As the healthcare industry tries to move away from fee-for-service, the new Scorecard being developed by Catalyst for Payment Reform will help states get a better understanding of whether or not new payment models are actually working, explained Linda Schwimmer, CEO and president of the New Jersey Health Care Quality Institute.
As the healthcare industry tries to move away from fee-for-service, the new Scorecard being developed by Catalyst for Payment Reform will help states get a better understanding of whether or not new payment models are actually working, explained Linda Schwimmer, CEO and president of the New Jersey Health Care Quality Institute. New Jersey is 1 of 3 states that will test the new Scorecard.
Transcript
The Scorecard is really going to help employers and state purchasers and health plans take a look at whether their focus on moving away from fee-for-service to alternative payment models, such as a patient-centered medical home or an accountable care organization, whether or not that’s working. There’s a lot of different strategies that a purchaser can take: they can shift costs so that employees or beneficiaries have to pay more; they can narrow networks, they can have high-deductible plans.
There’s a lot of different strategies they can take. One strategy is moving toward alternative payment models. And people think that they’re working. They have a sense that they’re working because it’s aligning incentives. But we really need to know for sure, at least whether they’re working directionally.
And so that’s really the purpose of this Scorecard, is it’s to help purchasers and policy makers know, “Are we moving in the right direction? Are we improving quality with this focus on new models?” And if we are, then let’s keep at it. And that’s really what we’re trying to show, directionally, how things are going.
The Pivotal Role of Payers in Improving Health Equity, Maternal Health Care in the US
March 26th 2024A presentation at the Greater Philadelphia Business Coalition on Health's 2024 Women’s Health Summit discussed how payers, including employers and public entities, can strategically influence health care purchasing to prioritize maternal health and equity.
Read More
Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
Listen
Increasing Lp(a) Awareness for Better Cardiovascular Health: Dr Mary McGowan
March 24th 2024For Lp(a) Awareness Day, Mary McGowan, MD, FNLA, chief medical officer of the Family Heart Foundation, highlights how most people with elevated Lp(a) are completely unaware that they have this increased risk and calls for increased testing.
Read More
Dr Al Benson on Reimbursement for Supportive Care When Treating Patients With Cancer
March 22nd 2024Al Benson, MD, FACP, FACCC, FASCO, medical oncologist at Northwestern University Feinberg School of Medicine and associate director of the Robert E. Tillery Comprehensive Cancer Center, discussed findings from a national survey assessing barriers to comprehensive cancer care delivery.
Read More
CMS is highly likely to negotiate the price of the obesity medication semaglutide in the coming years; many health care providers are trying to determine whether their cyberattack insurance will help cover their losses after the Change Healthcare hack; the US life expectancy increased for the first time in 2 years.
Read More