Social risk adjustment can ensure equitable, value-based healthcare payment. Learn how social risk can be used to avoid exacerbating health inequity.
Alternative Payment Models
Our experts in health policy, economics, medical care, quality measures and risk adjustment create valuable content on current and emerging alternative payment models that adequately incentivize payments for providing high-quality, cost-efficient, and equitable care. Through our content, consulting services, and solutions, our team works with payer and provider organizations to support APM collaboration and contracting, design balanced APMs, establish VBC organizations like ACOs, or improve APMs with a physician-focused advisory council.
See a sample of the proposed Medicare Advantage changes expected to go into effect in 2024, including issues around equity and access.
Many disabled Americans face deep, longstanding health inequities, including barriers to care, lower quality of care, and disparate health outcomes. See more.
This overview article highlights Section 1115 waivers and recent developments to promote coverage, access to and quality of care.
Because the PHE end date will likely be extended in January 2023, state Medicaid offices are preparing for a complex & critical next phase. See more.
Payers and providers can leverage common goals while tapping into each other's unique strengths and value in the patient-member experience. Learn more.
Accountable care organizations (ACOs) are healthcare organizations designed to move care delivery-and-payment away from the traditional, volume-driven, fee-for-service model toward an integrated approach.
ACO benchmark ratcheting reduces incentives to participate in alternative payment models. Read ways to design effective ACO benchmarking policies here.
Learn how to evaluate and improve alternative payment models by leveraging the Physician-Focused Payment Technical Advisory Committee (PTAC) as a resource.
For commercial payers looking to initiate or expand accountable care organization (ACO) programs, understanding provider concerns is crucial.
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