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Value-Based Payment Models

The SDOH Reality Check: Coding, Claims and Value-Based Care

by Michael Pattwell, Principal Business Advisor, Value-Based Care, Edifecs 09/19/2023 Leave a Comment

The SDOH Reality Check: Coding, Claims and Value-Based Care

While the need to address social determinants of health (SDOH) is definitely not new, 2023 marks the first year SDOH is codified into national and statewide value-based payment program mandates. These mandates are designed to hold Managed Care Organizations (MCOs) and Accountable Care Organizations (ACOs) accountable. While the rollout of SDOH code sets across our healthcare ecosystem is one phase, alone it’s not enough. The next phases are even more critical: codes must be collected, used,
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Edifecs and 3M Partner on Integrated Value-Based Payment Solution

by Jasmine Pennic 01/11/2023 Leave a Comment

ICD-10 Impact on Cash Flow_EHR Implementations

What You Should Know: - 3M Health Information Systems and Edifecs (a global health IT solutions provider) announced a collaboration and new unique solution for providers and payers that will accelerate the adoption of value-based payment (VBP) models. - A new, combined solution that will overcome barriers that have previously prevented rapid adoption of VBP models. This advanced approach will allow payers and providers to quantify the value of preventing negative events and allocate
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Lyfegen Raises $8M for Value-Based Contracting for High-Cost Drugs

by Jasmine Pennic 09/20/2022 Leave a Comment

Lyfegen Raises $8M for Value-Based Contracting for High-Cost Drugs

What You Should Know: - Lyfegen, a global health tech SaaS company driving the world’s transition from volume to value-based healthcare for high-cost drugs raises $8M in Series A financing round led by aMoon, with additional participation from APEX Ventures and others. - Lyfegen’s value-based contracting software is used by healthcare payers and leading pharma companies, including Novartis, Roche, MSD, Bristol Myers Squibb (BMS) and Johnson & Johnson. Value-Based
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Report: The State and Science of Value-Based Care

by Fred Pennic 09/16/2022 Leave a Comment

Report: The State and Science of Value-Based Care

What You Should Know: - Providers believe 96% of payment is now value-based in some capacity, and 58% believe their EHR vendor won’t be able to support the data strategies required to thrive under value-based care, according to a new study conducted by Morning Consult and Innovaccer. - The 37-page national research study uncovers key IT infrastructure issues healthcare leaders said are impeding or essential for progress towards accelerating their transformation to value-based
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Canvas Medical Raises $24M for EMR & Payments Platform

by Syed Hamza Sohail 07/18/2022 Leave a Comment

Canvas Medical Raises $24M for EMR & Payments Platform

What You Should Know: - Canvas Medical, the EMR that enables clinicians and developers to power the future of care delivery, has raised $24M in Series B funding led by M13 with participation from Haystack and previous investors Inspired Capital, IA Ventures, Upfront Ventures, and Irongrey. - In addition to this funding, Canvas has achieved federal certification through the Office of the National Coordinator for Health Information Technology (ONC).  A Full-Stack Ambulatory EMR and
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6 Success Strategies as CMS Drives More Accountable Care by 2030

by Siddharth Thakkar, VP, Product and Marketing at IKS Health 07/13/2022 Leave a Comment

6 Success Strategies as CMS Drives More Accountable Care by 2030

For the better part of a decade, the shift toward value-based care in the U.S. has been driven by the establishment of the Center for Medicare and Medicaid Innovation (CMMI). Working to develop, test and evaluate new payment and delivery models in Medicare, Medicaid and the Children’s Health Insurance Program, CMMI has taken aim at improving the provider experience, generating better patient outcomes and reducing the overall cost of care. Recently, CMMI stated that by 2030 every Medicare
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Report: Advancing Tech-Enabled Health & Home Care

by Research Reports 04/29/2022 Leave a Comment

Report: Advancing Tech-Enabled Health & Home Care

What You Should Know: The Milken Institute Center for the Future of Aging today released a report to identify actionable recommendations to better integrate health and home care through technology. These recommendations were gathered from a convening of stakeholders representing health care, technology, government and policy, research and academia, philanthropy, advocacy, and community-based organizations. Report Background While the COVID-19 pandemic heightened the focus on
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BCBS of Michigan Launches Joint Venture with Honest Medical Group

by Fred Pennic 04/25/2022 Leave a Comment

BCBS of Michigan Launches Joint Venture with Honest Medical Group

What You Should Know: - Blue Cross Blue Shield of Michigan (BCBSM) today announced a joint venture with Nashville-based Honest Medical Group to offer physicians comprehensive operational, clinical, and financial support for shared accountability Medicare contracts. - The joint venture is the first of its kind for BCBSM and aligns with the organization's continued expansion of Blueprint for Affordability, its member-focused, value-based care and payment
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Clarify Health Acquires Embedded Healthcare, Behavior Change Platform

by Jasmine Pennic 03/14/2022 Leave a Comment

Clarify Health Acquires Embedded Healthcare, Behavior Change Platform

What You Should Know: - Clarify Health, leading cloud analytics and value-based payments platform company, just announced its acquisition of Embedded Healthcare  - a behavior change platform company created by notable healthcare leaders such as Dr. Ezekiel Emanuel to scale value-based care for health plans.  - The announcement marks the company’s second acquisition in 6 months and represents Clarify Health’s deep commitment to further build out its technology and cement its
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What Will It Take for Hospitals to Survive the Pandemic?

by Dr. John Frownfelter, MD, FACP, Chief Medical Officer at Jvion 04/14/2021 Leave a Comment

What Will It Take for Hospitals to Survive the Pandemic?

On New Years Eve, just as the Covid-19 outbreak in Los Angeles was at its worst, all 451 of Olympia Medical Center’s exhausted employees learned they would soon lose their jobs. After 74 years, the hospital closed for good on March 31st, leaving residents of the surrounding community — poor and mostly people of color — without a place to see a doctor.  And it isn’t the only hospital closing. At least 47 hospitals have closed or filed for bankruptcy in the last year, and there will
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