Value Based Care

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Value Based Insurance Design New Clinical Categories for MA Plans

The Centers for Medicare & Medicaid Services (CMS) is announcing refinements to the Medicare Advantage Value-Based Insurance Design (MA-VBID) model. Beginning January 1, Value Based Insurance Design Model for Medicare Part C018, CMS will add and to the clinical categories for which participants may offer benefits. CMS will also make adjustments to existing clinical categories and [...]

CMS Merit Based Incentive Payment System (MIPS) in 60 Day Comment Period, Sunsetting of Meaningful Use

New Federal healthcare industry payment models, based on the April 27th release of a proposed rule, present MIPS, MACRA, and APM methods for calculating healthcare reimbursement. The document proposes once in a generation changes in how healthcare providers are paid.  The Meaningful Use program is eight years old while the Medicare payment system is 25 [...]

By | 2017-06-03T02:54:19+00:00 May 12th, 2016|MACRA, MIPS, Value Based Care|0 Comments

Should Drug Price Transparency Legislation be Based on Inefficient Markets Theory?

The inefficient markets theory is being reconsidered after the 2007 financial crisis in the U.S. Is it enough to provide the public with data on the cost of a service or alternative ways to purchase it? In healthcare the intersection of price, quality and sources of suppliers alone does not determine whether pricing is appropriate.

By | 2017-05-04T04:06:21+00:00 July 23rd, 2015|Accountable Care Organization, ICD-10|0 Comments

Value Based Care Regulations Yield Physician Discontent, No Change in Behavior

Clinicians are in a knowledge management crisis – massive amounts of data but getting the right information to clinicians, IT personnel and others at the right time is the challenge. What was missing from the RAND report were biomedical informatics perspectives.