February 19th 2024
For operational efficiency, value-based initiatives need a scalable digital infrastructure that can handle multiple reimbursement models, including fee for service.
Price and End Points. For Cancer Drugs, There Is a Disconnect, Research Finds
October 31st 2022Overall survival is considered a more definitive end point. But according to Vinay Prasad, M.D., M.P.H., and colleagues , drugs approved based on progression-free survival and overall response rate were priced higher than those approved based on overall survival.
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Low-revenue MSSP ACOs Produced Better Results in 2021 Than High-revenue ACOs: CMS
August 30th 2022The Centers for Medicare and Medicaid Services released results today showing that on a per capita basis, the net savings for low-revenue accountable care organizations (ACOs) was higher than the net savings for high-revenue ACOs.
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It’s Time to Tame the “Diagnostic-Coding Arms Race”: NEJM Opinion Piece
July 29th 2022The trend of primary care practices and businesses bearing risk has pitfalls. A trio of experts have suggestions for how they can be avoided, including taking steps to de-emphasizing diagnostic coding in the calculations that determine payment.
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Medicaid managed care organization (MCOs) may be better equipped to address social determinants of health (SDOH) and health equity than payers who use fee-for-service models because SDOH are central to many requirements for MCOs, including those pertaining to population health management, health equity and care coordination.
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