A Primer on Medicare Advantage, Risk Sharing, Capitation, and Value Based Care

4 min read

Medicare advantage…risk sharing…capitation… value based care…what does it all mean?!? Such jargon can be unintuitive and intimidating, and is (unfortunately) increasingly ubiquitous within the healthcare industry. This article aspires to be a high-quality 5 minute primer that’ll (1) give you a high-level overview, and (2) provide you with links to helpful resources where you can learn more. A Brief Primer on Terminology: Value Based Care (VBC): although somewhat arbitrarily defined (some define “value = (quality + outcomes) / cost”, others define “value = outcomes / cost”), the principle is simple: an emphasis on paying for tangible, long-term health outcomes that…...

This content is for DDI Basic Membership only.
Join Now
Already a member? Log in here
Kush Gupta I am a physician and biomedical engineer who is deeply frustrated with the current state of healthcare delivery. Clinically, I am particularly compelled by the medical complexity and humanistic challenges of caring for critically ill patients. In my free-time (depending on the season), I can be found skiing the slopes of Tahoe or kitesurfing out in the Bay.
Amit Garg I have been in Silicon Valley for 20 years -- at Samsung NEXT Ventures, running my own startup (as of May 2019 a series D that has raised $120M and valued at $450M), at Norwest Ventures, and doing product and analytics at Google. My academic training is BS in computer science and MS in biomedical informatics, both from Stanford, and MBA from Harvard. I speak natively 3 languages, live carbon-neutral, am a 70.3 Ironman finisher, and have built a hospital in rural India serving 100,000 people.