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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?

Curbing Health Care Spending Growth - Providers Take the Reins - Michael Chernew Talk Still

New Marketplace

Curbing Health Care Spending: The Provider’s Role

Health care costs have historically grown at about 2% faster than income in the United States. One way or another, we have to control health care spending growth, and the onus is on the provider.

Elements of a Sustainable Complex Care Management Contract

New Marketplace

Sustainable Financing for Complex Care Management Is Critical to a Value-Driven Health Care System

Care management should be payer-agnostic at its core.

Comparison of Certain Model Features in Blue Cross NC Blue Premier vs Next-Generation ACO Model vs BCBSMA Alternative Quality Contract

New Marketplace

Engineering a Rapid Shift to Value-Based Payment in North Carolina: Goals and Challenges for a Commercial ACO Program

We believe North Carolina can be a model for the nation.

Small Molecule Drugs Facing Generic Competition - Orphan and Non-Orphan Drugs - Orphan Drug Act

New Marketplace

It’s Time to Reform the Orphan Drug Act

Three proposals for improving the law to reflect 21st-century drug development practices.

Three-Part Pricing of PCSK9 Inhibitors

New Marketplace

A New Model for Pricing Drugs of Uncertain Efficacy

Are we paying too much for new drugs before we know how well they work? This innovative pricing model proposes postponing major rewards until efficacy is established — which could help both patients and payers while still paying back investments on the most effective drugs.

A Prescription for the Ailing U.S. Health Care Market - Leemore Dafny talk still

New Marketplace

Prescription for an Ailing U.S. Health Care Market

Three components for treating the unhealthy, uncompetitive U.S. health care market — beginning with a buyer’s revolt.

Cautious Optimism That Value-Based Reimbursement Will Become Primary Revenue Model

New Marketplace

Survey Snapshot: What Would Accelerate the Adoption of Value-Based Care?

NEJM Catalyst Insights Council members weigh in on the barriers and path forward to value-based health care.

Fee-for-Service Continues to Account for the Majority of Revenue

New Marketplace

New Marketplace Survey: Transitioning Payment Models: Fee-for-Service to Value-Based Care

In a survey of the NEJM Catalyst Insights Council sponsored by Optum, respondents express enthusiasm for value-based care but have conflicting opinions about just how far along that path they should go.

Comparison Between Traditional and Proposed Health Reimbursement Plan for Primary Care Outcomes Model Across Five Key Domains

New Marketplace

Payment Designed for People: Introducing the Primary Care Outcomes Model

A care and payment model that engages primary care physicians in an aligned model built on trust and value could result in better patient care at lower costs.

Figure 1. Differential Changes in Total Medicare Spending for Patients in Accountable Care Organizations (ACOs), According to the Type of ACO, Year of Entry, and Number of Years of Participation.

New Marketplace

Medicare Spending after 3 Years of the Medicare Shared Savings Program

After 3 years of the MSSP, participation in shared-savings contracts by physician groups was associated with savings for Medicare that grew over the study period, whereas hospital-integrated ACOs did not produce savings (on average) during the same period.

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