Complimentary from the publisher

Complimentary from the publishers of VBP News December 2021

Third Quarter 2021 Value Based Care Financial Results Podcast
This MCOL podcast features a discussion by Doug Sherlock, Senior Health Care Analyst and President, Sherlock Company (www.sherlockco.com), featuring his insights into the quarterly financial performance of value based care organizations for the third quarter 2021.

"Palliative care services that might be included or bundled into value-based payment models can be completely different from one another, and aren’t always at the full discretion of the provider. The payer may be mandating certain things that they want to see in that model and providers need to understand how to make sure that they’re putting together a program that manages that. There’s some pitfalls in palliative care that you need to watch out for and you need to understand how best to position yourself to talk with payers and negotiate payment in value-based settings."
- David Cook, CEO, Hosparus Health

According to Humana's "Value-based Care Report," based on 2020 data from its Medicare Advantage members, healthcare spending paid to primary care physicians was 17.5 cents per dollar in value-based care (VBC) models and 6.7 cents per dollar for non-VBC models. Humana states that, compared to Non-VBC models, their VBC agreements helped reduce total medical costs by 13.4%; incidents of costly hospital admissions were reduced by 7% and emergency room visits by 12%; and hospital admission rates were 22% less than Original Medicare in 2020.

Source: Value Based Payment News, Volume 6 Issue 23, December First Edition 2021, "The State of Value Based Care at Humana."

	HSR: 4 VBP Measures with Positive Impacts on a Long-term Care Population 1. Rates of flu vaccination among average-need clients: 1.60% 2. Not experiencing uncontrolled pain among above-average-need clients: 0.69% 3. Stable/improved pain intensity among heavy-need clients: 1.25% 4. Stable/improved shortness of breath among light-need clients: 0.88% Notes: From an article entitled, "Medicaid Long-term Care Workforce Training Intervention and Value-Based Payment Metrics," by Mei-Chia Fong PhD, David Russell PhD; Carlin Brickner DrPH; Oude Gao MHA; Sandi Vito MA; and Margaret McDonald MSW. This study examined the impact of a scaled implementation of workforce training intervention on value-based payment measures in a home-based Medicaid managed long-term care plan population in which 3,656 clients received services from the trained aides. Source: Health Services Research, December 18, 2021

How cutting off subsidy payments to insurance companies would affect Obamacare

Managing cost and patient risk for optimal value-based care

In this webinar discussion:
• Barriers to managing cost and risk for optimal value-based care
• How cost management and population technology health solutions play a role in value-based care success
• What oncology practice leaders are doing to prepare for the next phase of value-based care.

Check out HealthshareTV, the home for health care videos

Goldman Sachs forecasts positive outlook for insurers in 2022, buoyed by VBC
FierceHealthcare, December 21, 2021

How Population Health, Risk Stratification Support Value-Based Care
Health IT Analytics, December 20, 2021

Consequential convergence: The intersection of interoperability and VB care
MedCity News, December 20, 2021

Supply Chain Resiliency & A Shift To VBC: Why Premier Is Investing In Data
Forbes, December 15, 2021

Former CMS chief of staff previews 4 areas of value-based care in 2022
Healthcare IT News, December 14, 2021

Why value-based administration is key to value-based care
MedCity News, December 9, 2021

Why Rural Providers Aren’t Transitioning to Alternative Payment Models
RevCycle Intelligence, December 2, 2021

New HCP-LAN Survey Results Show Increase in Alternative Payment Models
AHIP, December 15, 2021

Home Care Services Reduce Medicare Spending for 30 Chronic Conditions
Avalere, December 8, 2021

Longitudinal Content Analysis of Low-Value Services Identified in Choosing Wisely
JAMA Internal Medicine, December 6, 2021

In this month's first issue:

The State of Value Based Care at Humana
Expiration of CMS Oncology Care Payment Model
Industry News with briefs regarding Independence Blue Cross and Penn Medicine; Addus Homecare and BCBS of New Mexico; and Enlace Health Partners and Wildflower Health

In this month's second issue:

Post-Pandemic, What’s a Phone Call From Your Physician Worth? by Julie Appleby
Publicly Traded Value Based Care Companies
Spike in Deferring Treatment Due to Cost
Employer Plan Costs Increased 6.3% in 2021
Industry News with briefs regarding Clover Health and Cricket Health; NeueHealth; and Independence Health and Quartet Health

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