Secretary Alex Azar, Health and Human Services, spoke on March 5th, 2018, at the Federation of American Hospitals. His presentation reaffirmed CMS’ commitment to value-based transformation. He said, “there is no turning back to an unsustainable system that pays for procedures rather than value”. Additionally, he said, “value must be rewarded handsomely”. With the repeal of SGR (sustained growth rate), provider reimbursement will not see an increase beginning 2019. Therefore, the assessment of value (quality, stewardship of resources, appropriate utilizations) will determine if and when providers will see additional reimbursement.
St. Vincent’s Health Partners (SVHP), Inc., the first nationally-recognized clinically-integrated network by URAC, has developed a network and operational infrastructure to manage patients through more than 140 care transitions. SVHP is participating in most models of reimbursement including Medicare Shared Savings, commercial and governmental payment models, and direct-to-employer contracting.
SVHP has partnered with PatientPing, a software company that allows care coordinators and the medical management team to better serve attributed patients and covered lives as they transition between healthcare settings. Our team receives a “ping” each time a patient is seen in the emergency department, admitted to the hospital, or uses skilled nursing facilities and home health agencies.