The COVID-19 pandemic exposed and exacerbated system health equity issues that have long plagued underserved communities. Read More
Growing Need for Complex Hierarchy Support Read More
Clinically integrated networks (CINs) are gaining traction as the collaboration model of choice to enable higher quality health care at lower costs. These partnerships of like-minded independent providers and hospitals with shared performance improvement, quality, value, and efficiency goals can have a profound impact on patient outcomes while decreasing overutilization. Read More
Value-based care (VBC) reimbursement models are designed to reward better patient outcomes while reducing the costs of healthcare. The American Medical Association (AMA) identifies several components necessary to make a VBC ecosystem successful. These include a clear, shared, patient-centric vision, the leadership and professionalism of healthcare workers, and broad access to care for anyone who needs it. Read More
The U.S. healthcare system’s transition away from fee-for-service toward value-based care represents the most significant change in how healthcare is delivered and paid for in generations. According to a recent study by McKinsey, the percentage of the insured population in value-based contracts is expected to grow by 10% per year from 2022 to 2025. Read More
SDoH include environmental and social factors such as employment status, income level, education level, housing security, physical activity, neighborhood safety, and access to healthy foods. Research shows SDoH have as much as an 80% impact on the health of an individual or population. Additionally, studies have confirmed a link between SDoH-related risk factors and chronic diseases (such as hypertension and diabetes), which together account for 90% of healthcare spending in the U.S. Read More
Value-based administration empowers payers, providers and CBOs to share patient information, coordinate care and deliver needed services, all while holding network participants accountable for the cost-and-quality metrics they committed to in risk-sharing arrangements. Few legacy systems are up to that task. Read More
Healthcare organizations have been on a long, winding road to value-based care, but the promise of improved patient outcomes and reduced costs is nearing as value-based care gains traction. Read More
Existing claims and clinical workflow-based legacy technology investments, both on the payer and provider sides, simply are not equipped to efficiently administer value-based arrangements at scale.
As more payers and providers implement value-based care (VBC), treatment increasingly is shifting to a patient’s home or community setting. For payers, integrating community-based organizations (CBOs) into traditional care networks offers both an opportunity and challenge.
Even the highest-quality medical care cannot overcome all of the factors patients encounter that lead to poorer health outcomes. One highly cited study attributes 81% of outcomes to socioeconomic factors and health behaviors and just 16% to clinical care. Read More
The transition from treating patients at a provider’s site to delivering care in the home and community requires two things: an ability to incorporate social determinants of health into the care coordination process and the inclusion of value-based care and community-based organizations as compensated care delivery partners in value-based care networks. Read More