There has been a constant battle for Medicaid in America – from states slashing Medicaid reimbursements or refusing to expand access, to Congress now threatening to cut and restrict Medicaid funding altogether. The program, which funds 78.4 million of our most vulnerable patients, is a necessity to primary care. Medicaid beneficiaries look like pregnant women… Read More »
The transition to value-based care (VBC) is fundamentally transforming the healthcare landscape, and 2025 is poised to be an inflection point to see whether the promise of VBC can be realized. For healthcare professionals – and especially for ambulatory care practices – embracing the nuances of this dynamic environment is essential not only for delivering… Read More »
What accounts for large differences in life expectancy from one neighborhood to another? This post explains what our team has discovered so far using an “artificially intelligent” approach to understanding social risk at the local level. Where you live affects how long you live In 2018, when the National Center for Health Statistics released the… Read More »
The COVID-19 pandemic caused large reductions in in-person office visits, costing primary care practices billions and exposing many of the risks associated with the fee-for-service (FFS) payment system. Capitation arrangements, in which providers are paid a per-member per-month payment, may offer a more attractive, less risky arrangement in the post-COVID-19 world. Almost all US health… Read More »
VBID and alternative payment models comprise two approaches to reform with different incentives that influence underlying motives. The underlying principle of Value-Based Insurance Design (VBID) is to align patient out-of-pocket costs, or cost-sharing (deductibles, co-pays, etc.), with clinical value of services. Decreasing cost-sharing for high-value services and increasing cost-sharing for low-value services is the goal of… Read More »