MedCity News July 28, 2025
High-performing groups treat utilization with the same rigor they apply to coding and quality. Here are four key principles we’ve seen successful organizations adopt.
Two topics dominate almost every conversation about value-based care (VBC): risk adjustment and quality. They are, without question, foundational. Risk adjustment sets the financial baseline for each patient population, while quality metrics confirm we are delivering the right preventive and chronic-care services. Yet there is a third pillar that too often escapes the spotlight, even though it can detract dramatically from organizational performance: utilization.
Why utilization trails its flashier siblings
In value-based care, utilization is the total mix of services a patient receives — how often they use them, where they’re delivered, and at what cost....
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