Value-based Reimbursement Transition in the US
Value-based Reimbursement Transition in the US
Market Due Diligence and Strategy Considerations
11-Dec-2015
Global
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Description
The US healthcare industry is undergoing a major transition toward value-based care, affecting all its stakeholders. Centers for Medicare and Medicaid Services (CMS) are steering this transition by developing policies and alternative payment models that affect all reimbursements for healthcare services. This document provides insight into CMS’s 2018 goals for this transition, the pathway adopted to achieve those goals, and current progress towards achieving these goals. Financial performance of various industry stakeholders including physicians, providers, and the Accountable Care Organizations as well as anticipated short term trends for the CMS implemented programs are highlighted. The document includes case studies that throw light upon innovative business models designed by healthcare vendors that support providers undergoing this transition.
Table of Contents
Research Scope
Key Questions Addressed
CEO’s Perspective
Background
Tiers of Value-Derived Compensation
CMS-Announced Value-Based Care Goals
CMS Targeted Payment Transition
Category 2—P4P for Providers
Re-admissions Reduction—Provider Impact
Value-Based Purchasing—Historical Provider Impact
Value-Based Purchasing—FY 2015 Provider Impact
Category 2—P4P for Physicians
Value-Based Modifier—Physician Impact
Value-Based Modifier—CY 2016, 2017 Physician Impact
EHR Meaningful Use—Physician Impact
Categories 3 & 4—Alternative Payment Models
Accountable Care Organizations Landscape
CMS Established ACOs
CMS Established ACOs (continued)
Categories 3 & 4—Other APMs
Other Activities Impacting Healthcare Stakeholders
Impact on Healthcare Vendors
Health Catalyst Risk-Sharing Contract in Pop Health
Health Catalyst Risk-Sharing Business Model Example
athenahealth
Sanitas
Population Health Management, Central to VBR, is Difficult Business for Providers
Health Catalyst Led Operational Efficiency Program Yielded Benefits Worth $74 Million for Texas Children Hospital
Catholic Health Partners Transitioned to PCMH & Achieved ACO Success through Explorys’ PHM Platform
Summary
Conclusion
Legal Disclaimer
Abbreviations
Hospital Value Based Purchasing Program— Parameter Weightage
The Frost & Sullivan Story
Value Proposition—Future of Your Company & Career
Global Perspective
Industry Convergence
360º Research Perspective
Implementation Excellence
Our Blue Ocean Strategy
Related Research
Popular Topics
No Index | No |
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Podcast | No |
Author | Siddharth Shah |
Industries | Healthcare |
WIP Number | 9AB9-00-44-00-00 |
Keyword 1 | Value-based Reimbursement Transition in the US |
Keyword 2 | Value-based Reimbursement Transition |
Keyword 3 | value-based programs |
Is Prebook | No |