Health Care Cost

When accountable care organizations first started forming, the country thought it would be easier than it has been, but finding the right partner is crucial, said Pam Halvorson, regional vice president of clinic operations with Trinity Pioneer ACO.

What we're reading, November 3, 2015: off-label drug use is associated with a higher risk of adverse drug events; CMS finalizes its rule for advanced care planning for end-of-life care; and Californians send measure to cut drug prices to the vote.

The Community Oncology Alliance (COA) created its Payer Exchange Summit to get payers who are thinking about getting involved in oncology payment reform or want to know what to do exposed to successful pilots, explained Ted Okon, MBA, executive director of COA.

Payer—provider teams presented updates on their cost-saving pilot projects and looked to the future of these models in oncology care.

The shift to a pay-for-performance environment healthcare gets the provider more involved with the patient, which has a greater impact on quality measures like adherence, said Mitzi Wasik, PharmD, BCPS, director of Pharmacy Medicare Programs at Aetna, Inc.

A new study in JAMA Internal Medicine has found that financial integration between physicians and hospitals has led to higher spending in outpatient care.

Better support for healthcare providers to reduce stress and prevent burnout was a key point of conversation during the opening keynote at US News & World Report's third annual Hospital of Tomorrow forum in Washington, DC.

As the country moves from volume to value, accountable care organizations (ACOs) can play a key role during the transition from fee-for-service. How well do you know ACOs?

Even though the US spent far more on healthcare in 2013 than other comparable high-income countries, it has the lowest life expectancy and some of the worst health outcomes, according to a study by The Commonwealth Fund.

Pathways are still a young enterprise so barriers to their adoption are being more readily recognized than the number of problems being solved are, according to Robert Dubois, MD, PhD, chief science officer and executive vice president of the National Pharmaceutical Council.

Pregnant women need clear, transparent information on the costs associated with childbirth so they can derive the most value form the healthcare they receive.

Although CMS has introduced a strict timeline to move to value-based payments, its new Oncology Care Model is partially relying on fee-for-service, and that's a good thing in the case of oncology, said Ira Klein, MD, MBA, senior director of quality, Strategic Customer Group at The Janssen Pharmaceutical Companies of Johnson & Johnson.

With pay-for-performance evolving from the "check-the-box" model, providers need to learn to work within teams that can understand these new programs, explained Mitzi Wasik, PharmD, BCPS, director of Pharmacy Medicare Programs at Aetna, Inc.

Meaningful use stage 3 is not scheduled to start until 2017, but 41 medical societies are calling to delay the start of stage 3, especially given recent changes to Medicare.

Multispecialty medical groups and integrated delivery systems expect fee-for-service payments to decline 24% in the next 2 years, according to results of a survey from the American Medical Group Association.