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The New York State Medicaid Redesign team this week released a concept paper for a new 1115 Waiver, including a request for $17 billion over 5 years from the Centers for Medicare & Medicaid Services to build an enhanced health care delivery system as part of New York’s overall efforts to “reimagine, rebuild, and renew” […]

Everyone in health care fervently supports the goals of value-based care—better quality and better outcomes at lower costs. But transitioning from the traditional fee-for-service system to population health management and payments based on capitation or global risk with reconciliation raises legitimate concerns and obstacles for physicians, hospitals, health plans and consumers. True, many payers and […]

If a financial advisor promised 25% of your investments would never produce returns, you probably would not trust that advisor with your financial future. Many businesses, though, do exactly that with their project investments. U.S. organizations have a 75% success rate for projects that achieve their planned goals or benefits, according to the Project Management […]

As both payers and providers grapple with a new round of COVID-19 stress to the health system due to variants such as Delta and Lambda, health plans face a growing array of challenges requiring rapid and effective response. Contact tracing and immunizations have taken on a new level of priority as the Delta variant burns […]

Providers barely had time to take a breath before confronting a new round of COVID-19, driven primarily by the Delta variant. Above and beyond caring for COVID patients, this deadly scourge continues to tax our health systems and their health care workers: Contact tracing and immunization campaigns remain imperative. The entire health care workforce, particularly […]

As the national health care landscape continues to shift towards value-based payment (VBP) models, the traditional approach by health systems and hospitals of measuring market share based on percent of admissions in a given market is putting them at a growing disadvantage. They must adopt the most telling measure for risk-bearing organizations, which is how […]

Like hospitals everywhere, St. Joseph Hospital Orange and Mission Hospital faced the challenge of meeting the demand for COVID-19 immunizations while concurrently balancing the impacts of pandemic-related staffing shortages. The two Providence hospitals in Southern California turned to COPE Health Scholars, aspiring health professionals already on site as part of hands-on experiential education courses, to […]

Technology and data are essential foundations for value-based care. But knowing how to maximize the use of both is not always clear or straightforward for clinicians who are focused on patients and their care. To help fill that gap, COPE Health Solutions and the other members of the Alliance for Technology-Driven Health have launched “The […]

What a wake-up call. On the heels of the Centers for Medicare & Medicaid Services (CMS) suspending Medicare Direct Contracting for most new applicants and sunsetting the Next Generation ACO model, the new director of the Center for Medicare and Medicaid Innovation (CMMI) last week signaled a likely move toward requiring providers to take financial […]

With the May 21 announcement that it was discontinuing the Next Generation ACO Model at the end of 2021, the Biden Administration continues to move decisively to put its stamp on The Centers for Medicare & Medicaid Services. While this decision has serious implications for NextGen ACOs participants, they are not alone.  The in-progress reassessment […]