ACOs With Risk-Bearing Experience Are Likely Taking Steps to Reduce Low-Value Medical Services
Experience with risk-based contracting best predicts active engagement of accountable care organizations in reducing low-value medical services, mainly through physician education and encouraging shared decision making.
Overuse and Insurance Plan Type in a Privately Insured Population
Health insurance plan type may be an important lever for reducing low-value healthcare use among patients with commercial insurance.
Measuring Overuse With Electronic Health Records Data
Electronic health records data can accurately quantify overuse of clinical services and the risk factors that may trigger low-value testing and screening.
New Strategies for Aligning Physicians With Health System Incentives
This article details strategies based on principles from psychology and economics that health systems may use to align with physicians.
Physician Perceptions of Choosing Wisely and Drivers of Overuse
The authors surveyed physicians regarding “Choosing Wisely” and hypothesized drivers of overuse, finding high reported prevalence of hypothesized drivers of overuse and widespread support for cost-consciousness.
Structural Capabilities in Small and Medium-Sized Patient-Centered Medical Homes
Thirty medical home pilot primary care practices had high structural capabilities at baseline and performance improved substantially after 24 months in practices starting with lower capabilities.
Infused Chemotherapy Use in the Elderly After Patent Expiration
As calls for improving the quality and cost efficiency of oncology increase, future empirical work is needed to examine the responsiveness of oncologists' treatment decision making to incentives among patients of all ages and insurance types.
Health Plan Resource Use Bringing Us Closer to Value-Based Decisions
There is a critical need for comparative information about plan resource use to support value-based purchasing efforts.
Use of Well-Child Visits in High-Deductible Health Plans
When preventive care was exempt from the deductible, well-child visits did not change for children switching from traditional plans to high-deductible plans.
Value and the Medical Home: Effects of Transformed Primary Care
A patient-centered medical home with intensive case management and a payer partner can significantly improve hospital utilization and may decrease total medical costs for a Medicare population.
Consumer Experience With a Tiered Physician Network: Early Evidence
A consumer survey on awareness, use, and trust of tiered provider networks indicated the need for increased consumer awareness of the networks.
Do Patients Continue to See Physicians Who Are Removed From a PPO Network?
We examined patient response to a narrowing of a preferred provider organization network that effectively raised the out-of-pocket price for a few physicians.
Bridges to Excellence—Recognizing High-Quality Care: Analysis of Physician Quality and Resource Use
Physicians recognized as high quality by Bridges to Excellence performed better than their peers on claimsbased quality measures and, in some cases, on resource use measures.
Quality Monitoring and Management in Commercial Health Plans
This survey of 252 HMOs found that almost all measure their performance on multiple indicators of quality and most use these data in quality improvement activities.
Incentive Formularies and Changes in Prescription Drug Spending
P4P: Rumors of Its Demise May Be Exaggerated
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