Percent of Children in Medicaid Managed Plans Increases to 94%
Nationwide, the children under 21 enrolled in Medicaid crew to 40.5 million in 2017 from just 23.5 million in 2000.
Medicare
Humana and Mercy Join Forced to Expand Access to Virtual Value-Based Care
Mercy and Humana recently announced that they are going to partner to offer their Medicare Advantage patients access to the telehealth center at Mercy. They will also be implementing a new VBP model for reimbursement.
Medicare Spend Increases on Opioids and Antibiotics While Low-Value Care Spending Decreases
A new study by the RAND Corporation found that low-value care spending dropped from 2014 to 2018 for Medicare recipients.
Payers Can Improve Care Management to Improve ROI
McKinsey & Company (McKinsey) recently released a report looking at the untapped potential of payer care management. McKinsey listed four actions for payers to take in order to achieve a broader vision for care management and improve ROI.
The Four Pillars to Build On in a VBP Environment
Four Pillars to Build On in a VBP Environment THE VBP Blog [1/14/2021] In 2020, we took on the monumental task of evaluating all ten states that offered managed care programs for the Intellectual and Developmental Disabilities (I/DD) population. In our final blog of that series, we broke down our findings into four main pillars. These frameworks provided structure across the many different approaches over the ten states. At the end of 2020, we offered our commitments as a company and in this blog we take a look at how those cross over. 4 Pillars of Reviewing Value-Based Care in I/DD Managed Care Time Matters: more than almost any other factor, the states that gave themselves time for a methodical… Read More »The Four Pillars to Build On in a VBP Environment
CMMI Releases Overview of Value-Based Care Models
The Center for Medicare and Medicaid Innovation (CMMI) introduced models that supported value-based care while looking for ways to lower cost and refine risk adjustment.
HHS to Expand Home Health Value-Based Payment Model
CMS announced that the Home Health Value-Based Purchasing (HHVBP) Model has been certified for expansion. The HHVBP Model has led to an average annual savings of $141 million to Medicare.
Study Finds Better Outcomes for Medicare Advantage Beneficiaries than Traditional FFS Medicare
Among others, the study found that there were better outcomes in MA than FFS for all populations analyzed in 17 of 22 clinical quality of care measures.
The Primary Care First Model Explained
The Primary Care First VBP Model Explained THE VBP Blog [12/17/20] The Primary Care First (PCF) model was established by the Centers for Medicare & Medicaid Services (CMS) Innovation Center. It offers a regionally-based, multi-payer approach to primary delivery and payment. By design, PCF allows for increased flexibility and freedom for practitioners to be innovative in their approach to increase quality and reduce costs. PCF will be offered in 26 regions in 2021, including many that were covered in our I/DD Managed Care Review blogs. In those blogs, we covered the ten current programs being offered. Out of those ten, five (New York, Tennessee, Kansas, Arkansas, and Michigan) also have a PCF option. This leaves us hopeful that PCF programs… Read More »The Primary Care First Model Explained
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