Health Care Cost

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.

An infographic that looks at 3 factors impacting diabetes care, based on the keynote speech from Patient-Centered Diabetes Care 2015 from Robert A. Gabbay, MD, PhD, of Joslin Diabetes Center.

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.