DCEs lack insight into costly, poorly coordinated care transitions unless they can monitor the entire continuum of care. Ensuring the proper transition of care – the movement of patients between care settings – is a crucial factor in achieving quality patient outcomes. When these are not properly managed, the results can be adverse medical events, […]
Read More
The Direct Contracting Entity program is further proof of the federal government’s commitment to value-based care, but most DCE participants are missing a significant savings opportunity: post-acute care. Introduced in 2019 by the Center for Medicare and Medicaid Innovation (CMMI), the Direct Contracting Entity program (DCE) is building momentum in 2021. With 53 participants already […]
Read More
CMS’s latest offering provides a significant opportunity for payers and providers, but those that can’t crack interoperability will struggle. On April 1, 2021, the first 53 organizations selected by CMS as Direct Contracting Entities (DCEs) kicked off their initial performance period. The second batch of DCEs will enter the model beginning their performance period in […]
Read More
COVID-19 delivered a type of perfect storm filled with disrupted usage patterns and delayed elective surgeries with many opting for post-acute care at home due to fear of infection and facility lockdowns. Lower utilization rates meant that health plans found themselves falling below the medical loss ratio (MLR) limits—even as restrictions are gradually lifted, some […]
Read More
According to a recent study, post-acute care (PAC) patient volumes decreased significantly during the COVID-19 pandemic. The cancellation of elective surgeries and decrease in non-urgent hospital admissions were the biggest drivers for provider loss of revenue. This was in part spurred on by the CMS guidelines recommending the cancellation or postponement of elective, non-essential procedures […]
Read More
The value-based care market will increase by almost 50% in 2021. Here is how health systems and payors can prepare for this market growth.
Read More