highlights from the hfm blog
Here are excerpts from recent postings on hfm's healthcare finance blog (hfma.org/hfmblog).
Can MA Value-Based Insurance Design Improve Health Care?
Healthcare delivery reform under the Affordable Care Act generally has gone like this: The
Usually, the onus falls on healthcare provider organizations-for example, accountable care organizations, which are on the hook to meet numerous quality measures and hold costs below targeted benchmarks-or commercial payers running
But these arrangements fall short of directly motivating the actor at the center of the healthcare stage-the individual member or patient. Eveiyone knows that engagement of the patient is the final, critical mile, and that is why billions of dollars are spent each year on patient outreach and communications, and on development and promotion of consumer-friendly apps and wearable devices. Engaged patients give the healthcare system a chance to diagnose and treat in a more timely, efficient, and effective way.
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ACO Performance: A Deeper Look
Given that almost three-quarters of
Health systems often realize strategic benefits from ACOs. Even without shared savings, health systems have used ACOs to improve physician alignment, reduce readmission penalties, secure market share, and support a focus on value-based care.
Health systems likely can worry less about competition from physician-sponsored ACOs. Physicians have little to gain beyond savings, meaning physician ACOs that don't achieve savings are likely to disappear. The newest data may discourage formation of such ACOs by physicians. However, physicians may still want to participate in ACOs developed by others to obtain better payment rates under future
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