For our industry, it’s no longer a question of “if” or even “when.” The shift from volume to value is in full swing, and the pace of change is rapid. Push has finally come to shove, and there is no doubt that reimbursement will be based on your ability to achieve the highest quality outcomes for patients.
Download our infographic to learn which four areas healthcare innovation is creating benefits for both payers and providers.
We all know the risks associated with self-pay patient accounts. The cost to collect is up to three times higher than on commercial insurance accounts, and the longer a self-pay balance goes unpaid, the lower the probability you will ever collect. The reality is, these problems are here to stay because of rising healthcare costs and more high-deductible, consumer-driven healthcare insurance plans.
In February 2016, Centers for Medicare & Medicaid Services made a game-changing announcement that affects the quality measures reporting requirements on providers generally and on physician practices specifically. The CMS said it and major private health insurers and major physician organizations agreed to standardized core sets of quality measures for seven delivery models and clinical services lines. In short, the agreement means that physician groups will be collecting and reporting the same set of quality measures to all payers for a particular delivery model or clinical service line.
Ninety-three percent of our nation’s total Medicare spending is on beneficiaries with multiple chronic conditions, according to the Centers for Medicare & Medicaid Services (CMS). With the new chronic care management (CCM) payment program authorized by the CMS, it is now financially feasible for physicians to deliver care between office visits.
For health care providers, the journey to value-based care starts by taking the first step. For many primary-care physician practices, that first step can — and, in many cases, will — be Medicare’s new Comprehensive Primary Care Plus, or CPC+, initiative.
The transition to value-based care is pushing radiology beyond its traditional borders, and success in this new model is measured in better patient outcomes. To succeed, radiologists and their hospital and referring community colleagues need broad access to both data and images.
Recently I was at UKRC, the largest radiology tradeshow in the UK, and I had the opportunity to join two McKesson customers at a symposium about transformation driven by quality in imaging. These customers told us how their organizations used strong governance groups, data-driven decision making processes and continuous improvement to improve quality in their imaging workflows across their entire enterprises.
The transition to value-based care is pushing radiology beyond its traditional borders, and success in this new model is measured in better patient outcomes. In order to achieve those outcomes, radiologists and their colleagues in the hospital and referring community need broad access to both data and images. A more integrated, collaborative radiology workflow can connect both systems and people, which helps provide much-needed context for better patient care. Here are four characteristics of an integrated, value-based radiology workflow.
Last week the results were reported from the second in a series of national research studies on healthcare’s transition from volume to value, conducted by ORC International and commissioned by McKesson. “Journey to Value: The State of Value-Based Reimbursement in 2016” surveyed 465 payers and hospitals in March. The findings reveal that healthcare is well down the road towards full value-based payment. Andrei Gonzales, M.D., director, VBR Initiatives, McKesson Health Solutions, shares his insights in this second in our two-part series on our Focus Ahead blog.