Dr. Jacque Sokolov, MD, Chairman & CEO, SSB Solutions, Inc, says that value-based products and the revenue flow associated with them is evolving on the commercial side as well as the Medicare and Medicaid sides. The revenue sharing programs are contrasted with fee-for-service contracts. Dr. Sokolov also says that value-based reimbursement can have more than 5 revenue streams including quality metrics, shared savings, patient care management fees, and other areas where physicians and hospitals can recieve additional revenues for performance in value-based areas.
This video was taken on November 8 at the NAMCP Fall Forum in Las Vegas, NV.
Attendees at the ACO and Emerging Healthcare Delivery Coalition meeting held October 16-17, 2014, in Miami, Fla., gained insights to help physicians and accountable care organizations achieve the “triple aim” of better population health, greater patient satisfaction, and lower costs. This initiative of The American Journal of Managed Care has now attracted more than 120 members.
Myriad Genetics, Inc., announced today that the Medicare Administrative Contractor (MAC) that has jurisdiction over most molecular diagnostic tests has issued its draft notice on how Medicare will provide reimbursement for Prolaris, a test that Myriad has developed to guide treatment decisions in prostate cancer.
The Centers for Medicare and Medicaid Services wants hospitals to find ways to keep patients from returning to the hospital, and the agency has created rewards and punishments in pursuit of this goal. A study in The American Journal of Managed Care is just one of a pair of recent clinical trials that finds readmissions may be beyond some hospitals’ control, and policymakers might need to rethink their approach.
A blog published by The Commonwealth Fund points to digital technology glitches being responsible for slower policy adoption by several state exchanges. But states are fixing their technology glitches and also setting examples for other states to follow, say the authors.
With a shortage of primary care physicians and the costs that come with a trip to the emergency room, can retail clinics fill the gap? A study published today in The American Journal of Managed Care finds they can, offering care that is just as good or better for common ailments like ear infections or strep throat.