If we want better health care outcomes in the U.S., we need to change the way we finance health care. Policies flowing from Medicare are a strong signal to the […]

These times of uncertainty and stress press us to rethink what we are doing and where we are headed in terms of health care. I had a chance to speak […]

Value-based reimbursement is the soup du jour in the medical industry these days. How value is defined, however, can vary depending on one’s perspective. Most experts in the field agree […]

Recently, I reviewed the Medicare Hospital Value-Based Purchasing (VBP) scores for three hospitals recognized nationally for outstanding care and patient safety. They didn’t look good. The ratings for clinical outcomes […]

Hierarchical Condition Categories (HCCs) have been the underlying risk adjustment for many Medicare programs for several years. But they didn’t attract wide interest until CMS began shifting more payment toward […]

With the unrelenting pressure to reduce unnecessary costs in healthcare delivery and despite (or maybe because of) the lack of clear direction from the federal government, Medicaid plans across the […]

I’ve spent much of the last few months traversing the State of New York speaking to our Medicaid MCOs about their strategies to reach the state’s value-based purchasing (VBP) goals. It’s […]

Value-based purchasing and population health management are supposed to change aspects of the relationship between insurers (health plans) and providers (accountable care organizations, health systems, etc).  New contracts are supposed […]

In New York State (NYS), as the final results for measurement Year 2 are solidifying, Value-based Payment (VBP) pilot programs are starting. The VBP pilots do not have an easy […]

Responding to value-based-purchasing, provider groups across the US are implementing or tweaking programs to reduce unnecessary hospital readmission or emergency department visits. Much of this is stimulated by Medicare’s plans […]

In the MedPAC October meeting, the commission returned to the seemingly intractable problem of equalizing access to health care for rural communities. Medicare payment offers three sources of support within […]