Tag: Value-Based Care

Managed Care Contracting Is Now a Margin Test

Health Policy and Economics

Managed Care Contracting Is a Margin Test

Managed care contracting now determines far more than a rate sheet. For post-acute and senior living leaders, it is a test of margin, access, and control….
How Reimbursement Cuts Affect Margins in Post-Acute Care

Health Policy and Economics

How Reimbursement Cuts Affect Margins

Medicare post-acute care (PAC) reimbursement is increasingly driven by stricter federal spending controls, closer Medicare Advantage (MA) utilization oversight, and limited rate increases. Current policy priorities center on value-based accountability, shifts to lower-intensity care settings,…

Fee for Service vs Value Based Care: What Changes

Health Policy and Economics

Fee for Service vs Value Based Care

A hospital can fill beds, a skilled nursing facility can maintain census, and a physician group can increase visits while the broader system still produces avoidable cost and uneven outcomes. That is the central tension…

Health Policy and Economics

CMS Releases Strategy on MAHA

The Centers for Medicare & Medicaid Innovation (Innovation Center), formerly known as CMMI and part of the Centers for Medicare & Medicaid Services (CMS) under the US Department of Health & Human Services (HHS), has…

Health Policy and Economics

InnovAge Fraud Litigation Expands

A Colorado federal judge last Wednesday certified a class of stockholders in a securities suit against InnovAge (https://www.innovage.com/) alleging the senior health care company made misleading statements in its initial public offering that later caused…

Health Policy and Economics

Exploring Age-Friendly Healthcare Programs

The Accreditation Commission for Health Care, Inc. (ACHC) has launched two new specialty credentials for organizations providing home care and/or hospice. These programs are in line with the Age-Friendly Health Systems (Care) programs and initiatives…

Health Policy and Economics

TEAM Model and Post-Acute Care

The mandatory Transforming Episode Accountability Model (TEAM) will advance CMS prior work on value-based care models, including bundled care initiatives. The TEAM model (participation) will be mandatory for selected hospitals and participation “optional” for post-acute…

Assisted Living

Unlocking the Potential: Overcoming Challenges for LTPAC Providers in ACO Participation

Yesterday, the American Health Care Association and the National Center for Assisted Living plus the National Assocation of ACOs released a white paper that includes a set of recommendations for CMS, designed to increase the…

Health Policy and Economics

Value-Based Care: What it is and How it Can Work for Post-Acute Providers

I get asked about value-based care a lot. It is a buzzword or term these days, somewhat driven by the rise in Medicare Advantage enrollment. Frankly, it is a bit of a catch-all concept that…

Health Policy and Economics

Value-Based Care: Why it Matters, or Should, for Post-Acute Providers

Value-Based Care is kind of a vogue term, one that I encounter quite often. I also have used it when speaking or writing and know most people have no idea what it means or how…

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Reg

Healthcare executive, consultant, and author covering post-acute care, senior living, and the economics behind both - for 30+ years.

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