Do We Have a Choice But to Ensure the Success of VBC? Part 1
In part 1, we delve into how physicians are looking at value-based care. It involves a visit to a local
In part 1, we delve into how physicians are looking at value-based care. It involves a visit to a local
Lakshmi Halasyamani, chief clinical officer at Endeavor Health, thinks value-based care isn't really about payment models. To her, this work centers on understanding patients' clinical, social and financial circumstances well enough to make care plans that actually work for their lives.
Pearl's $110 million raise includes a $50 million equity investment led by Andreessen Horowitz with participation from Viking Global Investors, AlleyCorp and Ulysses Capital, as well as a $60 million debt facility led by Trinity Capital.
CMS is proposing to make its joint replacement bundled payment model mandatory nationwide. Experts say it is a logical step, but warn that mandatory participation could be challenging for hospitals to implement.
Healthcare leaders can’t tell whether value-based care and Medicare Advantage are truly lowering costs. Some see promise in these models and ongoing innovations, while others say the programs haven’t delivered measurable savings and point to direct contracting as a more transparent way to control spending.
As AI-enabled coding increasingly adjudicates and reimburses claims on the first pass, often at higher levels, payers face a growing challenge: traditional cost-containment mechanisms are unable to keep pace.
Chamber's Series A round was led by Frist Cressey Ventures, with participation from General Catalyst, AlleyCorp, American Family Ventures, Company Ventures, Optum Ventures, Healthworx Ventures and Black Opal Ventures.
A unified workflow for all referrals, resulting in fewer clicks and less confusion, means provider matching can be conducted based on specialty, location, insurance, and real-time availability, for an easier track to the right provider, not just any provider.
CMS’ new ACCESS model, slated to begin on July 1, aims to shift traditional Medicare fee-for-service toward value-based care by tying payments to patient outcomes and encouraging tech-enabled, preventive care. Experts say it could benefit digitally mature, value-focused providers first, but its overall success will hinge on clear metrics, better data sharing and sustained participation.
Shared savings programs are appealing in theory, but the incentives are too weak and unpredictable to support a scalable business model for hospitals, said Patrick Runnels, chief medical officer of University Hospitals.
Providence and Humana launched a new initiative to standardize and streamline data exchange between payers and providers. The program leverages FHIR-based APIs to create a scalable, real-time system that can be replicated across other healthcare organizations nationwide.
Experts believe value-based care won’t ever reach scale unless fundamental barriers are addressed — including voluntary models, misaligned payer incentives, excessive metrics and weak employer engagement.