The American journal of managed care
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To understand how Medicare Advantage (MA) plan representatives perceive the alternative financing model Pay for Success (PFS) and its potential to address members' social risk factors. ⋯ MA plan representatives were unfamiliar with PFS, but most expressed interest in it as an alternative model for funding initiatives to address members' social needs. Education of MA representatives about PFS as an alternative payment model for innovative programming is warranted. However, further guidance from CMS is needed to assuage the concerns raised by these representatives.
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To execute a chronic kidney disease (CKD) intervention to assess feasibility and preliminary outcomes for a health plan. ⋯ This scalable CKD intervention demonstrated feasibility. For advanced CKD, decreased hospitalization and a reduction in several important costs were observed. These preliminary results support the stratification of laboratory data for CKD population health innovation in commercial health plans.
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The founder and president of the Institute for Clinical and Economic Review responds to the commentary on heterogeneity in value assessment.