Payment Reform

Articles for Payment Reform

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.
This week, the top managed care articles included a report from the Congressional Budget Office on the impact of eliminating the cost-sharing reduction payments; a decision from CMS to eliminate 2 mandatory bundled payment programs; and a new value-based alliance that called for ending use of a test for diagnosing heart attacks.
There is a lot of evolution happening in healthcare in a number of areas, including policy, technology, and the market, explained Deanne Kasim, founding partner of Santesys Solutions.
At the 2017 American Society of Clinical Oncology Annual Meeting, oncologists heard from fellow experts on the best way to navigate the daunting challenge of payment reform.
The survey found a jump in physician burnout since 2013 and a gap in the commitment to combat medical errors, a problem that persists despite the movement toward quality measures.
Public and private payment reforms such as accountable care organization contracts have shown some initial evidence of changes in physician behavior, but their full promise remains to be seen, according to Zirui Song, MD, PhD, resident at Massachusetts General Hospital.
Incentives must be aligned between payers and providers to transition to value-based care and physicians must have the best access to information to make the right decisions in these value-based arrangements, explains L. Patrick James, MD, chief clinical officer for health plans and policy, medical affairs, for Quest Diagnostics
Although the country is moving toward value-based payments, for providers it’s basically still a fee-for-service world, said Charles J. Fazio, MD, MS, of HealthPartners Health Plan, at America’s Health Insurance Plans’ Institute & Expo, held June 9-10 in Austin, Texas.
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