 |
| “We've had tremendous growth in payment reform but not as much to show for it as we would like. What it signals to us is it's time to increase the size of incentives that are being offered to healthcare providers, as well as change the nature of them.” | ||
| -Suzanne Delbanco, Executive Director, Catalyst for Payment Reform |
| According to a
report from The Catalyst for Payment Reform, the percentage of payments in value-based or alternative payment methods has grown
to 53% in 2017 from 10.9% in 2012. The types of value-based
payments being implemented aren't necessarily the most
effective. According to the study, 29.7% of commercial payments
flowed through shared savings arrangements in 2017, up from
23.7% in 2016. Pay-for-performance arrangements accounted for
16.6% of payments, down slightly from 17%. No payment method
posing downside risk to providers has accounted for more than 4%
of total payments in any year studied. Bundled payments, in
which providers are paid a fixed price for an episode of care,
accounted for just 2% of payments in 2017. Full capitation, in
which providers receive a set amount to manage a patient's
entire care, accounted for 2.8% of payments. Shared risk and
partial capitation models accounted for even less. Source: Modern Healthcare, December 4, 2019 |
|
‘Food Pharmacies’ In Clinics: When The Diagnosis
Is Chronic Hunger There’s a new question that anti-hunger advocates want doctors and nurses to ask patients: Do you have enough food? Public health officials say the answer often is “not really.” So clinics and hospitals have begun stocking their own food pantries in recent years. Kaiser Health News, December 10, 2019 Some family doctors ditch insurance for simpler approach Physician Emilie Scott was only a few months into her first job when she started hearing the complaint: She was spending too much time with each patient. Like many primary care doctors working in large medical systems, Scott was encouraged to see a new patient every 20 minutes. But that was barely enough time to talk and do a physical. Washington Post, December 9, 2019 UnitedHealth's OptumRx to acquire troubled specialty pharmacy and PBM UnitedHealth Group's pharmacy benefit manager OptumRx announced Monday that it will acquire Diplomat, a struggling specialty pharmacy and PBM headquartered in Flint, Mich. Modern Healthcare, December 9, 2019 Obamacare Back At The High Court — With Billions For Insurers On The Line More than $12 billion is at stake for the nation’s health insurers Tuesday when the Supreme Court hears another Affordable Care Act case. For the federal government, the potential damages could be far greater, as its reputation as a reliable partner to private businesses is on the line. Kaiser Health News, December 9, 2019 Value-based pay still struggles to improve costs, quality Despite progress in the movement to pay hospitals and doctors for the value of healthcare services they provide, the payment models implemented are not moving the needle on the cost and quality of healthcare, a new report suggests. Modern Healthcare, December 4, 2019 Hospitals sue HHS over negotiated price disclosure rule Hospitals sued HHS on Wednesday over a new rule that would force them to disclose the rates they negotiate with insurers. The complaint alleges HHS doesn't have the legal authority to require hospitals to publicly disclose the prices that commercial health insurers and hospitals negotiate with each other. Modern Healthcare, December 4, 2019 Mayo closes two more facilities, blames rural health care crisis Mayo Clinic on Wednesday announced it will close facilities in Springfield and Lamberton in southwestern Minnesota early next year, continuing a trend of closures and service cuts in rural areas. MPRNews, December 4, 2019 Study: Fewer Medical Students Are Coming From Rural Areas The number of medical students coming from rural areas has fallen by almost 30% since 2002, according to a new report. Researchers say the trend is partly to blame for healthcare workforce shortages in rural states like New Hampshire. NHPR, December 4, 2019 Centene to sell Illinois plan to CVS Health Health insurer Centene Corp. announced plans on Monday to sell its Illinois health plan subsidiary to CVS Health to help secure state approval for its proposed merger with WellCare Health Plans. Modern Healthcare, December 2, 2019 Aetna aims to address health effects of loneliness among older people Aetna this month became the latest managed health care firm to take aim at social influences on health with a new line of programs meant to measure and combat the effects of loneliness and isolation among