Medicare Value-Based Payments Explained
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- Опубликовано: 19 авг 2024
- Medicare Value-Based Payments (also Called Alternative Payment Models) to Hospitals Fall Into 3 Main Categories:
1 - Pay for Performance (P4P): There are 3 Sub-Types of Pay-for-Performance
--Value-Based Purchasing: Fee-for-Service with $1.5B at Stake in Quality Bonuses to be Paid-out by Penalizing those Hospitals with Poor Quality. Budget Neutral for Medicare.
--Readmission Reduction: Fee-for-Service with 3% Penalty for Readmissions for 6 Conditions, Only Downside for Hospitals, No Upside. Medicare Saves.
--Hospital-Acquired Conditions (e.g. Catheter-Associated Urinary Tract Infection): Fee-for-Service with 1% Penalty, Only Downside for Hospitals, No Upside. Medicare Saves.
2 - Bundled Payments: Fixed Payment for 32 Different Episodes of Care, Voluntary Program
--Fixed $ Amount for Hospital + Doctor + Post-Acute Care
--Program is Shrinking: Participating Hospitals from 830 to 715
3 - Shared Savings: Accountable Care Organizations (ACO) - Fixed Payment for a Population of Patients for a Certain Period of Time (aka 'Capitation'), Voluntary
--517 ACOs Currently Care for 11.2 Million Medicare Beneficiaries - 28% of Total Traditional Medicare Population, BUT 56% of Hospitals Plan on Ending Their ACO
Sources:
Advisory Board Company Slide Presentations Previously Shared Publicly on the Internet.
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Wow! Very clear. Not afraid anymore to interview for a position with VB reimbursement
Thank you for your feedback.
Thank you for breaking it down Doc. Reading it from a journal won't come out as clear as this.
Thanks so much, Arch. Appreciate you watching.
Thank you so much for this video!!! This has made it so easy for me to understand now. I have been struggling for days, research, reading books etc., and in just a few minutes with your video, I understand.
Super! Thank you for watching.
Thanks! This is the clearest video for VBP.
Thank you for watching and for your feedback.
My god this was so confusing for me and you made it easier. THANK YOU!
Super. Thank you for watching. Glad it helped.
Another great video!! Thanks for the thorough explanation. Can you please do a video explaining the difference between traditional Medicare & Medicare Advantage plans ?
Thank you for the suggestion. It is a great idea.
This is great, would love to chat about bundled payments vs capitated agreements
Thank you for watching!
Your videos are quite informative and keep doing the good work. I'm not sure if anyone has told you that your video camera keeps going in and out-of-focus in every now and then in most of the videos you've produced and it affects the eyes of the viewer a lot. It prevents the person from concentrating on the great content you produce. If you can do anything to fix it, that'll be wonderful. Thanks!
Thank you for watching and for the feedback.
Which model is best for a data driven telehealth business in the CCM/RPM space?
Not sure. Good question.
love this video. the link for sources isn't working. where can i find these?
I know. The Advisory Board took down access to the online modules. It is unfortunate. Thank you for watching.