Over a decade of programs championed by the Center for Medicare and Medicaid Innovation, focusing on accountable care and bundled payments, have had some notable successes. Private value-based care arrangements, structured by health plans and state Medicaid departments have had some significant achievements.
Many facets of healthcare remain in a state of flux at the close of 2022. Verinovum’s SWAT (Strategic Workforce and Tactics) team has been closely following these trends and has made predictions about how nine of them might play out in 2023.
The midterm election cycle has come and gone. A divided government means that it is highly unlikely that Congress, and specifically the House, will pass any monumental policies that would face defeat in the senate or a veto from the Executive Branch. What does this mean for healthcare and health policy in 2023?
Competitive pressures and complex regulatory plan performance reporting requirements create an additional challenge – acquiring correct and accurate data to demonstrate the best possible value to potential members, governmental agencies, and employer purchasers.
While a seismic shift in the administration, receipt, and payment for healthcare in the U.S. Quality has become a hot topic of discussion among stakeholders, change has been slow. The definitions of quality and value are rarely simple to quantify, and waste and error remain ubiquitous.
The U.S. healthcare system’s information technology infrastructure is a house of cards when it comes to interoperability and clinical data usability. Efficiently sharing patient and member information among clinicians, practices, payers, and patients is an ongoing challenge and this house of cards often collapses due to complex interoperability and data quality issues.
In this whitepaper, we look at the value of clinical data curation and enrichment in terms of ensuring compliance with regulatory and certification requirements, negotiating value-based care contracts, and supporting healthcare’s new Quadruple Aim.