Tag Archives: value-based care

Healthy Equity is A Critical Part of Value-Based Payment Models

As value-based payment models have continued to expand, this expansion has occurred in the more affluent communities. Additionally, communities with more socioeconomically vulnerable individuals were less likely to be selected for joint replacement bundles, another form of a value-based payment. A big reason for this lack of equitable distribution of value-based care, can be linked to the absence… Read More »

Taking a Look at What Causes Low-Value Care

Low-value care is defined as the utilization of health services that harm or in which the costs outweigh the possible benefits and there are many reasons for these actions. The desire for clinicians to eliminate situations that might cause harm is a driving factor. Although they may be unable to inform you of precisely what is occurring in… Read More »

There is Wastefulness in a Vial, But We Can Do Better

As we continue to examine areas of excessive waste to enhance affordability, it’s crucial to put all areas under the microscope, including pharmaceuticals. Though convenient, single-dose injection vials lead to wasted medication. In fact, in 2018, the Centers for Medicaid & Medicare Services (CMS) reportedly paid $725 million for discarded drugs administered in hospital outpatient clinics and physician… Read More »

Healthcare Can Be More Affordable if We Can Limit Waste

The cost of healthcare in the United States is exorbitant. There are multitudes of reasons for our elevated unit price. Many believe, waste, makes up a significant part of the problem. And the largest component of wasteful spending is what we identify as administrative costs. These are dollars that are not improving patient care, and yet, they impact… Read More »

Taking a Closer Look at Capitation for Value-Based Care

As we focus on delivering value-based care; higher quality at a more affordable price, the conversation concerning payment models rapidly pivots to global capitation for a population of lives. The opposite payment model is a fee-for-service model, and currently, there is a belief that service-based fees lead to an over-utilization of services. Consequently, many believe the only possible… Read More »

How Alternative Payment Models in Healthcare Can Impact Cost

As we continue to focus on value-based payment models, there is a strong belief that moving away from fee-for-service payments towards a per-patient rate for primary care providers will decrease overall costs. The counter concern is that this may also lead to reduced care because of the financial incentive to avoid services. Primary care providers (PCPs) have the… 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 »

Investment in Social Determinants is Rising

As we continue to focus on value-based care, with special attention put on the social needs of those we serve, how these investments occur becomes paramount. Historically, the buckets of allocated dollars for social needs lived in the public health sector, either by governmental or philanthropic funding. However, as we move towards value-based payment models, other delivery entities… Read More »

Paying for Costly Medical Technologies in a Value-Based World

Healthcare is an industry where innovation and technology continue to progress and create an opportunity to improve lives. However, the cost of such products continues to rise and thus impacts the overall cost of care. But, suppose one surmises the purpose is to enhance care in a manner that delivers value, i.e., where the expense plays a significant… Read More »