Health Care Cost

Bundled payments may be part of the future in healthcare’s move to value-based care, but this payment scheme runs into the challenge of penalizing providers for factors that are beyond their control, explained Joshua T. Cohen, PhD, research associate professor of medicine at Tufts Medical Center.

During the last month of 2015, The American Journal of Managed Care asked readers to choose what they thought was the top healthcare story from the year. Options included overall themes from the year and specific events.

The most read articles from The American Journal of Accountable Care explore the future of healthcare delivery as the United States moves to value-based care.

A new study published by the American Cancer Society found that younger colorectal cancer survivors end up spending over $8500 annually in medical expenses and they also experience significantly greater loss of productivity compared with individuals without cancer.

The rising cost of drugs was in the spotlight in 2015, and the manuscripts in The American Journal of Pharmacy Benefits highlights the growing concerns of the healthcare industry in regards to rising expenditures.

As the healthcare system moves to an environment of value-based payment, bundled payments could become the next step in healthcare transformation. However, there are both opportunities and risks in this form of value-based payment, explained Michael Ciarametaro, MBA, director of research at the National Pharmaceutical Council, at the ISPOR 20th Annual International Meeting.

Providers and payers came together to discuss challenges and share success stories as they adapt to the changing healthcare realm.

Most physicians consider telehealth a promising tool in improving patient access to primary care services, but only 15% use it in their practice.

HIMSS is working to determine the readiness of providers to participate in the types of value-based payment models that CMS is moving toward.

The effort comes at a key time: CMS is moving ahead at full steam to require more use of alternate payment models in reimbursement.

The 17% decline in hospital-acquired conditions from 2010 to 2014 is the result of a decades long campaign and means lives saved, the avoidance of pain and suffering, and less costly care, said David Blumenthal, MD, MPP, president of The Commonwealth Fund.

The current dialogue occurring between payers and providers is critical in today's healthcare environment, and it's an interaction that certainly was not happening just 5 or 6 years ago, according to Ted Okon, executive director of the Community Oncology Alliance.

Initial adoption of clinical pathways grew from payers mandating their use with individual providers, but there is now greater interest from accountable care organizations and others to use pathways to reduce variation and cost while improving outcomes, explained Robert Dubois, MD, PhD, chief science officer and executive vice president of the National Pharmaceutical Council.