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As both payers and providers grapple with a new round of COVID-19 stress to the health system due to variants such as Delta and Lambda, health plans face a growing array of challenges requiring rapid and effective response. Contact tracing and immunizations have taken on a new level of priority as the Delta variant burns […]

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Providers barely had time to take a breath before confronting a new round of COVID-19, driven primarily by the Delta variant. Above and beyond caring for COVID patients, this deadly scourge continues to tax our health systems and their health care workers: Contact tracing and immunization campaigns remain imperative. The entire health care workforce, particularly […]

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As the national health care landscape continues to shift towards value-based payment (VBP) models, the traditional approach by health systems and hospitals of measuring market share based on percent of admissions in a given market is putting them at a growing disadvantage. They must adopt the most telling measure for risk-bearing organizations, which is how […]

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Like hospitals everywhere, St. Joseph Hospital Orange and Mission Hospital faced the challenge of meeting the demand for COVID-19 immunizations while concurrently balancing the impacts of pandemic-related staffing shortages. The two Providence hospitals in Southern California turned to COPE Health Scholars, aspiring health professionals already on site as part of hands-on experiential education courses, to […]

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Technology and data are essential foundations for value-based care. But knowing how to maximize the use of both is not always clear or straightforward for clinicians who are focused on patients and their care. To help fill that gap, COPE Health Solutions and the other members of the Alliance for Technology-Driven Health have launched “The […]

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What a wake-up call. On the heels of the Centers for Medicare & Medicaid Services (CMS) suspending Medicare Direct Contracting for most new applicants and sunsetting the Next Generation ACO model, the new director of the Center for Medicare and Medicaid Innovation (CMMI) last week signaled a likely move toward requiring providers to take financial […]

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With the May 21 announcement that it was discontinuing the Next Generation ACO Model at the end of 2021, the Biden Administration continues to move decisively to put its stamp on The Centers for Medicare & Medicaid Services. While this decision has serious implications for NextGen ACOs participants, they are not alone.  The in-progress reassessment […]

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If you’re like me, you remember the first round of capitated payments in the late 1980s and early 1990s. There were some good reasons why that grand experiment in managed care eventually collapsed, but one of the biggest culprits was lack of useful and actionable data as well as detailed analytics. Providers and payers did […]

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Under the Biden administration, the Centers for Medicare & Medicaid Services has paused its 2021-22 contracting cycle for Medicare Direct Contracting and is assessing its other alternative payment programs. While many are busy trying to read the tea leaves as to which programs will survive and which will be cut, two patterns are clear: Programs […]

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If you were shut out of Medicare Direct Contracting (MDC) when the Centers for Medicare and Medicaid Services (CMS) recently announced it would not accept new 2022 applicants, all is not lost. The pause on new MDC applicants is part of a broader examination of CMS’ various Medicare models to encourage value-based care and value-based […]

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