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Medicare and Medicaid

The policy landscape is changing, so understanding Medicare and Medicaid reform is essential for Medicare and Medicaid providers. New initiatives such as the Medicare shared savings program promise gains for patients and organizations. How can we make it all work?

Treatment Authorization Increases and Rapid Boost in New Mexico Medicaid Members Treated for Chronic HCV

Care Redesign

A Collaborative Model to Expand Medicaid Treatment Coverage for Chronic Hepatitis C Virus

How managing the benefit coverage expansion for the treatment of HCV in New Mexico was successfully achieved after less than 2 years.

Massachusetts Community Health Centers Collaborative Teledermatology Process

Care Redesign

A Teledermatology Initiative to Increase Access for Community Health Center Patients

A group of seven community health centers in Massachusetts collaborated to implement a teledermatology program that improved access to specialty care for patients with skin conditions and reduced overall dermatology spending.

Vertical Integration and Bold Experimentation - Peter Orszag Talk Still

New Marketplace

Vertical Integration and Bold Experimentation

Four points on improving value in health care via vertical integration and aggressive experimentation.

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.

People Living with Dementia Around the World - Value-Based Chronic Illness and Dementia Care

Care Redesign

Value-Based Care Must Strengthen Focus on Chronic Illnesses

To effectively control costs and improve value, new models must address our increasingly older patients and chronic care patients, especially those with Alzheimer’s and related dementias.

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.

Safety-Net Providers Lead Disruptive Innovation to Cut Overuse - Frederick Cerise talk still

Leadership

Safety-Net Providers Lead Disruptive Innovation

It should be no surprise that simpler, cheaper, and more convenient care arises from safety-net providers.

Shachar01_pullquote value-based care fee-for-service fraud and abuse laws

New Marketplace

Are Fraud and Abuse Laws Stifling Value-Based Care?

To realize the true potential of value-based care, we must update the underlying assumptions in our fraud and abuse regulatory system.

Missouri Show Me Health Plans Cost Calculator for Health Insurance Enrollment screen shot - health insurance education

New Marketplace

Facilitating Health Insurance Enrollment in an Uncertain Environment

Lessons learned from five years of open enrollment in Missouri.

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