MedCity News February 23, 2025
The distinction between value-based care and value-based payment isn’t merely semantic — it represents a crucial fork in the road for healthcare delivery. As AI and other technologies become more prevalent in healthcare, we must ensure they’re deployed in service of improving patient care rather than merely optimizing revenue.
In the world of Medicare Advantage, a disturbing shift is occurring. What began as a noble push toward value-based care has increasingly morphed into an aggressive pursuit of value-based payment optimization, with artificial intelligence serving as the latest tool in this concerning transformation.
The scale of the issue is staggering. A Center for American Progress (CAP) analysis estimates MA plans are overpaid by 22 to 39 percent, translating to $83 billion...
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