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Value-Based Care

The healthcare system is transitioning to value-based care. We can help you navigate the alphabet soup: APM, ACO, MSSP, EPM, MACRA, OCM, OBC. Count on us to guide you through the transition.

Hillary Stires

Liquid Biopsies: What You Need to Know

Liquid biopsies test blood samples for circulating tumor DNA (tumor derived cell-free DNA), circulating tumor cells, cell-free tumor DNA, proteins, metabolites, exosomes, messenger RNA, and microRNAs. The promise of liquid biopsies is a new modality that screens for cancer in ways that complement and, in some cases, improve existing tests, and allow testing for early detection, cancer diagnosis, and monitoring of minimum residual disease and recurrence, without the need for invasive biopsies.

Brigit Kyei-Baffour

Cell and Gene Therapy Pipeline Patient Affordability Opportunities

With a number of cell and gene therapies (CGTs) expected to obtain Food & Drug Administration (FDA) approval in the next 3 years, stakeholders must consider the unique patient access and affordability barriers that may limit patient ability to receive these novel treatments. Stakeholders should explore affordability solutions that can optimize access, or they risk excluding patients from obtaining potentially life-saving treatments.

Samantha Ferguson

Understanding Success Among OCM Participants

Avalere analysis finds that success in the first 4 performance periods of the Oncology Care Model (OCM) was correlated with reductions to inpatient expenditure and spend reductions within certain high-cost tumor types. Further, smaller community-based practices and those that had lower per-episode expenditure in the baseline period tended to be more successful.

Heather Flynn

Avalere Analysis Shows Home Care Services Reduce Medicare Spending

Avalere analysis determined that Medicare Fee-for-Service (FFS) patients receiving home-based care services experienced a decrease in Medicare spending over time when compared to a statistically balanced, matched control group who do not appear to have received home care services. The spending differential was also found to be higher among Medicare beneficiaries with functional limitations and multiple chronic conditions.

Dan Mendelson

Dan Mendelson Commentary on Health Equity Featured in Forbes

The COVID-19 pandemic and a summer of focus on racial justice has finally begun to intensify government interest in reducing racial disparities in healthcare. Understanding that healthcare providers and systems tend to respond to the economic incentives that are presented to them, current government decisions on payment options around renal dialysis present an important test case for the Trump Administration.

5 Activities to Make the Most of the HEDIS® Off-Season

While the HEDIS® collection season lasts for a limited time, the focus on initiatives that impact HEDIS results is a year-round priority. The period between submission and HEDIS season ramp-up, known as the “off-season,” offers an opportunity for health plans to elevate the member experience, amplify quality improvement activities, and improve HEDIS submission effectiveness.

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