Value-based Reimbursement News and Resources for Healthcare

Researchers Propose Framework to Ensure Equitable Healthcare Algorithms

August 2, 2022 - In new commentary published in Health Affairs, researchers from the Rand Corporation posit that having knowledge of race and ethnicity, and including that data in healthcare algorithms, is necessary to combat algorithmic bias effectively, rather than taking a “race-blind” approach. The authors further argue that when race and ethnicity...

Why AI Is the Solution to Radiology Data Problem

October 21, 2019 by Pure Storage

Radiologists are under increasing pressure to read and interpret hundreds of images a day. One study estimated that the average radiologist needs to interpret one image every 3–4 seconds in an...

Data Analytics Help 84% of Orgs Assess Clinical, Financial Success

September 25, 2019 by Jessica Kent

Eighty-four percent of healthcare organizations are using data analytics tools to measure improvements in multiple areas, including clinical, financial, or operational processes, a survey from HIMSS...

ACS, HBS Partnership to Address Value-Based Care, Reduce Costs

July 24, 2019 by Emily Sokol, MPH

The American College of Surgeons (ACS) and Harvard Business School (HBS) announced a value-based care partnership aimed at improving quality care while reducing costs. The duo’s primary goal is...

Strategies for Collecting High-Quality Patient-Reported Outcomes

July 18, 2019 by Emily Sokol, MPH

Patient-reported outcomes (PROs) are direct reports from patients about their health, quality of life, functional status, and goals of care. The healthcare industry is placing an increased focus on...

5 Successful Risk Scoring Tips to Improve Predictive Analytics

July 09, 2019 by Emily Sokol, MPH

Risk scoring allows organizations to understand their population based on defined risk factors and anticipate the future risk of the group. A risk score is a metric used to predict aspects of a patient’s care (cost, risk of...

New Project Puts an Actuarial Eye on Big Data, Healthcare Costs

January 29, 2019 by Jessica Kent

Healthcare costs in the US are on the rise, with the industry spending billions each year to combat chronic disease, manage administrative tasks, and advance medical treatments. Although organizations...

UX, AI, and Amazon: Top 5 Healthcare Predictions for 2019

December 06, 2018 by Jennifer Bresnick

2018 was nothing if not eventful for the healthcare industry, and 2019 is already shaping up to be more of the same. Between the federal urgency around enabling patient access to health data,...

Lack of Data Analytics Tools Deflates Faith in Value-Based Care

July 17, 2018 by Jennifer Bresnick

The road to value-based care has never been a smooth one, but healthcare providers and payers may be in the midst of a particularly bumpy part of the journey, reveals a new survey from Quest...

Users Opt for Integrated EHR, Population Health, RCM Platforms

May 04, 2018 by Jennifer Bresnick

Integrated electronic health record (EHR), population health management, and revenue cycle management (RCM) platforms are receiving top marks in user satisfaction from a growing number of organizations...

AMA Invests $27M in Health2047 to Accelerate Value-Based Care

May 01, 2018 by Jessica Kent

The American Medical Association (AMA) has announced that it will help boost chronic disease reduction, productivity, and value-based care through a $27.2 million investment in Health2047, a Silicon...

BCBS Value-Based Care Programs Boost Quality, Reduce Costs

April 27, 2018 by Jessica Kent

The Blue Cross Blue Shield Association (BCBSA) recently announced that its network of value-based care programs, including accountable care organizations (ACOs) and patient-centered medical homes...

Humana Launches Value-Based Care Model for Expectant Mothers

April 25, 2018 by Jessica Kent

Humana has partnered with OB-GYN practices to introduce a national value-based payment model that will improve maternity care quality and reduce costs for Humana members with low- to moderate-risk...

HCOs Falling Short of Population Health, Value-Based Care Goals

April 10, 2018 by Jennifer Bresnick

Slow and steady may win the race in Aesop’s fables, but healthcare organizations that are falling short of their population health management and value-based care goals will have a hard time...

Clinical Analytics Aid Payers, Providers with Value-Based Care

February 13, 2018 by Jennifer Bresnick

Clinical analytics and data integration are helping health payers and providers boost quality and meet the challenges of value-based care, says the 8th Annual Industry Pulse Report from Change...

751 Orgs Get Medicare Penalties for Hospital Acquired Conditions

December 28, 2017 by Jennifer Bresnick

Medicare has penalized 751 of the nation’s hospitals and health systems for high rates of hospital acquired conditions (HACs) such as preventable falls, infections, and pressure...

Penn State, Highmark Health to Spend $1B on Population Health

December 20, 2017 by Jessica Kent

Penn State Health and Highmark Health have announced a population health management partnership designed to deliver quality, value-based care to patients across central Pennsylvania. The partnership...

Population Health, Value-Based Care Still Challenging for ACOs

December 19, 2017 by Jessica Kent

As alternative payment models like accountable care organizations (ACOs) start to replace fee-for-service models in healthcare, leaders must translate value-based care policies into realities that will...

CMS Requests Input on “New Direction” in Patient-Centered Care

September 20, 2017 by Jennifer Bresnick

CMS officials have opened up an informal survey designed to collect public input on how the agency can take an innovative approach to fostering affordable, effective patient-centered care. With a...

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