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The Other Medicaid Drug Rebate News: Oklahoma’s State Plan Amendment
On June 27, 2018, the Centers for Medicare & Medicaid Services (CMS) approved a state plan amendment (SPA) authorizing Oklahoma’s Medicaid program to enter into value-based purchasing arrangements with drug manufacturers. The new SPA permits the state to negotiate supplemental drug rebates based on performance and outcome benchmarks as part of a value-based contract, which […]
ACOs and Other Value-Based Purchasing Models Have Yet to Cut Costs
David Muhlestein provided insights regarding the three “What is Driving the Total Cost of Care?” white papers for a RevCycleIntelligence article entitled “ACOs and Other Value-Based Purchasing Models Have Yet to Cut Costs” and a FierceHealthcare article entitled “Report: Value-based payment models haven’t cut costs yet.” David told RevCycleIntelligence that, “Many healthcare providers began making […]
What’s Driving Health Care Costs?
This morning, Health Affairs Blog published a post entitled “What’s Driving Health Care Costs?” that highlights major findings from the three mixed-methods studies conducted by Leavitt Partners, the Healthcare Financial Management Association (HFMA), and McManis Consulting released on Monday. The article further examines why population-based VBP models are not yet lowering market-Level health care costs. […]
How Addressing Social Determinants of Health Cuts Healthcare Costs
A RevCycleIntelligence article entitled “How Addressing Social Determinants of Health Cuts Healthcare Costs” cites the Leavitt Partners “Social Determinants Matter, But Who Is Responsible?” white paper. The article states, “Providers in a recent Leavitt Partners survey cited insufficient appointment time and lack of compensation as top barriers to addressing SDOHs. Fee-for-service payments do not reimburse […]
What is Driving Total Cost of Care?
In a combined quantitative and qualitative analysis of factors that may be influencing total cost of care in healthcare markets across the United States, researchers from the Healthcare Financial Management Association (HFMA), Leavitt Partners, and McManis Consulting found that: The penetration of population-based value-based payment (VBP) models is not yet having an impact on curbing growth in total cost of care. […]
Executive Summary — What is Driving Total Cost of Care?
In a combined quantitative and qualitative analysis of factors that may be influencing total cost of care in healthcare markets across the United States, researchers from the Healthcare Financial Management Association (HFMA), Leavitt Partners, and McManis Consulting found that: The penetration of population-based value-based payment (VBP) models is not yet having an impact on curbing growth in total cost of care. […]
Growth of Population-Based Payments is Not Associated With a Decrease in Market-Level Cost Growth, Yet
This paper examines whether the magnitude of population-based value-based payment (VBP) models is associated with decreased spending and increased quality at the market level. Using Medicare claims Limited Data Set (LDS) for 2012-2015 and Truven Health MarketScan Commerical Database for 2012-2014, we conducted growth curve modeling and fixed effects regression analyses to examine whether the […]
Market Factors Associated with Medicare Costs and Cost Growth
Medicare costs in the United States are high and the rate of cost growth is increasing. However, there is significant variability between markets in per-beneficiary costs and the rate of cost growth. We used a variety of public and private data sources to assess which market factors were associated with market-level per-beneficiary costs and cost growth. Taken together, […]