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 […]

Value-based payment models are attracting attention for risk adjustment methodologies, especially HCC risk adjustment, which is used to calculate cost benchmarks for Medicare Advantage and other CMS payment models including […]

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 […]

Shifting from volume-driven to value-based healthcare wouldn’t be so difficult if value meant just one thing. But every payer and value-based program defines value to suit its own purposes—on good […]

As usual I have a song in my head and this month is no different (rock ‘n’ roll tunes are so catchy)!  As we are about to navigate through uncertain […]

Following Medicare’s lead, New York State Medicaid has implemented requirements on health plans to rapidly increase the percentage of dollars being spent under value-based care arrangements. Not only will plans […]

Value-Based Payment (VBP) is top of mind for all who work with a Medicaid population in states across the U.S. Through its Delivery Service Reform Incentive Payment (DSRIP) Program and […]