California Primary Care Association’s Post

Like several other states, California is getting serious about trying to limit the growth of statewide healthcare spending. The California Department of Health Care Access and Information (HCAI)’s Office of Health Care Affordability’s Board has approved a statewide healthcare spending growth target of 3 percent. The spending target will be phased in over time. Initially starting at 3.5 percent for 2025 and 2026, the target will be lowered to 3.2 percent for 2027 and 2028 before ultimately reaching 3 percent for 2029 and beyond. Other states are working on cost growth targets as well. In July 2022, when California enacted its legislation that involves setting cost targets, it became the 10th state attempting to rein in healthcare costs in this manner. In 2012, Massachusetts became the first state to enact a healthcare cost-growth benchmark, which set a target for annual rates of increase for all healthcare spending tied to growth in the state’s economy. It also established several mechanisms to hold payers and providers accountable for keeping spending growth below the benchmark. https://lnkd.in/gYb35Gsm

Quantum Health Launches New Service For Medicare Advantage Learn more & get our take 👇 https://lnkd.in/gQ__mBKE “Medicare Advantage plans are challenged with helping millions of people manage complex care. They need a proven navigation service that can be with their members throughout their healthcare experience while helping plans address gaps in care and drive better member engagement,” – Shannon Skaggs, President at Quantum Health “We have designed our Medicare Advantage navigation service to meet the unique needs of both Medicare Advantage plans and their member populations. That means leveraging our core capabilities to support acute care for an increasingly aging population, expanding provider networks and virtual care options to cover less penetrated markets and rural populations, and addressing social determinants of our members’ health — all to close clinical care gaps and improve clinical outcomes,” – Dan Shur, Chief Product Officer at Quantum Health #medicareadvantage #maadadvantage #SoHCNews

Plan to double income from private healthcare.

Very upsetting to see how private equity can negatively impact healthcare when we see issues arise like Steward Health Care. Stems from the fact that physician owned hospitals were labeled as bad and then banned. When in fact, physician owned hospitals can be a more effective way to run healthcare in this country. Need to repeal the Obamacare ban on physician owned hospitals.

Whether you're a Teddy Roosevelt fan or not, "“Nothing in the world is worth having or worth doing unless it means effort, pain, difficulty…" seems true to form. HFMA attendees are still committed to fighting this fight and we are here for it and to help! #valuebasedcare #collaboration #trust #transparency #transformation

I recently sat down to discuss the current state of healthcare in Michigan, addressing the challenges faced by employers and employees alike. In this video, I examine the impact of rising costs and healthcare provider consolidation on patient care and affordability. I also explore potential solutions to increase competition, enhance transparency, and shift towards a more proactive healthcare model. I invite you to join the conversation on how we can work towards ensuring affordable, high-quality healthcare for all Michiganders. Let me know your thoughts in the comments below. #HealthcareInMichigan #AffordableCare #SymplBenefits

The tide is changing in healthcare, with innovation at the forefront. 🌊 What does that mean for private equity healthcare? 🤔 At Polsinelli’s recent roundtable, I had the chance to dive deep into this topic with other experts. Here’s some coverage from Hospice News - Here’s a recap: https://ow.ly/L0qv50Sqc8H. #Healthcare #PrivateEquity #PatientCare #HealthcareInnovation

My new piece in JAMA Internal Medicine with Zeke Emanuel and Amol S Navathe discusses some of the challenges in value-based care program design and implementation. But why should you care about VBC in the first place? For those outside of healthcare, VBC may sound like jargon. Even within healthcare, many see VBC as a buzzword or worse – a ploy to boost profits. But we all know that the American healthcare system is broken. We feel it through rising premiums, and unfortunately, many lack adequate access to care. Nationally, rising healthcare costs are a major contributor to the deficit, with substantial implications to the country’s financial well-being and our ability to undertake big programs. Exploring the root cause, you will inevitably land on the misaligned incentives inherent to a fee-for-service system. To me, this is what VBC is about: realigning incentives to the benefit of all stakeholders: patients, clinicians, and the nation at large. It’s not going to be easy or fast. There are going to be disagreements and frustrations along the way. But it’s a challenge that we must face. #valuebasedcare #vbc #healthcareeconomics #healthcarereform #healthcaredata https://lnkd.in/e6WBJ7hg

Health systems aren't making the necessary investments to make Medicare Advantage work for them financially. Doesn't keeping people healthy vs caring for them only when they're sick seem like the truest form of healthcare? https://lnkd.in/eFHefG4b "Are you in the sick care business or are you in the healthcare business? If you're in the healthcare business, you should be striving to prevent acute care utilization, not driving more of it. And you want to be in a business model that's aligned with preventing acute care utilization, and MA is that model."

In a value-based care environment, providers get paid for driving value, increasing quality and reducing healthcare expenditure in an already bloated healthcare system. And that is exactly what FQHCs do day in, day out, as the primary care provider in the communities that they serve. In the existing system, the fee-for-service world, they don't get paid for that... Let's get FQHCs paid for all the work they do. 🎥 Hear more from Yuvo Health's CEO and co-founder Cesar Herrera on the topic in the video below. #valuebasedcare #valuebasedhealthcare #fqhc #ffs #chc