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.
Featured Content
Provider Performance Under Oncology Care Model Varies by Cancer Type
Clinicians who treat certain types of cancer may be better positioned to earn performance-based payments under the Oncology Care Model.
Health Plan Interest in Outcomes-Based Contracts Increasing
Outcomes-based contracts most common in cardiovascular disease, infectious disease, and oncology.
Strategic Imperatives for Skilled Nursing Facilities Preparing for New Payment System
In August 2018, CMS is expected to finalize a proposed new payment methodology for skilled nursing facilities (SNFs) that would shift the focus from resource use to patients’ clinical needs.
More than 1 in 5 Medicare Cancer Patients Receive Care from Oncology Care Model Doctors
More than 25% of patients with breast and lung cancers have been treated by a participating Oncology Care Model doctor. Participation trends could accelerate the transformation of treatment for some cancers, according to Avalere experts.
CMS Takes Steps to Advance the “Meaningful Measures” Initiative
CMS removes 25 existing hospital quality measures in the Proposed FY2019 Inpatient Prospective Payment System (IPPS) Rule as part of its broader effort to focus on measures that matter.
Financial Results of MSSP and CMMI Demos Are Mixed
MSSP and CMMI demonstrations vary in budgetary impact but generally show quality improvement.
Registries Continue to Give More Opportunities for Clinicians to Meet Reporting Requirements
The number of CMS-approved Qualified Clinical Data Registries grew by 40% in 2018, allowing specialties to have more opportunities to report on meaningful quality measures.
Medicare ACOs Have Increased Federal Spending Contrary to Projections That They Would Produce Net Savings
Incentive payments in upside-only Medicare ACOs have increased federal costs, but data suggest that ACO experience and adoption of two-sided risk could constrain future Medicare costs.
Medicare Financial Incentives Encourage Providers to Take on Greater Financial Risk
While clinicians have been hesitant to assume risk, bonus payments would result in 9 out of 10 ACOs and their participants achieving a net positive financial impact.
Emerging Trends for Market Access Planning in 2018
Market access teams should consider 3 growing trends in their 2018 strategic planning.
Webinar: The Data-Driven Enterprise: Drive Growth and Deliver Value
Learn more how analytics derived from proprietary commercial datasets empower provider executives to successfully partner across the healthcare industry.
Our Take on the Final QPP Rule
Yesterday, the Centers for Medicare & Medicaid Services (CMS) released a final rule that makes changes to the second year of the Quality Payment Program (QPP) for 2018. The QPP was created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
Podcast: E4 – Digital Health the Missing Partner in Pain Management?
In the final episode of our digital health podcast series, we interview Martha Lawrence, Chief Executive Officer of AccendoWave, discussing how technology has the promise to reduce pain for patients as an alternative to opioids. AccendoWave's system assesses patient discomfort levels using EEG technology.
Podcast: Evolving Value-Based Care Strategies in 2017 and Beyond
Tune in as Avalere's Fred Bentley explores how a leading health system adapts to evolving value-based payment models in an interview with Dr. Robert Nesse, senior director for Payment Reform at Mayo Clinic.
CMS Proposal for New Medicare Payment System Could Lead to Large Payment Variability for Specialists
New analysis from Avalere finds that payments to certain physician specialists could increase or decrease by as much as 16% for their 2018 performance under the Merit-based Incentive Payment System (MIPS).
Webinar: Shifting Gears: Strategic Partnerships to Drive Value-Based Care
Avalere experts discuss the need for unique stakeholder collaborations to facilitate success in the transition to a value-based care system.
Dan Mendelson Op-ed Featured in Medtech Insight
Avalere's President and Founder, Dan Mendelson, recently wrote a column about the new strategies that device manufacturers should take in this era of healthcare.
New Medicare Incentives Encourage Accountable Care Organizations To Assume Greater Risk
Avalere simulation finds that more ACOs will be eligible for earnings if they take on two-sided risk.
Takeaways from the Updated Better Care Reconciliation Act (BCRA)
As the Senate prepares to begin debate on a revised version of the Better Care Reconciliation Act (BCRA) next week, Avalere offers the following observations on select components of the legislation:
Podcast: E3 – The Future of Technology in Community Hospitals
Tune in to the third episode of our digital health podcast series as we explore the role innovation and technology play in the healthcare landscape. Today, we interview Sajid Ahmed, Chief Information & Innovation Officer of the new Martin Luther King Jr. Community Hospital. Hear how he leads its greater than $70 million health information technology initiative and launched the innovation hub that serves 1.35 million residents from all over South Los Angeles.