Medicare recipients. The Hartford-based insurer, now a subsidiary of CVS Health, is rolling out a “social isolation index” it says can gauge customers’ likelihood of becoming solitary and cut off from family, friends, and society at large. Journal Inquirer, November 28, 2019 UnitedHealthcare to Open Member Medicare Services Centers in Walgreens UnitedHealthcare, the health benefits business of UnitedHealth Group, and Walgreens will open 14 UnitedHealthcare Medicare services centers within Walgreens stores in five metropolitan areas as part of a multiyear agreement. The UnitedHealthcare Medicare services centers will begin to open in January 2020 at Walgreens stores in the Las Vegas, Phoenix, Cleveland, Denver and Memphis markets. Through these centers, Walgreens customers can learn more about Medicare, meet with service advocates to discuss their UnitedHealthcare plan benefits and even enroll in plans. UnitedHealthcare, November 25, 2019 Health insurers' debt obligations have soared in the last decade Debt issued by publicly traded health insurers has soared over the past decade as the companies have looked to the bond market to raise money for large-scale mergers and acquisitions. Combined short and long-term debt among nine publicly traded insurers reached its highest point in at least 10 years at $115.5 billion in 2018 compared with $24.8 billion in 2009, according to a recent report by credit rating agency AM Best. Modern Healthcare, November 25, 2019 Cigna CEO Says Health Insurer Is Open to More Acquisitions Cigna Corp. is open to making more acquisitions, Chief Executive Officer David Cordani said, almost a year after the health insurer bought drug-benefit manager Express Scripts. An expected $8 billion in free cash flow in 2020 should give Cigna “strategic optionality,” Cordani said in an interview with Bloomberg TV’s David Westin at the Economic Club of New York on Wednesday. Bloomberg, November 20, 2019 |
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As Healthcare Goes Digital, Social Care Lags Behind Since 2009, federal legislation has awarded billions of dollars to physicians and hospitals that make health information technology part of their practice. While many highlighted the downsides of digitization, the providers who unlock its full potential know very well that it benefits clinical care immensely. Forbes, December 6, 2019 Implementing a Statewide Healthcare Cost Benchmark State interest in healthcare cost containment has grown dramatically since Massachusetts enacted the nation’s first statewide cost benchmarking program in 2012. At that time, most states were focused on coverage expansion through the Affordable Care Act (ACA). More recently, however, coverage gains have plateaued, and in some cases coverage has contracted, primarily because of affordability issues. Manatt, December 2019 National Health Care Spending In 2018 US health care spending increased 4.6 percent to reach $3.6 trillion in 2018, a faster growth rate than the rate of 4.2 percent in 2017 but the same rate as in 2016. The share of the economy devoted to health care spending declined to 17.7 percent in 2018, compared to 17.9 percent in 2017. Health Affairs, December 5, 2019 Health Care Experts Advocate for Value-Based System The health care system of the future must be value-based, industry experts agree. The question is: How quickly can the industry evolve? "As we sit here today we're still in both worlds, which is incredibly difficult to navigate," said Marvin O'Quinn, president and chief operating officer of CommonSpirit Health, during a keynote discussion at the U.S. News Healthcare of Tomorrow conference in Washington, D.C., on Tuesday. US News, November 20, 2019 |
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James Capretta: Is There a Crisis in American Healthcare Today?
Is America the best place in the world to get
medical care? How should we think about recent proposals for
healthcare reform like “Medicare for All” or creating new
incentives for controlling costs? In this Conversation, James
Capretta, a fellow at the American Enterprise Institute and a
leading scholar on health policy, presents an incisive, nuanced,
and accessible account of American healthcare today. |
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HDM: 8 Healthcare trends that
will rock medical care in the 2020s 1. Artificial intelligence 2. Digital health tools 3. Imaging technology 4. Data sharing and interoperability 5. Patient communication and engagement 6. Payer evolution 7. Precision medicine 8. Virtual or remote care Source: HDM |
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