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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?

Griffin Myers Head Shot Oak Street Health

Care Redesign

Rebuilding Health Care as It Should Be: Personal, Equitable, and Accountable

How Oak Street Health, a full-risk, value-based primary care model and social determinants practice, embeds itself in the community to keep its elderly population, “happy, healthy, and out of the hospital.”

Medicaid Referral to Specialist by the Numbers without eConsults

New Marketplace

Can eConsults Save Medicaid?

How eConsults unlock medical expertise for the underserved.

Donald Berwick Melinda Buntin Patrick Conway Raymond Vara Edward Prewitt head shots IHI forum panel on health care policy

New Marketplace

Signal or Noise? Navigating Health Care Policy — Part 2

A discussion from the Institute for Healthcare Improvement National Forum. Part 2 of a two-part series.

Donald Berwick Melinda Buntin Patrick Conway Raymond Vara Edward Prewitt head shots IHI forum panel on health care policy

New Marketplace

Signal or Noise? Navigating Health Care Policy — Part 1

A discussion from the Institute for Healthcare Improvement National Forum. Part 1 of a two-part series.

HaH-Plus Program Reduces Patient Days Spent in Health Care Facilities in Final 180 Days of Life

Care Redesign

Hospital at Home–Plus Reduces Days Spent in Hospitals and Other Inpatient Facilities

Patients enrolled in Mount Sinai Health System’s HaH-Plus program spend about one-third as many days in health care facilities as inpatients in the last 180 days of life.

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.

New Marketplace

Hospital Readmissions Reduction Program (HRRP)

Medicare’s Hospital Readmissions Reduction Program was established by the ACA to combat excessive and costly readmissions. Learn about HRRP penalties, criticisms, and strategies to reduce readmissions.

Responding to Opioids Epidemic - chronic pain, opioids epidemic data

Care Redesign

The Physicians’ Quandary with Opioids: Pain versus Addiction

The national addiction crisis has led to a crackdown on physician prescribing abilities for opioids. Frontline physicians and clinical leaders are torn between wanting to prevent addiction and wanting to treat chronic pain.

Mostashari01_pullquote - Medicare Advantage Holds the Key to Reforming the ACO Program

New Marketplace

Medicare Advantage Holds the Key to Reforming the ACO Program

Value-based care continues to be the emphasis of federal policymakers, as well as many providers. Aligning Medicare Advantage with ACOs would boost both programs.

Much Ado About Nothing Over Healthcare Payment Reform Panel Clip Still

New Marketplace

Much Ado About Nothing Over Payment Reform?

Are we too concerned about payment reform? Should we let the system play its course, or should we give it subtle nudges?

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