The Value-Based Healthcare Model Is the Future Fee-for-service billing has been the dominant financial structure throughout the history of modern US healthcare. This payment structure
Value-based care programs have never been simple, and Direct Contracting is no different. Nonetheless, understanding how Direct Contracting works is critical to succeeding in the
In the same way that there has been tremendous evolution in value-based models in the past decade, the way in which we access and use
It’s no secret that the U.S. healthcare system could benefit from a healthy dose of creativity and innovation. Over the past several decades, healthcare costs
The introduction of the Direct Contracting model by the Centers for Medicare and Medicaid Services (CMS) has attracted much attention. The model offers an opportunity
Starting in March of 2020, healthcare practices began to see the profound impact of COVID. As the pandemic forced quarantines, lockdowns, and isolation, providers saw
We’re announcing our Series A fundraise led by Vineeta Agarwala at Andreessen Horowitz with follow-on funding from AlleyCorp and Kevin Ryan. Many startup announcements and
For years, Medicare Advantage plans have provided an alternative path for Medicare beneficiaries to access their benefits. Instead of accessing their Medicare benefits directly through
Efforts to move American healthcare systems toward a value-based healthcare model continue to evolve. The Center for Medicare and Medicaid Services (CMS) is invested in
Medicare may be one of the best healthcare markets for value based care models. The below arguments lay out why further investments in value based
For decades, the Center for Medicare and Medicaid Services (CMS) has embraced a fee-for-service reimbursement model, just as the rest of the US healthcare system
With the advent of the COVID-19 pandemic, many ACOs who had enrolled in program models prior to the pandemic were stuck feeling uncertain about the
I am a physician and I am not satisfied with my electronic medical record system. This is unfortunately not a unique or interesting statement: the
While the pandemic has affected a number of industries, its impact on the healthcare sector is particularly pervasive. Elective procedures and visits were put on
Primary Care Physicians (PCPs) make up the lion’s share of the medical workforce and are the main point of contact to the healthcare system for
Direct Contracting strives to create high-value patient care by empowering providers to better serve patients. By changing reimbursement models and encouraging risk-sharing, the CMMI Direct
For many providers, the permutations of program tracks and risk models in Medicare’s new Direct Contracting model can be overwhelming. First, it is critical to
Throughout the history of U.S. healthcare, the predominant mechanism for financial compensation has been fee-for-service: hospitals, doctors and providers have been compensated based on the
Running a physician practice inevitably means two distinct and often orthogonal challenges: taking care of patients and managing the “business” side of the practice. A
As Medicare programs move toward risk-based contracting, there will be challenges in care coordination across these transitions. Accountable Care Organizations (ACOs) and Direct Contracting Entities
Team, You have all been working incredibly hard over the last seven months and our collective accomplishments speak to the effort and talent you have
Over the last several years, the Centers for Medicare and Medicaid Services (CMS) has increasingly invested in innovative Medicare programs. An exemplary model is the
Health Maintenance Organizations (HMOs) managed the care of over 95 million Americans in 2018. These entities are legal insurance organizations characterized by shared technology across
In value-based care medicine, there are three important goals: enhancing the quality of care, reducing healthcare costs, and improving the patient experience. In combination, these
Medicare is the health coverage program administered by the Centers for Medicare and Medicaid Services (CMS). This program uses public funds to pay for care,
We’ve been lucky to meet and speak with some of the great minds in healthcare as we built Pearl Health and through our time scaling
Like many of my peers who entered the workforce after the 2008 market crash, I began my career with an eye towards balancing financial security
The term “capitation” may bring back some bad memories for providers who have been practicing for a long time. In the 1980s, health maintenance organizations
When it comes to healthcare value, the U.S. is far from being a global leader. For half a century, the country has watched healthcare expenditures
Despite being the most advanced nation in the world, the U.S. struggles with healthcare. As is often noted, the U.S. spends roughly double per capita
Source We all have some level of reliance on Medicare. Whether you’re retired and on the program, about to move into benefits in the coming
Pearl Health believes that understanding the likely path of healthcare reform is critical for providers and payers alike to position themselves for success in the
The US healthcare system is at an inflection point. COVID further exposed the inequality, profiteering and bureaucracy that prevents people from getting the care they
Healthcare is a big business with huge resources deployed. From my time in the industry I have found that you can do a lot with