
Financial results from the first 2 years of the Pioneer ACO Model reveals the gains and losses of the 32 organizations that started the program, and illuminates why just 19 remain.

Laura is the vice president of content for The American Journal of Managed Care® (AJMC®) and all its brands, including Population Health, Equity & Outcomes; Evidence-Based Oncology™; and The Center for Biosimilars®. She has been working on AJMC since 2014 and has been with AJMC’s parent company, MJH Life Sciences®, since 2011.
She has an MA in business and economic reporting from New York University. You can connect with Laura on LinkedIn or Twitter.

Financial results from the first 2 years of the Pioneer ACO Model reveals the gains and losses of the 32 organizations that started the program, and illuminates why just 19 remain.

The majority of low-income adults in 3 states favored Medicaid expansion, but knowledge about their states' plans for the program under the Affordable Care Act was low, according to a report from the Commonwealth Fund.

CMS released financial results from the first 2 years of the Pioneer ACO program. The program is down to 19 accountable care organizations from the original 32 that started the program, and the financial results reveal why those that dropped out did so.

Over the last decade, all 5 national coordinators for health information technology have discussed the importance of connecting healthcare data, but the timing is finally right now, according to Karen B. DeSalvo, MD.

Although people seem to assume Big Data will answer all questions and improve quality of care while increasing efficiencies, the healthcare industry needs to focus on what data is actually actionable, according to John Halamka, MD, chief information officer at Beth Israel Deaconess.

Including pharmacy benefits as part of an employer's total health insurance benefit package has clear health benefits and cost savings, according to a study from Blue Cross Blue Shield Association and Prime Therapeutics, LLC.

During the third year of the Hospital Readmission Reduction Program, CMS will penalize more hospitals than it did during the second and third years of the program; however, the overall readmission rate for Medicare beneficiaries is down.

The rising cost of prescription drugs, CMS initiative updates, and successes in home and community-based services for dual Medicare and Medicaid beneficiaries were discussed at the America's Health Insurance Plans' National Conferences on Medicare and Medicaid, and Dual Eligibles Summit in Washington, DC.

Hepatitis C and the price of Sovaldi were, understandably, the main focus of aconversation on rising prescription drug prices at the America's Health Insurance Plans' National Conferences on Medicare and Medicaid, and Dual Eligibles Summit in Washington, DC.

A new information governance framework of 8 principles from the American Health Information Management Association aims to help meet the patient care, safety, and operational goals of healthcare organizations.

At $531 billion, Medicaid is the second largest piece of healthcare spending and cannot be pushed off to be thought about another day, Cindy Mann, JD, CMS deputy administrator and director of the Center for Medicaid and CHIP Services, said at the America's Health Insurance Plans' National Conferences on Medicare and Medicaid and Dual Eligibles Summit.

The first round of Open Payments data, known as the Physician Payments Sunshine Act, were made public Tuesday and revealed 4.4 million payments valued at nearly $3.5 billion paid out to 546,000 individuals and almost 1346 teaching hospitals.

At the America's Health Insurance Plans' National Conference on Medicare and Medicaid and Dual Eligibles Summit in Washington, DC, Patrick Conway, deputy administrator for innovation and quality and chief medical officer for CMS, spoke on the future of delivery system reform.

Plans designed specifically for disabled dual-eligible Medicare and Medicaid beneficiaries are not necessarily enough to reduce use of costly services, according to a new report from the Government Accountability Office.

Medicaid enrollment under the Affordable Care Act grew even in states that chose not to expand eligibility, making access to care a more pressing issue, according to a new report issued by HHS' Office of the Inspector General.

Nearly $212 million in grant awards has been made available to all 50 states and the District of Columbia to support programs aimed at preventing chronic diseases, according to a recent announcement by HHS Secretary Sylvia M. Burwell.

UnitedHealthcare is establishing new accountable care organizations with Advocate Health Care and Illinois Health Partners that will provide coordinated care for more than 65,000 Illinois residents.

Healthcare providers have shown a lack of progress regarding ICD-10 readiness compared with a year ago, while vendors are mostly prepared, according to a new WEDI survey.

Poor interoperability across health information technology systems is preventing accountable care organizations from using the technology to improve clinical quality.

The uninsured rate among Latinos dropped sharply under the Affordable Care Act, but there were stark differences between states that have expanded Medicaid and those that have not.

The Affordable Care Act will save hospitals a projected $5.7 billion in uncompensated care this year, according to a report released by HHS. Roughly three-quarters of those savings are coming from Medicaid expansion states.

Patient experience and satisfaction is becoming an increasingly important aspect of providing healthcare, and a new roadmap outlines opportunities and key strategies to include patients and families in healthcare delivery.

The health insurance Marketplace will have 77 new insurers offering coverage in 2015, according to a report released by HHS. Overall, there will be a net 25% increase in the number of insurers that consumers will be able to choose from.

Driven by a consolidation of offerings, the number of Part D prescription drug plans will decrease by 14% in 2015. While monthly premiums will decrease overall by 2%, there will be large premium variations.

Only a small proportion of industry stakeholders find any value in using the unique Health Plan Identifier within transactions, according to survey results from WEDI.

In 2013, lower health insurance rates saved consumers a total of $1 billion. States that enhanced their rate review programs will receive $25 million in rate review grant awards.

Since 2000, small-group health insurance premiums averaged annual increases of 5.5% nationally; however, double-digit increases were not uncommon, according to a report from the Urban Institute.

Although a majority of adults with health insurance purchased through the Affordable Care Act's marketplace said they find it easy to afford the care they need, the number of people still enrolled has dipped to 7.3 million, according to recent numbers.

After examining the security and privacy of the Healthcare.gov website and its supporting systems at CMS, the Government Accountability Office published a report with 6 security management and 22 technical security recommendations.

As part of National Health IT Week, the Office of the National Coordinator for Health IT, outlined its 10-year vision to achieve interoperability for health IT.

259 Prospect Plains Rd, Bldg H
Cranbury, NJ 08512
© 2025 MJH Life Sciences®
All rights reserved.
