The transformation of healthcare from volume-based to value-based mode has encouraged public and private payers to reform reimbursement models emphasizing on accountability for care quality and healthcare costs. Thanks to the ever-increasing healthcare costs, payers and providers are increasingly preferring bundled payments over fee-for-service (FFS) payment structures. (1,2) Bundled payments, also known as episode payments/case […]
Value-based healthcare is driven by ‘meaningful’ treatment that matters to the patient. The purpose of value-based healthcare is not minimizing the costs, but maximizing the ‘value’, which is defined by “patient outcomes divided by cost”; (1) thus emphasizing on a patient’s importance. (2) The progress in efficient healthcare services relies to a great extent on […]
In the US, ‘pay-for-performance’ (P4P) programs have gained popularity among healthcare policymakers as well as private and public players, including Medicaid and Medicare. The term ‘pay-for-performance’ covers all the initiatives that contribute to the quality, efficacy, and overall value of healthcare. (1) These programs provide financial incentives or disincentives to providers or institutions as per […]
Drug prices in the US are the highest in the world, which necessitate new or alternate payment approaches. For instance, the new treatments for hepatitis C virus (HCV) infection are highly effective and very expensive at the same time, at least from the view of many payers, physicians, and patients. Even 5 years after these […]
An excellent population health management approach considers multiple aspects of health, such as sufficiency of medical care, public health interventions, social and physical environments and related services, genetics, and individual behavior. (1) Data from multiple sources can be used to conduct population health management programs and to assess their value. In addition to these diverse […]
There are humungous quantities of data existing in healthcare; data from all kinds of sources, such as clinical, patient, payer, R&D, pharmacy as well as revolutionary technologies that are being quickly embraced, for e.g. data from wearable devices. According to a report by International Data Corporation (IDC), (1) the volume of healthcare data which was […]
The healthcare industry is challenged with administrative and regulatory intricacies that make achieving the healthcare objectives, such as better patient outcomes and reduced costs, difficult. Difficulties faced while improving patient outcomes are predominantly taxing, since health systems measure and report thousands of outcomes annually. (1) In addition, healthcare industry is saturated with the need for […]
Health care is undergoing remarkable change with the global delivery system transitioning to a value-based system from the fee-for-service approach, which has been in place for the past half century. It is predicted that, in this ever evolving business model, hospitals, health care systems, physician groups, and other health care providers will take on more […]
