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.
Yesterday’s announcement that Pennsylvania will become the 27th state to expand Medicaid under the Affordable Care Act was closely watched in both healthcare and political circles, for it shows further accommodation to both local health needs and political considerations. Will Pennsylvania’s deal with the Centers for Medicare and Medicaid Services be the last, coming after Arkansas and Iowa? Or is it a sign that Medicaid, which has always combined federal mandates with some local flavor, will continue to shift with the political winds in the states?
Balancing health care tailored to the individual with a modern reimbursement scheme based on population health is the challenge that awaits the nation’s healthcare system. Based on a study in The American Journal of Managed Care, it can be done, even among patients like seniors who use more healthcare than most.