Section 1115 Waivers: An Overview and State by State Comparison
Abstract: Health care reform has evolved over the past few decades, but one constant in this transformation has been Section 1115 waivers. These waivers broadly permit states to conduct “Medicaid research and development” programs to better meet the health care needs of their unique populations. Thus, the onus of health care reform is shifted to […]
Communicating a Value Proposition: Community Based Organizations as Key Actors of VBP
Meeting Consumers’ Demands in Safety Net Health Systems
MACRA: The Times are Changing!
Las Vegas Population Health 360 Key Conference Takeaways
Thank you all for joining our Las Vegas Population Health 360 Conference. More than 100 health care leaders gathered for this invite-only event to discuss current trends, challenges and the future vision of the value-based payment landscape. Attendees engaged in a series of panels and round table discussions throughout the two days to learn best […]
Heads You Win, Tails You Win – Roadmap to a Win-Win Path to Downside Risk in Medicare Alternative Payment Models
ACOs that started in the Medicare Shared Savings Program’s Track 1 in either 2012 or 2013 must determine whether to move to a risk-based model by their third contract periods, which begin in 20191. A number of the MSSP ACOs are making strides in improving quality, reducing hospitalization and waste in Medicare. The Centers for […]
Key Trends in 2018 for Health Care Organizations Moving to Value-based Payment and Population Health Management
Health care is in a tumultuous time and what’s for certain is that nothing is for certain. The passing of the recent Tax Cuts and Jobs Act of 2017 (TCJA) has broad but still not completely understood implications for the business community and economy, including non-profit health hospitals and health care systems, generally adding more […]
CMS announces new Medicare-Medicaid ACO model
On Thursday, CMS announced the creation of a new ACO model geared toward patients who qualify for both Medicare and Medicaid, also known as dual eligible. Dual eligible patients typically have more complex health needs, chronic conditions and social issues than the general Medicare population. Consequently, they account for a disproportionate share of spending in […]
Insurers Increase Participation in ACA Markets and Must Focus on Key Provider Partnerships
The Affordable Care law has survived for nearly a decade despite efforts to upend it, including legal challenges (one pending1 and another that went all the way to the Supreme Court), Congressional attempts to repeal it and executive orders aimed at weakening it. While fiery debate continues over the fate of the roughly 21 million Americans, […]
Heads You Win, Tails You Win – Roadmap to a Win-Win Path to Downside Risk in Medicare Alternative Payment Models
ACOs that started in the Medicare Shared Savings Program’s Track 1 in either 2012 or 2013 must determine whether to move to a risk-based model by their third contract periods, which begin in 20191. A number of the MSSP ACOs are making strides in improving quality, reducing hospitalization and waste in Medicare. The Centers for […]