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Reinventing Utilization Management to Bring Value to the Point of Care

February 21, 2018  |  Nilo Mehrabian Vice President, Product Management, Decision Support, Change Healthcare
article
How an automated exception-based approach can make UM more efficient and effective.

Is the Discourse Over the MSSP Program Teetering Towards Potential Conflict?

September 21, 2018  |  Mark Hagland
commentary
The joint statement by nine associations challenging CMS Administrator Seema Verma around her plans to insert more rigor into the MSSP program, feels like a teeter-totter moment for CMS

NAACOS, AMA, Others Urge CMS to Reconsider MSSP Proposed Changes

September 21, 2018  |  Rajiv Leventhal, Managing Editor
news
NAACOS and eight other healthcare stakeholder groups have sent a letter to CMS, expressing concerns about the federal agency’s proposed changes to the Medicare Shared Savings Program.

Town Hall Ventures Close First Fund at $115 Million

September 20, 2018  |  David Raths, Contributing Editor
news
Town Hall Ventures, an investment firm built to address the healthcare challenges of the most vulnerable Americans, has closed its first fund at $115 million.

Survey: Physicians Sour on Value-Based Care Metrics, EHRs

September 19, 2018  |  Rajiv Leventhal, Managing Editor
news
More than 50 percent of U.S. physicians who receive value-based care compensation said they do not believe that the metrics the reimbursement is tied to improve the quality of care or reduce costs, according to a new survey.

The CEO of a Nationwide Association of MD Groups Sees the Future—and It’s Not in Fee-For-Service

September 18, 2018  |  Mark Hagland
article
Don Crane, CEO of APG, a nationwide association of medical groups working in risk-based contracting, shares his perspectives on the future of medical groups in a shifting landscape

On Staten Island, a Highly Innovative Program That's Redefining What’s Possible Under Medicaid

September 17, 2018  |  Mark Hagland
article
Healthcare leaders on New York City's Staten Island have been achieving exciting success in population health management in their community’s Medicaid and uninsured populations

On Capitol Hill, Healthcare Leaders Raise Concerns with CMS’ Proposed ACO Rule

September 17, 2018  |  Heather Landi, Associate Editor
article
During a House subcommittee hearing, healthcare leaders voiced concerns that CMS' proposed changes to the MSSP ACO program will impede progress in the transition to value-based care.

Humana’s CMO Speaks of the “Bold Goal” Embedded in the Company's Population Health Work

September 14, 2018  |  Heather Landi, Associate Editor
article
Roy Beveridge, M.D., Humana’s chief medical officer, shares his perspectives on the drive to value-based care, population health and addressing social determinants of health.

The Shock of the New: The Paris Art World of 1916—and the U.S. Healthcare Landscape of 2018

September 13, 2018  |  Mark Hagland, Editor-in-Chief
commentary
What does a revolution in art from a century ago say about the present moment in U.S. healthcare?

Check and Checkmate: Is the Debate Around the MSSP ACO Program About to Get Super-Heated?

September 12, 2018  |  Mark Hagland
commentary
The publication this week in Health Affairs of a study sponsored by NAACOS that implicitly denounces CMS’s method for calculating the success of MSSP ACOs, is a fascinating move in a chess game playing out on multiple policy levels

New Healthcare Alliance Launches APM for Addiction Recovery

September 12, 2018  |  Rajiv Leventhal, Managing Editor
news
A national multi-sector alliance of healthcare stakeholders has announced the creation of the Addiction Recovery Medical Home (ARMH) model.
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