Now more than ever, healthcare consumers are looking for value from their health plans. Traditionally, value has centered on the quality of clinical care and the total cost of care for those services.

The Camden Coalition’s model for care management and care coordination may not have achieved its initial aims of reducing hospital readmissions, but the program was successful in improving patient ...

The Camden Coalition's care management model has a return on investment because it reduces hospital readmissions, emergency department utilization, and overall healthcare spending. The Camden ...

Recent actions by the California Attorney General’s Office signal increased scrutiny of management services organizations (MSOs) and private-equity-backed health care structures. Our Health Care Group ...

Progressive care management approaches can enable meaningful, patient-centric outcomes without assuming risk. In Fresno, California, a woman receiving ongoing cancer treatment shared with her clinical ...

Cancer care involves significant hidden labor, with patients and providers navigating a complex system with inadequate compensation. Value-based care models like PCM offer reimbursement for ...

Since 2013, Medicare has reimbursed clinicians for delivering transitional care management (TCM) services after patients’ discharge from eligible medical facilities. Concurrently, Medicare has ...

Managing patients with type 2 diabetes takes time. Clinicians in primary care, where most diabetes visits take place, lack that time. Planned visits by diabetes care managers—nurses, pharmacists, ...

Value-based payment (VBP) is designed to support collaborative partnerships between patients and physicians, improve the quality of care and reduce health care spending. To achieve these aims, VBP for ...

“APCM is designed to reduce administrative burden compared with using multiple stand-alone care management codes and communication technology codes, many of which require tracking time spent.” ...