Health Care Cost

Adoption of alternative payment models that reduce the number of visits to the emergency department could cause unintended consequences for emergency care through a reduction in revenue, according to researchers at the Brookings Institute.

The authors report on a conceptual "specialty ACO" design in cardiology in which cardiology-specific historic spending targets are created to capture cardiovascular disease—related reimbursement and a quality measurement system is introduced.

In its third year, Patient-Centered Diabetes Care, which took place April 16-17, 2015, in Boston, showed how new payment models, new therapies, and new approaches to patient engagement are changing care for persons with diabetes. The American Journal of Managed Care and Joslin Diabetes Center presented this year's meeting.

Pathways, particularly in oncology, have been gaining a lot more attention lately as payers are looking to bundle payments, Robert W. Dubois, MD, PhD, chief science officer and executive vice president of the National Pharmaceutical Council, explained at the Academy of Managed Care Pharmacy's 27th Annual Meeting & Expo in San Diego, April 7-10.

HHS Secretary Sylvia M. Burwell's announcement that CMS would move to value-based payments was a nail in the coffin for those skeptics who believed the push for value contracting would pass, according to Joseph Gifford, MD, chief executive of the Providence-Swedish Health Alliance.

The Health Care Payment Learning and Action Network kicked off with its inaugural meeting bringing together public and private sector actors to discuss efforts to move healthcare toward a system that pays based on quality rather than quantity.

Physician practices looking to engage in new healthcare payment models reported they need help and guidance to further advance delivery reforms, according to a joint study from the RAND Corporation and the American Medical Association.

Providers' perspectives point to key considerations for policy makers as they seek to broaden participation in the Bundled Payments for Care Improvement Initiative.