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Healthcare Payment Models

Creative healthcare finance and making use of alternative payment models can lead to innovative healthcare payment solutions that drive value. How does your organization's revenue model stack up?

Effect of Value-Based Payment Programs on Providers That Serve the Poor

New Marketplace

Financial Incentives and Vulnerable Populations — Will Alternative Payment Models Help or Hurt?

Understanding APMs’ potential consequences for vulnerable populations is critical if we wish to maximize benefits and reduce harms.

Why Employers Drag Feet on Value-Based Insurance and Reshaping Health Care Coverage: A Classic Public Good Problem Panel Clip Still

New Marketplace

Reshaping Care Coverage: A Public Good Problem

The companies most capable of leading transformation in health care coverage are the ones that least need to.

Example 4-Quadrant Analysis and Price Setting for a Single-Procedure Bundle - Lessons Learned from DRG Implementation

New Marketplace

Making Bundled Payments Work: Leveraging the CMS DRG Experience

Given its clout and experience, CMS is uniquely positioned to lead the U.S. health system toward high-value care. Bundled pricing based on real costs, leveraging lessons from DRG implementation, would establish the right types of provider incentives.

Kocher03_pullquote risk-based primary care provider

New Marketplace

Opportunities for Risk-Taking Primary Care Providers

Embracing two-sided risk while adopting workflow redesign and reviewing benchmarks is leading to improved clinical and financial outcomes.

Why Employers Drag Feet on Value-Based Insurance and Reshaping Health Care Coverage: A Classic Public Good Problem Panel Clip Still

New Marketplace

Why Employers Drag Feet on Value-Based Insurance

Why are employers hesitating? What do they value and want to invest in when it comes to health care payment plans?

Change the Model - Change the Medical School Curriculum Panel Clip Still

New Marketplace

Change the Model → Change the Curriculum

If we’re going to change the health care payment model, do we need to change medical school curricula and how we train physicians?

Primary Care ACO Models - Way of the Future? Panel Clip Still

New Marketplace

Primary Care ACO Models: Way of the Future?

Evidence shows that primary care–led, risk-bearing, ACO-like practices and independent physician group models generate more savings.

Lack of Incentive Is Top Barrier to Implementing Value-Based Payment

New Marketplace

Survey Snapshot: Payer-Provider Alignment Is Difficult Even for Integrated Organizations

NEJM Catalyst Insights Council members say stronger incentives and better use of analytics could improve alignment.

Kaplan04_pullquote Time to Sink Two Canoe Payment Models Argument

New Marketplace

Time to Sink the Two-Canoe Argument

Although the transition from fee-for-service to quality-based payment can leave physicians feeling trapped “with a foot in two canoes” while straddling the two payment methods, there are compelling ethical, professional, and business reasons against rationalizing continued support of fee-for-service medicine.

Do Drug Market Exclusivity Periods Help or Harm?

New Marketplace

Drug Market Exclusivity Periods: Helpful/Harmful?

What impact do market exclusivity periods have on the cost of drugs and on incentives for innovation?

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