inputs affecting the health services unit cost equation. One of these such areas is payments to… Read More »