Partnerships between health care providers and Accountable Care Organizations (ACOs) can help to create effective, value-based palliative care models for patients, but navigating the development of those relationships requires communication and a true commitment to collaboration. These opportunities extend across both the inpatient and community-based settings, with a mind toward improving quality and improving patients’ quality of life.

Accountable Care Organizations (ACOs) have revolutionized healthcare delivery in the United States, improving patient outcomes while reducing costs. Among the leading ACOs in the country, Citrus ACO and Physicians ACO stand out as two of the top-performing organizations. These ACOs, under the leadership of Louis Morgenier, have played a pivotal role in saving Medicare over $1 billion. Their success is a testament to strategic planning, data-driven decision-making, and a commitment to value-based care.

Value-based care isn’t the only priority highlighted in The New Healthcare C-Suite Agenda: 2024-2025 Market Report. It’s just the only one where providers identified payers as part of both the solution and the problem. The new report from Sage Growth Partners is based on annual survey responses from more than 100 hospital and health system C-Suite executives and “reveals a new prioritization on growing revenue, fortifying the workforce, reducing costs, [and] transitioning more revenue into value-based care arrangements.”

Behavioral health has lagged behind in the shift to value-based care, and a new paper from experts at Cigna outlines why these providers should consider making the switch along with the barriers they may face. For example, there are significant technology gaps that may hinder uptake of value-based care, according to the report. Mental health providers are often slower than hospitals in adopting new electronic health records and other tech platforms critical to these models. Also, data gaps are a major challenge, with just 20% of mental health practices using measurement in their work, according to a 2018 JAMA study.

Integrating a health-equity perspective into organizational strategies, operations, financial metrics, and quality initiatives could help life sciences and health care organizations meet their business goals while also improving Americans’ health. Recent surveys by the Deloitte Center for Health Solutions reveal that 75% of life sciences executives and 64% of health care executives anticipate an increased focus on health equity in 2025.

A new tribal sponsorship program rolled out last year in Nevada is aimed at getting tribal citizens covered and protecting them from incurring debt for uninsured care. It allows tribes to buy health insurance through the state’s Affordable Care Act marketplace for people living in their service area, including Native Americans from other tribes. Tribal leaders and Nevada officials say the sponsorship model increases access to coverage and care for tribal citizens and their families by allowing them to seek medical care outside the tribal health care system.

One of the key metrics in clinical care is patient length of stay (LOS), traditionally defined as the time between a patient's admittance and discharge from a hospital. LOS is a critical factor in everything from reimbursement and accreditation to patient satisfaction and clinical outcomes.

New technologies like AI and concepts like remote patient monitoring (RPM) and Hospital at Home are helping healthcare executives gain a better understanding of LOS, and in turn they're reducing costs and improving care management.

The HHS has released a strategic plan that lays out the agency’s road map for overseeing artificial intelligence in the healthcare sector. The plan — which covers AI in medical research, products like drugs and devices, healthcare delivery, social services and public health —  comes as AI has become an enticing emerging technology for healthcare executives looking to stretch the industry’s often-beleaguered workforce. 

With drug prices rising faster than inflation and outpacing many other health care costs, policy makers are under increasing pressure to find sustainable solutions that balance patient access, innovation, and affordability. We believe centralized procurement—in which governments negotiate drug prices directly with pharmaceutical companies—can be an important tool to address these challenges. This includes the recent introduction of Medicare price negotiations through the Inflation Reduction Act (IRA) of 2022.

This study explores the facilitating and inhibiting factors in the design/development, implementation, and applicability/evaluation of value-based payment models of integrated care. Adequate outcome measures, targets, benchmarks, and incentives are important in value-based payment models. The less quantifiable items, such as strong leadership, transparency, communication and trust, and motivation and engagement of the involved stakeholders, are also important for successful adoption of these models and promote high-quality care at lower or equal costs.