Policy makers and health plans seek value-based management of specialty drugs. This study examines real-world factors that favor some approaches over others and their potential impact. Objectives: ...

Even before COVID-19, health systems were experiencing reduced fee-for-service margins. In 2019, median Medicare margin nationally decreased 2.2 percent while hospital costs rose 2.5 percent per year.

The Medicare Advantage (MA) program, which allows Medicare beneficiaries to voluntarily enroll in a private plan that administers health benefits, was established by the Balanced Budget Act (BBA) of ...

While progress toward the adoption of value-based care has been a slow lumber, the healthcare industry is still pushing toward that transition, with UnitedHealth Group weighing in on how best to ...

About the Author: Ian Chiang is a principal at Flare Capital Partners, a healthcare technology and services-focused VC firm. Prior to joining Flare, he was the SVP of product and innovation and a ...

The Optimal Care Model reduces waste by empowering physicians with evidence to balance cost and quality in cardiology care. Algorithms help primary care physicians assess coronary artery disease risk, ...

This article is the latest in the Health Affairs Forefront featured topic Accountable Care for Population Health, featuring analysis and discussion of how to understand, design, support, and measure ...

Forbes contributors publish independent expert analyses and insights. I cover transformation and innovation across the health care industry. For two decades, value-based care has been built upon a ...

Value-based pricing can be powerful, but it often breaks down when the value isn’t clearly measurable, clients feel misaligned with the price or providers overcharge too early in their business ...

Medicare Advantage members in value-based care arrangements had 24.3% fewer inpatient hospital admissions than those in Original Medicare in 2024. Humana Medicare Advantage members receiving ...

Precision Value Based Management owns the technology that grades and ranks physicians for payers, hospital systems, and ACOs, with over 21 million patients that are being tracked. “They know exactly ...