Many of the accountable care organization (ACO) models are being tested to find changes to make to the Medicare Shared Savings Program, but there is a general problem with short-lived models ending and being replaced by new ones, said Michael Chernew, PhD.
Many of the accountable care organization (ACO) models are being tested to find changes to make to the Medicare Shared Savings Program, but there is a general problem with short-lived models ending and being replaced by new ones, said Michael Chernew, PhD, Leonard D. Schaeffer Professor of Health Care Policy and director of the Healthcare Markets and Regulation Lab at Harvard Medical School; chair of the Medicare Payment Advisory Commission; and co-editor-in-chief of The American Journal of Managed Care®.
Transcript:
CMS has been testing ACO models for years now. Will the testing ever be over or is the continuous testing of new models the purpose?
There is something permanent in place: the Shared Savings Program. And the way I think of a lot of this testing is to think of things that might move into the Shared Saving Program, overall. So, I'm not sure the health care system will ever not be learning. I do think it's important for them to build models that don't get tested, and then sunsetted, and they have to put in place replacements.
And I think that's been a general problem in this paradigm, which is the models of limited lifespans, and when they sunset—if they sunset—they need to develop a successor model. You've seen a lot of that: CHART [Community Health Access and Rural Transformation Model] was the successor to AIM [ACO Investment Model]. And the direct contracting, in some way, was the successor to the Next Gen [Next-Generation ACO Model]; Next Gen, in many ways was the successor to Pioneer [ACO Model].
And that sequencing of successor models, I think, has created some churn and uncertainty in the system. And I think they will work increasingly, to build some of the things they learn into the Medicare Shared Savings Program, which was created in statute in the [Affordable Care Act] and doesn't really fit this same testing-diffusion paradigm.
Integrating RECIST and Clinician Approaches Boosts NSCLC Research
May 8th 2024Outcomes among patients with stage IV non–small cell lung cancer as evaluated within clinical trials via Response Evaluation Criteria in Solid Tumors (RECIST) and clinician response criteria in observational studies were compared for their concordance and reliability.
Read More
Tackling Health Inequality: The Power of Education and Experience
April 30th 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our final episode of this limited series and our conversation with Janine Jelks-Seale, MSPPM, director of health equity at UPMC Health Plan.
Listen
The Joint Commission is launching the Rural Health Clinic Accreditation Program to standardize staff training and patient care practices at rural health clinics nationwide; the American Cancer Society recently launched the largest-ever study of cancer risk and outcomes in Black women; the HHS COVID-19 vaccination campaign saved $732 billion by preventing illness and related costs.
Read More
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
Listen
AA Unlikely to Cause Anxiety, Depression but May Be Affected by Mental Illness
May 7th 2024A Mendelian randomization study using genetic analysis found that alopecia areata (AA) increases the risk of anxiety and depression, but not the other way around, providing unique evidence for a causal link while adding to existing evidence.
Read More