VBP Bulletin
  Complimentary from the publishers of VBP News                                May 2021  
     
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Quote
  "If we keep pumping money into the fee-for-service program, we shouldn't be surprised if it really takes a lot of coaxing and therefore [produces] very little net savings and maybe additional net cost for providers to move into alternative models. And probably the easiest way to get savings in models is to make them mandatory so that we don't just get a selected group that thinks they can succeed under the particular rules in place at the time."
- Mark McClellan, MD, PhD, Professor at Duke University and founding director of the Duke-Margolis Center for Health Policy

 
Factoid
  A recent analysis by Avalere compared a Medicare Advantage population managed by CareCentrix to a “statistically similar non-CareCentrix-managed cohort.” Avalere found the CareCentrix-managed cohort had:
• readmission rates up to 22% lower during the initial 30-, 60- and 90-day periods following discharge
• a 21% reduction in ED visits compared to the baseline, greater than the 10% reduction in the other cohort
• a 71% reduction in SNF expenditures following discharge, compared with 47% in the non-CareCentrix group.

Source: Value Based Payment News, Volume 6 Issue 10, May Second Edition 2021, "Avalere: CareCentrix Post-Acute Care Model ‘Improves Outcomes, Reduces Readmissions & ED Visits’."
 
 
HealthSprocket List
 
Journal of General Internal Medicine: Percent of total cost for 7 low-value preventive services in Medicare, 2007-2016

1.
Screening for bacteriuria in asymptomatic adults: 35.5%
2. Vitamin D supplementation for primary prevention of fractures among postmenopausal women: 17.4%
3. Prostate cancer screening for men 75 years and older: 9.7%
4. Cervical cancer screening for women over 65 years: 11.7%
5. COPD screening among asymptomatic adults: 6.8%
6. Screening low-risk asymptomatic adults for cardiovascular disease with either rest/stress ECG: 4.3%
7. Colon cancer screening over 85 years: $14.5%

Notes: These seven services were utilized 31.1 million times for Medicare beneficiaries in 2007 to 2016 at a total cost of $477,891,886. From an article entitled, "The Utilization and Costs of Grade D USPSTF Services in Medicare, 2007–2016."

Source: Journal of General Internal Medicine, April 14, 2021
     
 
Healthshare TV
 
How cutting off subsidy payments to insurance companies would affect Obamacare Should my health organization accept a value-based payment opportunity?

During this presentation, Dr. Clint MacKinney will discuss the state of rural value-based care and payment, and recommend four strategies to inform value-based contract decision-making to help prepare rural healthcare organizations for value-based care.

 
 
  Check out HealthshareTV, the home for health care videos 
 
 
 
Insights
  ISPOR: Are Value-based Programs Finishing What Fee-for-Service Couldn't?
Managed Healthcare Executive, May 17, 2021
 
     
  Why Healthcare Data Won’t Magically Create Value-Based Care
HIT Consultant, May 13, 2021
 
     
  Do Health Plans Have a Plan to Help Employer-Purchasers Get Better Value?
The American Journal of Managed Care, May 13, 2021
 
     
  Pharmacist Integration is Essential to Implementing Value-Based Care Models
Pharmacy Times, May 13, 2021
 
     
  Hospices Navigate Regulatory, Financial Concerns to Launch PACE Programs
Hospice News, May 7, 2021
 
     
  7 low-value services cost Medicare nearly $500M a year, UCLA study finds
Becker's Hospital Review, April 29, 2021
 
     
  CMS' proposed inpatient payment rule for 2022: 8 things to know
Becker's Hospital Review, April 28, 2021
 
     
  Focus on Quality in Value-Based Care Could Impact Hospice M&A
Hospice News, April 28, 2021
 
     
  Why federal agency that oversees healthcare payment innovation is rethinking
Healthcare Financial Management Association, April 26, 2021
 
     
  Value-Based Care Best Practices: A Phased Approach
HealthPayer Intelligence, April 26, 2021
 
     
What's News
 
Innovaccer Expands VBC Leadership to Provide Additional Quality & Risk Mgmt.
PR Newswire, May 18, 2021
 
VB Pay-for-Performance Gaps in Care Delivery for a Large-Scale Health System
Population Health Management, abstract only, May 14, 2021
 
Looming changes to quality reporting in the MSSP draw strong pushback
Healthcare Financial Management Association, May 5, 2021
 
Humana Collaborates with Providers to Offer VBC for Original Medicare
Humana News Release, May 4, 2021
 
A field guide to U.S. healthcare reform: The evolution to value-based healthcare
Laryngoscope: Investigative Otolaryngology, May 1, 2021
 
Assessment of Overuse of Tests & Treatments at Hospitals Using Claims
JAMA Network Open, April 27, 2021
 
 
This Month in VBP News
 
 

In this month's first issue:

  • 'The Utilization and Costs of Grade D USPSTF Services in Medicare, 2007 to 2016'
  • Washington DC Watch: AMA, Colleges & Societies Seek MIPS Data Changes; NAACOS Balks @ Planned MSSP Alterations
  • Industry News with briefs regarding: Babylon, and Amwell

In this month's second issue:

  • Authors: ‘Non-Judgmental Communications Key to Reducing Low-Value Care’
  • Industry News with briefs regarding: AmeriHealth and Howard U
  • Washington DC Watch: Magellan, Health Partners ‘Achieve 5 Stars for Statin Use in Persons with Diabetes’
  • Penn/LDI Report Lays Out 10 Steps to Revive Value Transition

Click here to view a brief (under 2 minutes) video with more information

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