Introduction Dual-eligible enrollees account for a disproportionately sizeable proportion of spending in both Medicare and Medicaid programs. However, until recently, these nearly 11.5 million[i] enrollees have not been in the spotlight in discussions regarding the move toward value-based payments. One of the biggest challenges in moving dual eligibles to value-based payments is solving the logistical and … Continue reading
As telehealth gains traction as a way to deliver health care, Medicare reimbursement remains a major obstacle to broad implementation due in part to scoring methodology from the Congressional Budget Office (CBO). Rather than decreasing health care costs, CBO’s scoring methodology assumes that telehealth increases utilization and therefore overall costs. Recent legislation on the Hill, … Continue reading
As the health care industry moves toward population-based models of care, providers are seeking partnerships to help manage the continuum of services. In order to find success in these partnerships, there is a need to identify the characteristics of providers that will yield a high degree of value for the ACO, their patients, and community. This series … Continue reading
