Healthcare Cost

Mike Fazio: Practices Are Happier With PP4 Results in the OCM

September 07, 2019

Video

There are less surprises in the results for performance period 4 of the Oncology Care Model, and practices seem to be mostly happier with how they’ve done, said Mike Fazio, senior vice president of client services, Archway Health.

Dr Shalom Kalnicki Discusses Bringing Value-Based Care to Radiation Oncology

September 01, 2019

Video

The cost of radiation oncology services has typically been a small part of the Medicare and Medicaid budget, but with more patients having complex radiation treatments, it is becoming more important to have alternative payment models in the space, said Shalom Kalnicki, MD, FASTRO, FACRO, professor and chairman, radiation oncology, Montefiore Einstein Center for Cancer Care and Albert Einstein College of Medicine.

Travis Broome Discusses Participating in Multiple Payment Reform Models

July 30, 2019

Video

Practices should make deliberate choices when choosing to participate in multiple payment reform models and should not just participate in something because it is the newest model, said Travis Broome, vice president of policy at Aledade.

Travis Broome: ACOs Are Being Affected Differently by Pathways to Success Transition

July 19, 2019

Video

Depending on how ready accountable care organizations (ACOs) are to move to risk probably affects how they view CMS’ decision to transition the Medicare Shared Savings Program (MSSP) to Pathways to Success, said Travis Broome, vice president of policy at Aledade.

Travis Broome Weighs In on the Push to Mandatory Payment Models

July 07, 2019

Video

The healthcare system has a long way to go to make voluntary payment models more attractive before it can consider making payment models mandatory, said Travis Broome, vice president of policy at Aledade.

Collective Action Can Make Impossible Things Happen in Healthcare

June 28, 2019

Article

Bringing together different stakeholders in healthcare to share the challenges they see and their own understanding of how to fix the problem can help make impossible things happen and bring change to the healthcare system, said Elizabeth Mitchell, president and chief executive officer, Pacific Business Group on Health.

Removing Barriers to Improve the Use of Diagnostic Tests for Precision Cancer Care

June 21, 2019

Article

Currently, the number of patients who are actually utilizing precision cancer care treatments is small, but it is growing fast. As that happens, physicians will need to get comfortable with ordering the right tests, explained Clynt Taylor, chief executive officer of Intervention Insights, and Lee Newcomer, MD, formerly of UnitedHealth Group.

Savings of MSSP ACOs May Be Overstated, Annals Study Finds

June 18, 2019

Article

Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) cover more than 32 million lives and have been found to save money and improve quality in past research, but a new study in Annals of Internal Medicine is calling their success into question.

An Update on the Work of the Medicaid Transformation Project

June 05, 2019

Podcast

The American Journal of Managed Care® sat down with David Smith, the executive director of the Medicaid Transformation Project, to get an update about the integration challenges health systems are facing, including system issues, infrastructure issues, coding and payment issues, and more.

Study Questions Penalizing, Incentivizing PCPs for Readmission Rates

May 21, 2019

Article

A study of readmission rates by primary care providers (PCPs) finds a lack of variation and calls into question implementing pay-for-performance programs that incentivize or penalize PCPs for readmissions.