February 23rd 2024
While adopting new payment models can come with challenges, there are strategies that can help oncology practices optimize their approaches, said Kathy Oubre, MS, CEO of Pontchartrain Cancer Center.
February 14th 2024
Progress With Risk-Based Agreements Failing to Keep Pace With Expectations
April 11th 2018The third annual population health survey from Numerof & Associates found that healthcare organizations have not made as much progress to transition to risk-based agreements as they predicted they would 2 years ago.
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New MIPS Improvement Activity Supports Remote Patient Monitoring
April 7th 2018Despite growth in the market, CMS has been slow to recognize the value that telehealth can bring to clinical encounters by encouraging utilization of telehealth technology through reimbursement models. However, now CMS has taken steps to encourage practices to leverage telehealth and remote monitoring activities through changes to the Quality Payment Program.
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Health Policy Experts Voice Ways to Tame Rising Drug Costs, Protect Patients
April 3rd 2018Health policy experts laid out a series of proposals to bring down prescription drug costs, lower US healthcare spending, and protect patients in a series of 3 papers published recently in Health Affairs. The papers, supported by the Commonwealth Fund, advocate for increasing competition, applying value-based purchasing, and protecting patients from high out-of-pocket costs.
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MSSP ACOs Fall Short of Projected Savings Estimates
March 30th 2018With most accountable care organizations (ACOs) continuing to participate in the upside-only track, the Medicare Shared Savings Program has not netted the savings that the Congressional Budget Office estimated in 2010. But some findings indicate the program will see greater savings as more ACOs transition to the downside-risk tracks and gain more years of experience.
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Designing APMs to Avoid Harm in Vulnerable Populations
March 28th 2018In a commentary for New England Journal of Medicine, Karen E. Joynt Maddox, MD, MPH, of Washington University School of Medicine, outlines key principles for designing alternative payment models (APMs) to avoid harming vulnerable populations and penalizing the providers who care for them.
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Study Models ASCO Alternative Payment Model in Advanced Ovarian Cancer Care
March 27th 2018At the Society of Gynecologic Oncology’s 2018 Annual Meeting on Women’s Cancer, 1 abstract found Patient-Centered Oncology Payment model would yield savings if hospitalizations were reduced, while another abstract piloted a scoring system for financial toxicity in gynecological cancers.
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This Week in Managed Care: March 23, 2018
March 23rd 2018This week, the top managed care stories included changes to the Next Generation ACO Model caused 7 accountable care organizations to leave the model; a report highlights how quickly hospital acqusition of physician practices is occurring; CMS finalizes coverage for Next-Generation Sequencing tests.
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Seven ACOs Exit Next Generation Model, Blaming CMS for "Unilateral" Changes
March 22nd 2018Two years ago, CMS announced a new model for accountable care organizations (ACOs) that had participants take on greater performance risk but also potentially greater rewards. After the Next Generation ACO Model grew to a list that included 58 organizations across the nation, 7 have now dropped out after CMS made changes to risk adjustment.
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Maryland All-Payer Hospital Model Reduces Costs, Lowers Readmissions
March 20th 2018In 2014, Maryland and CMS entered a 5-year agreement employing the All-Payer Hospital Model in the state to cut costs while improving quality. According to the year 3 performance data, Maryland has met or is on track to meet all model requirements, saving hundreds of millions of dollars as it lowers hospital readmissions and steers the state away from a volume-based system.
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How Public Payers Are Adopting VBID Principles Despite Constraints
March 18th 2018During a session on expanding the role of value-based insurance design (VBID) in public insurance at the University of Michigan V-BID Center’s annual V-BID Summit on March 14, panelists representing 3 different payers shared how they have seen value-based principles take hold in their plans and their predictions for the future.
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How Public Payers Are Adopting VBID Principles Despite Constraints
March 18th 2018During a session on expanding the role of value-based insurance design (VBID) in public insurance at the University of Michigan V-BID Center’s annual V-BID Summit on March 14, panelists representing 3 different payers shared how they have seen value-based principles take hold in their plans and their predictions for the future.
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Investing in the Vital Role of a Cancer Care Coordinator
March 16th 2018At the Association of Community Cancer Centers' 44th Annual Meeting & Cancer Center Business Summit, held March 14-16, 2018, in Washington, DC, panelists shared strategies that have helped their organizations adapt to value-based care while ensuring that they never lose sight of the patient at the center of it all.
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Aligning Around Value: Challenges With Quality Measures and Implementing Clinical Nuance
March 16th 2018Panelists Kavita Patel, MD, Brookings Institute; Michael E. Chernew, PhD, Harvard Medical School; and Katy Spangler, Spangler Strategies discussed implementing the value-based insurance design concept in health policy and payment models, challenges with quality measurements, the role of employers in value-based care, and more at the VBID Summit, held March 14 by the University of Michigan Center for Value-Based Insurance Design.
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Changing Trends in Oncology Practice: Value-Based Care and an Empowered Patient
March 16th 2018What are the biggest drivers of change in oncology care and what needs most attention? This was the crux of the discussion during an early panel at the Association of Community Cancer Centers' 44th Annual Meeting & Cancer Center Business Summit, held March 14-16, 2018, in Washington, DC.
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Improving Quality of Care in Oncology Through Healthcare Payment Reform
Overview of alternative payment models and how leading national organizations are involved with linking quality improvement initiatives and payment reform.
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For Patients With Heart Failure, Healthcare Reform Brings Change and Unintended Consequences
March 12th 2018Healthcare reform pledged to do better for patients with heart failure, creating the incentives and team-based approaches these fragile patients need. In some cases, this has happened, but there have also been unintended consequences, according to a panel appearing Sunday at the 67th Scientific Session of the American College of Cardiology, being held in Orlando, Florida.
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Thirty-Day Readmissions: Relationship to Physician Attending Type and Social Connectedness
This study examined patient clinical and demographic characteristics, healthcare system factors, and patients’ experiences of care associated with 30-day readmissions in a hospital with a Pioneer Accountable Care Organization.
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Policy Improvement Areas to Reduce Financial Hardship
March 8th 2018Elected officials and others who affect policy know that cost-sharing and out-of-pocket costs are issues in healthcare, but they don’t truly understand the issues, said panelists during a policy discussion on ways to improve access and reduce financial hardship during the Cost-Sharing Roundtable.
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UnitedHealthcare Reports Positive Shift Toward Value-Based Care Plans
March 7th 2018A continued shift towards value-based care incentivizes better health behaviors and improves coordination of care among healthcare providers by focusing on cost savings, according to UnitedHealthcare’s second annual report on value-based care.
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Reacting to the Results of the First Performance Period of OCM
March 4th 2018The first results of the Oncology Care Model (OCM), a 5-year bundled payment demonstration from CMS, were released recently, and at a session at the National Community Oncology Dispensing Association Spring Forum 2018, Mike Fazio of Archway Health discussed the reconciliation statements from the first performance period of OCM, and where practices can look to make improvements going forward.
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