In 2004, the introduction of special needs plans (SNPs) marked a pivotal moment for payers serving Medicare Advantage populations. It sparked a dynamic approach to addressing the unique requirements of high-need beneficiaries. Over the years, we've observed an uptick in payers moving into the SNP market, seeking to provide tailored healthcare solutions.

The CMS announcement concerning new eCQM reporting has enlivened the ACO community with both excitement and fruitful discussion. There's uncertainty about the scope, execution, and timeline, but this circumstance also unveils the chance to construct a data infrastructure, capable of significantly boosting the ability of ACOs to congregate data and enrich their analytics abilities. This not only empowers ACOs to fine-tune their value-based care contracts but also ushers in vital capabilities - such as population health management, risk stratification, decision support at critical care junctures, persistent care across diverse settings and providers, and sturdy data analysis. The enforced eCQM reporting is primed to establish an elevated quality-care benchmark for all patients, not only those who are Medicare beneficiaries.

Delivery of patient-centered care is gaining momentum not only in the GCC, but across the globe. As simple as it may sound, I believe it is one of the most intricate aspects of healthcare that needs undivided attention to achieve quantifiable outcomes. Even now, few health systems aren’t aware of the importance of building one-to-one (1:1) consumer journeys by bringing in personalization, accessibility, and innovation and how it can help them “find, guide, and keep patients for life.”

In the ever-changing world of healthcare, a concept that has gained significant attention in recent decades is value-based care. This innovative approach shifts the focus from volume-based services to providing high-quality care that aligns with patient outcomes and cost-effectiveness. This blog explores the history of value-based care, when it was started, the key moments in the building of today’s of value-bsaed care landscape and its transformative impact on healthcare.

In U.S. healthcare, providers operate under two primary models to secure compensation for their services: the fee-for-service (FFS) model, and the value-based care (VBC) model. This blog provides a brief comparison - FFS Vs. VBC - delving into the major differences in the methods. Furthermore, we'll evaluate each model's pros and cons, considering their impact on patient care, health systems, as well as the overall healthcare ecosystem.

State Medicaid programs are increasingly interested in adopting various value-based payment (VBP) models with the aim of fostering efficiency and enhancing health outcomes within the system. Unlike Medicaid’s traditional fee-for-service payment model, which relies on the quantity of care delivered, value-based payment models incentivize providers to meet quality objectives and generate cost savings. Some models also incentivize improving the patient experience and addressing disparities in health equity.

In part 1 of our series on payer-provider collaboration, we talked about the challenge of data silos. In part 2, we’ll look at the challenge of provider abrasion and its cure: meaningful payer-provider collaboration based on shared and timely access to data.

Meet Chris, a 57-year-old individual battling stage 1 lung cancer in the Chicago metropolitan area. Amid his treatment, he finds himself dissatisfied with his current healthcare provider's level of attention and care. Chris is grappling with limited guidance regarding his illness, available treatment options, and the most suitable path forward. Moreover, he's often left to fend for himself when scheduling appointments, intensifying his stress and frustration.

The healthcare sector is in a state of continuous evolution. Technological advancements act as the primary impetus, propelling this change at a breakneck pace. Two such advancements, Artificial Intelligence (AI) and Machine Learning (ML), stand at the helm, laying the groundwork for an enhanced healthcare landscape by improving patient outcomes and optimizing the overall patient experience.

Cancer Statistics Society, a statistical division of the American Cancer Institute, estimated that there will be more than 1.9 million new cancer cases and more than 600,000 deaths due to cancer in the US, based on historical trends. That's a 31% mortality rate from new cases, and a horrific stat to ponder.