HealthPayerIntelligence | March 10, 2023
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Medicaid managed care organizations can leverage financial bonds to help increase funds for social determinants of health interventions and avoid underinvesting, according to research published in Health Affairs. Social determinants of health, including food insecurity, transportation barriers, and housing instability, can impact health equity and lead to avoidable health outcomes and spending. Interventions to address these factors typically require significant upfront funding, with benefits occurring down the line in the form of cost savings. Medicaid managed care organizations experience enrollment and eligibility changes, which may dissuade them from investing in interventions as they are not guaranteed a return on investment. An organization investing in something and not reaping the full return as cost savings is known as the wrong pocket problem.
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The National Law Review | March 9, 2023
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Health care providers looking to explore or expand their involvement in value-based care through affiliation with an accountable care organization (ACO) have a large number of options available to them. In the Medicare space, many providers find themselves being courted by ACOs participating either in the Medicare Shared Savings Program (MSSP), or the recently implemented ACO Realizing Equity, Access, and Community Health (REACH) Model. Programmatic rules and statutory requirements dictate that providers can only ultimately participate in one of these two models. Providers, then, when faced with a choice of competing ACO proposals, must evaluate which model and partnership bests fits their clinical, operational, and financial goals. |
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By the time the end of March rolls around, we will have seen just over 1,100 days of continuous Medicaid and CHIP enrollment. Federal guidance within the 2023 Consolidated Appropriations Act effectively decoupled continuous enrollment provisions from the Public Health Emergency (PHE) and will allow states to resume their redetermination process as soon as April 1st. Most states and many plans have already completed the first phase of the unwinding by encouraging enrollees to update their contact information to ensure they receive their renewal paperwork when it arrives in the mail. And while most all of us reading this piece are well aware of where we’ve been over the last year and what the next one might look like, a recent Urban Institute study in December 2022 found 6 in 10 adults in Medicaid-enrolled families were not aware of an upcoming return to the regular Medicaid renewal process.
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Healthcare prices are on the rise, and in a system already notorious for its lack of affordability, many employers are nervous about what this means for their employees’ health. But instead of taking a wait-and-see approach, some employers have decided to change the way they provide healthcare altogether. Business Group on Health, a nonprofit organization representing large employers’ perspectives on health and wellness solutions, awarded The Walt Disney Company the Helen Darling Award for Excellence in Health Care Value and Innovation, recognizing the employer’s shift toward value-based care for its 77,000-plus employees in Orlando, Florida.
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UPCOMING WEBINARS:
How Innovative Digital Trends are Revolutionizing ACO Outcomes
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Topic: Which digital trends to implement and which to avoid, and how to leverage digital innovation, in order to optimize cost savings, deliver the most value, and create efficient and scalable processes
March 21, 2023 | 1 PM EST
How to Prepare for Market Changes to Health Equity and Social Determinants of Health
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Topic: The changing Health Equity & Social Determinants of Health landscape, key considerations for health plans, and planning for the future
March 23, 2023 | 2 PM EST
Reskilling and Upskilling the Workforce for the Future
of Value-Based Care
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Topic: Creating pathways for education and upskilling current workers and reskilling those who are already in the workforce
April 4, 2023 | 1 PM EST
Harnessing predictive analytics to boost post-acute outcomes
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Topic: ACO post-discharge performance, how to predict and manage high-risk discharged patients, and how providers and payers can direct patients and beneficiaries to the best SNFs
April 6, 2023 | 1 PM EST
RECORDED WEBINARS:
Transforming Transitions for High-Risk Patients: How an IPA revamped care transitions to improve outcomes
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Topic: How CAIPA enables their physician practices to facilitate early interventions for gaps in care for patients discharged home
Unlocking the power of digital health: How ACOs can deliver value through digital platforms
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Topic: Challenges facing ACOs at delivering population health at scale and improving health equity metrics, and how digital platforms can be leveraged to overcome these challenges and help ACOs succeed
Check our our Webinar Archive to view past webinars on a variety of value-based care related topics!
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ViVE 2023
March 26-29, 2023 | Nashville, TN
2023 Virtual Fourth National Medicare Advantage Summit
April 25-28, 2023 | Virtual
APG Annual Spring Conference 2023: Going the Distance
May 31-June 2, 2023 | San Diego, CA
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On occasion, we showcase one of our solution providers in a 4-5 minute interview and ask them what they bring to the VBC Community and what sets them apart.
Today's guest:
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Proficient Health improves care delivery and reduces costs by removing technology and communication barriers, and facilitating better communication and delivery/exchange of clinical information across a wide range of providers with disparate systems. Proficient Health's EHR companion supports better patient care, easier consults, improved operational efficiencies, enhanced in-network optimization and lowered costs for both healthcare providers and patients. With an abundance of experience and knowledge of the issues that healthcare organizations and providers face every day, the Proficient Health team understands the importance of collaboration in healthcare, and goes above and beyond to implement strategic solutions for their customers that are successful in meeting their business goals and delivering the best-possible care to their patients.
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Platinum Level Exhibitors
Thank you to our Platinum Level exhibitors. These organizations offer the absolute highest quality products & services to the ACO & IPA community. To learn more & visit their interactive booths, click on the logos below:
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Gold Level Exhibitors
Thank you to our Gold Level exhibitors. To learn more & visit their interactive booths, click on the logos below:
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Our thoughts and prayers are with the people of Ukraine. |
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