Susan Morse

LAS VEGAS - The Staten Island Performing Provider System is running into all of the challenges inherent in implementing a value-based model for Medicaid payment reform in New York State.

Group will serve as a  matchmaker between organizations that would like to develop and pilot solutions.

LAS VEGAS -- When Inova Health saw that Affordable Care Act initiatives for value-based care would cut 7 percent, or $220 million, out of the $3 billion health system’s successful fee-for-service revenues, the northern Virginia provider knew it needed to change, said President and COO Mark Stauder.

One success story is the Colorado Rural Health Center partnered with Cyberscience Corp. to speed up processes, a move that has saved time and money.

Rene Cabral-Daniels, CEO of the Community Care Network of Virginia, says some doctors are not effectively partnering in value-based models.

Providers range from linking some payments to the effective management of a population to full population-based management.

While it may not sound all that exciting at first blush, a working knowledge of the low-, mid- and high-risk stratification of populations is key to successfully moving toward value-based care.

For the first time, the Centers for Medicare and Medicaid Services and America's Health Insurance Plans have announced standard quality measures among payers, a move designed to reduce confusion and complexity for reporting providers.

The consultant, which proposes moving away from evaluating physicians independently to a methodology in which physicians are evaluated in clusters, will share insights at HIMSS16.

The administration's 2016 year-end goal was to have 10 million people covered through the exchanges.