fee for service
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Report: Many Employers, Consumers Don’t Understand Value-based Care
Although many employers and consumers don’t understand the difference between value-based care and fee-for-service, most are in favor of value-based care after being given the definition, a new survey found.
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Report: MA Enrollees Are More Likely to be Socioeconomically Disadvantaged than Traditional Medicare
The average income of a traditional Medicare enrollee is $85,085, versus $76,720 for a Medicare Advantage enrollee, according to a whitepaper done in partnership between Harvard Medical School and software solutions company Inovalon.
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Payer’s Place: Dawn Maroney
Dawn Maroney, President, Markets of Alignment Health and CEO of Alignment Health Plan, to discuss how they are using technology to provide better service and care to consumers.
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Providers Need to Commit to VBC Sooner Rather Than Later, Experts Agree
Experts argued that value-based care is here to stay and will play a major role in the future of healthcare during MedCity’s Invest conference in Chicago. A panel of four agreed that the success of value-based care depends on organizational commitment — it’s a quixotic mistake to think these alternative payment models can gain traction overnight.
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VBC Won’t Save Safety Net Hospitals, Experts Say
A shift from fee-for-service payment models to value-based models is not an effective way to address the severe financial pressures that safety net hospitals are facing, experts argued at the HIMSS conference in Chicago. One called for a paradigmatic shift “away from cost savings and toward understanding where investments are needed.”
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Remote patient monitoring use is on the rise, but reimbursement needs to catch up
The reimbursement model for remote patient monitoring needs to evolve as it may be holding providers back from investing in these programs, according to panelists at the MedCity INVEST Digital Health conference. Key issues with the structure as it stands now include the fact that there are too many gray areas that result in claims denials.
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CMS changes to Stark Law appear largely positive, experts say
CMS has finalized changes to the Physician Self-Referral Law, also known as Stark Law. Healthcare law experts say that these changes will generally make it easier for hospitals and physicians to remain in compliance with the statute.
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The three horizons of the value-based care continuum
During a presentation at the World Congress Integrated Delivery Systems Summit last week, NextGen Healthcare’s Bruno Nardone took a closer look at today’s value-based care environment.
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Survey: 43 percent of physicians say they have the needed tools to succeed under value-based care
What does the future of value-based care look like, and how does technology tie in? A new survey from Quest Diagnostics and Inovalon takes a closer look.
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Applying Remote Patient Monitoring to Surgery Prep and Recovery, Oncology and Women’s Health
Join us to learn about the latest trends in remote monitoring and how to extend its benefits beyond chronic conditions to more patients – all while using fewer staff resources.
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Report: Fee for service still dominant method of healthcare payments
Commercial health plans have “dramatically shifted” in how they pay hospitals and physicians, with 40 […]
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Why Do I Only Get 10 Minutes With My Doctor?
Good question. You call for an appointment and are told it will be about 20 […]
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Medicare and the Continuing Loss of Primary Care Physicians
Primary care physicians (PCPs) have been marginalized by Medicare for decades with low reimbursement rates […]
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Hospitals, MedCity Influencers, Policy
Of course hospitals make money from complications!
A new JAMA article (Relationship Between Occurrence of Surgical Complications and Hospital Finances) by a variety of health care wonks including some of my former Boston Consulting Group colleagues demonstrates that hospitals make more money when surgical patients have complications. The article is useful in that it documents the extent of the situation but the […]
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Hospitals, MedCity Influencers, Policy
Don’t blame docs for codes that pay more for scans and surgery than listening and guidance
A recent analysis of billing codes suggests that doctors are gaming the system to get paid more. Doctors will tell you that counseling patients is much harder work than doing surgeries all day, but they are not the ones who set the reward for different types of work.
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Payer’s Place: Dr. Anil Singh
Dr. Anil Singh shares his insights into the strategies employed by the organization to identify the most effective digital solutions for their members.
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Discover the Next-Gen Platform for Integrated Collaborative Care
Beyond EHRs and digital front doors, reducing the gaps in patient care journeys.
