Health Care Cost

Keynote speaker Dr Julie Vose said the oncologist faces many administrative burdens in the transition to value-based care. Solving them is essential to spending more time with the patient.

The value of the ACO & Emerging Healthcare Delivery Coalition live meetings is the information exchange that happens among organizations that are all looking at the same problem but from different angles, said Tabatha Dragonberry.

The top stories in managed care this week include findings on cancer survival disparities, CVS Health claimed drug spending growth slowed in 2015, and Horizon Blue Cross Blue Shield of New Jersey's OMNIA plan is interfering with existing patient-centered medical homes.

Pay-for-performance (P4P) programs have the potential to improve overall quality of care and the prevalence of these programs has increased in the last 15 years. Here are 5 things to know about P4P and how it can impact healthcare in the move to value-based care.

Payment reform in the US is progressing considerably, but more transparency is necessary in order to change payment for the better in the United States, said Elizabeth Mitchell, president and CEO of the Network for Regional Healthcare Improvement.

Ted Okon, MBA, of the Community Oncology Alliance, will participate in a tweetchat with The American Journal of Managed Care on February 29, 1-2 pm ET, to discuss the 340B program, payment reform, the Oncology Medical Home, and more.

The full slides from the 2015 Patient-Centered Diabetes Care keynote speech, where Robert A. Gabbay, MD, PhD, discussed new care models being implemented to improve patient health in the long term.

Risk adjustment for social determinants of health could reduce penalties to children’s hospitals for patient factors that are beyond their control, according to the results of a new study published in JAMA Pediatrics.

Population health, healthcare value, innovations in healthcare, cost of care-these were just some of the topics discussed at the meeting.

The shared savings payments were for specialists in hip and knee replacements, knee arthroscopy, and pregnancy. These areas have been among CMS' top targets for savings, while New Jersey has been focused on reducing its high rate of C-sections.

A collaboration led by CMS and America’s Health Insurance Plans released 7 core sets of quality measures created to reduce complexity, decrease cost burden, and ensure high-quality care.

A summary of updated breast cancer screening guidelines, MEDPAC recommendations for 340B, and disparity in survival of young patients with Hodgkin lymphoma.

A. Mark Fendrick, MD, co-editor-in-chief of The American Journal of Managed Care and director of the University of Michigan Center for Value-Based Insurance Design, testified before a Michigan senate subcommittee on the benefit of clinical nuance.

What we're reading, February 9, 2016: Novartis signs 2 performance-based deals for its new heart drug; 8 states significantly reduced uninsured rates; and the Obama administration will ask for $1.8 billion to prepare to fight the Zika virus.

The Network for Regional Healthcare Improvement (NRHI) has been leading a project to measure and report on total cost of care across different regions, and the end result could inform payment change, care delivery design, and health policy, explained Elizabeth Mitchell, president and CEO of NRHI.

Patrick Conway, MD, MSc, deputy administrator for innovation and quality and chief medical officer at CMS, describes the proposed changes to the Medicare Shared Savings Program and how they will assist accountable care organizations transitioning to tracks with more risks.

The latest piece in HHS’ roadmap to move the healthcare industry to value-based payments is the Accountable Health Communities model. Here are 5 things to know about how this model addresses social determinants of health.

The healthcare industry is undergoing payment reform, which includes important initiatives like addressing social determinants of health, but may not be keeping the patient perspective central as these changes are made, Lewis Sandy, MD, senior vice president of Clinical Advancement at UnitedHealth Group, said at the AcademyHealth National Health Policy Conference.

There is a huge range in readiness when it comes to making the move to merit-based incentive payments, but in order to successful make the transition successfully, organizations need the structures in place, the leadership on board, and relationships with the community, explained Elizabeth Mitchell, president and CEO of the Network for Regional Healthcare Improvement.

While the pace of payment reform is moving quickly, Patrick Conway, MD, MSc, deputy administrator for innovation and quality and chief medical officer at CMS, said he thinks about how to maintain that pace.

An infographic that looks at what it means to be a physician leader, based on an interview with Anthony D. Slonim, MD, DrPH, president and chief executive officer for Renown Health.

At the annual meeting of the American Society of Hematology, physicians gathered to discuss the impact of alternate payment models on clinical practice.

CMS has proposed changes to accountable care organizations benchmarks in the Medicare Shared Savings Program, as well as a way to better facilitate the transition to performance-based risk.

The 3 prescriptions for reforming the 340B Drug Discount Program proposed by authors in the December issue of Evidence-Based Oncology would limit safety net hospitals' abilities to treat vulnerable patients.

Accountable primary care is essential in lowering healthcare costs as a whole and making it care more accessible to patients. Debbie Zimmerman, MD, chief medical officer of Lumeris, discussed how to improve primary care and get primary care physicians aligned with the delivery of accountable care.

For the second year, Anthony D. Slonim, MD, DrPH, is in the running for Modern Healthcare’s 50 Most Influential Physician Executives and Leaders. Recently, he discussed what it means to be a physician leader, the industry’s move to population health, and more.

As Americans as asked to pay a greater portion of their healthcare expenditures, new insurance design models are being implemented, such as value-based insurance design, to combat issues like nonadherence.

Robert W. Dubois, MD, PhD, of National Pharmaceutical Council, will discuss care pathways, how they are created, their implementation in US healthcare, and more, on January 28, 1-2 pm ET, during a tweetchat.

The digital health panel at the JP Morgan Healthcare Conference analyzed how the industry can move from collecting data to turning it into actionable and useful information.

Placing greater focus on patient experience can build trust between consumers and healthcare organizations, which important for the effectiveness of the healthcare system, said Ashish K. Jha, MD, of the Harvard T.H. Chan School of Public Health.