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Navigating Value-based Payment
In the 14 years since passage of the Affordable Care Act (ACA) and 9 years since the passage of the Medicare Access and CHIP Reauthorization Act (MACRA), there have been numerous programs developed by Medicare, states and commercial payers to support the movement to outcomes or value-based reimbursement.
Capitated and Global Budget Models
At the upstream end of the value-based payment spectrum, organizations can assume full risk for a population through capitated payments, global budgets, and provider led insurance plans.
CMS Issues Final Notice of Benefit and Payment Parameters for 2025
The Centers for Medicare & Medicaid Services (CMS) April 2 released its standards for qualified health plans (QHPs) offered through the health insurance marketplaces for 2025. Beginning in plan year 2025.
Current and Emerging Payment Models
Health care is currently in the middle of a transition from a system of payment based on the volume of services provided (fee-for-service) to payment based on the value of those services (value-based care and alternative payment models).
Accountable Care Organizations
What are Accountable Care Organizations? What are ACOs? An ACO is a group of clinicians, hospitals and other health care providers who come together voluntarily to give coordinated high-quality care a designated group of patients.
The 340B Drug Pricing Program
For more than 30 years, the 340B Drug Pricing Program has provided financial help to hospitals serving vulnerable communities to manage rising prescription drug costs. Despite significant oversight from HRSA and the program’s proven record of decreasing government spending and expanding access to patient care, some want to scale it back or drastically reduce the benefits that eligible hospitals and their patients receive from the program.
AHA Statement to House on "Access to Health Care in America: Ensuring Resilient Emergency Medical Care”
The American Hospital Association (AHA) welcomes the opportunity to comment on ways to ensure patients can receive timely emergency medical care, particularly in rural and underserved areas. We share the committee’s interest in ensuring that Americans have high-quality, affordable health care in the face of life-threatening crises.
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The Health Equity Roadmap
The Health Equity Roadmap: A national initiative to improve health care outcomes, health equity, diversity and inclusion, and end health inequities.