Health Care Cost

One of the challenges providers will face in the new Oncology Care Model that CMS announced earlier this year is measuring quality and meeting quality standards under, according to Patti Forest, MD, MBA, senior medical director of network quality and performance at Blue Cross Blue Shield of North Carolina.

Adoption of alternative payment models that reduce the number of visits to the emergency department could cause unintended consequences for emergency care through a reduction in revenue, according to researchers at the Brookings Institute.

The authors report on a conceptual "specialty ACO" design in cardiology in which cardiology-specific historic spending targets are created to capture cardiovascular disease—related reimbursement and a quality measurement system is introduced.

In its third year, Patient-Centered Diabetes Care, which took place April 16-17, 2015, in Boston, showed how new payment models, new therapies, and new approaches to patient engagement are changing care for persons with diabetes. The American Journal of Managed Care and Joslin Diabetes Center presented this year's meeting.

Pathways, particularly in oncology, have been gaining a lot more attention lately as payers are looking to bundle payments, Robert W. Dubois, MD, PhD, chief science officer and executive vice president of the National Pharmaceutical Council, explained at the Academy of Managed Care Pharmacy's 27th Annual Meeting & Expo in San Diego, April 7-10.