Value-Based Care

While Joe Antos, PhD, the Wilson H. Taylor Scholar in Health Care and Retirement Policy at the American Enterprise Institute, believes that the ACO model is here to stay, he said that the way these organizations operate are likely to change.

Medicare accountable care organizations have either not yet focused on mental illness or have been, for the most part, unsuccessful in early efforts to improve their management of it.

Maximizing the utility of technology platforms and making them meaningful to ensure quality cancer care was the underlying theme of Emerging Issues and Opportunities in Health Information Technology, a National Comprehensive Cancer Network Policy Summit, held June 27, 2016, in Washington, DC.

Many accountable care organizations are beginning to adopt various programs or strategies into their framework to increase patient access to behavioral health care, but several challenges remain.

Stephen Nuckolls, CEO of Coastal Carolina Quality Care, explained during his presentation at the National Association of Accountable Care Organizations Spring 2016 Conference that the more physicians read and learn about value-based care, the more they are accepting the change. He added that as the idea has become more accepted, ACOs are beginning to evolve as well.

Critics of the Hospital Compare "Star" ratings ask whether the failure to take patient wealth into account unfairly penalizes hospitals that care for larger numbers of poor patients.

As the healthcare industry moves from volume to value, new healthcare delivery models are being tested and promoted, and CMS has put a lot of faith into the accountable care organization. So has Aledade.

Although the term "accountable care organization" (ACO) may not be here to stay, value-based organizations are here to stay based on the direction CMS is headed, said Jeb Dunkelberger, vice president of accountable care services at McKesson and clinical & commercial operations at ACO Partner.

Analyzes whether hospital participation in accountable care organizations is associated with a hospital’s quality and cost improvement outcomes in other Medicare value-based payment programs.

While speaking at the National Association of Accountable Care Organizations Spring 2016 Conference, Stephen Nuckolls, CEO of Coastal Carolina Quality Care, said that fair and transparent benchmarks are important in creating successful ACO programs.

The president predicts that in 20 years, the nation will look back on "Obamacare" as a moment of courage that has improved people's lives.

One of the biggest concerns Farzad Mostashari, MD, chief executive officer of Aledade, has about accountable care organizations, is that they are going to experience backlash similar to what managed care has received in the past.

This week, the top stories in managed care include the largest healthcare fraud takedown, one successful accountable care organization imparted its secrets, and a report identifies pharmacy trends in the public health exchanges.

In the most recent Web-based session of The American Journal of Managed Care’s ACO & Emerging Healthcare Delivery Coalition, speakers examined 3 practice transformation models.

More insurers are moving towards alternative payment and delivery models, but the transition needs to happen a lot quicker, explained Michael E. Chernew, PhD, during a panel discussion at the ACO & Emerging Healthcare Delivery Coalition Spring Live Meeting.

Coverage from Patient-Centered Diabetes Care, April 7-8, 2016. Presented by The American Journal of Managed Care and Joslin Diabetes Center.

In order to get physicians engaged and involved in accountable care organizations (ACOs), it is important to educate them on the mission and understand that the organization is looking to improve, not ration, care, Stephen Nuckolls, CEO of Coastal Carolina Quality Care, explained at the National Association of Accountable Care Organizations Spring 2016 Conference.

More than 58% of healthcare payers’ businesses have already shifted to full value-based reimbursement models, a 10% increase since 2014.

A new analysis by the Dartmouth Institute has found that Medicare accountable care organizations (ACOs) are making modest yet increasing gains when treating patients with comorbidities.

Carolinas HealthCare System created a behavioral health service line to drive transformation in value-based healthcare. Four projects are described, which demonstrate that modest investment in behavioral health pays dividends in reduced cost and increased quality and experience.

For 2 successive years, the Hackensack Alliance Accountable Care Organization achieved cost savings and maintained quality by using physicians with patient-centered medical homes and nurse care coordinators focused on high-risk patients.

An expert panel at The Community Oncology Conference: Innovation in Cancer Care, held in Orlando, Florida, April 13-15, 2016, provided insight on current transitions in healthcare reform, and their predictions for the future.

Recently, McKesson Business Performance Services and Blue Cross Blue Shield of Arizona partnered to form ACO Partner, a shared savings program focused on improving outcomes and costs.

Many large, well-integrated medical groups with infrastructure to manage care effectively continue to receive a majority of revenue from fee-for-service and pay physicians based on productivity.

Scottsdale Health Partners helps patients with social needs through a complex care coordination program and working with community resources like adult protective services or other city government branches, James Whitfill, MD, chief medical officer, explained at the National Association of ACOs Spring 2016 Conference.

Poster presentations at the American Diabetes Association Scientific Sessions compared canagliflozin, an SGLT2 inhibitor, to sitagliptin, a popular DPP-4 inhibitor, using claims data.

The new accountable care organization (ACO) benchmarking rule changes it so ACOs aren't just competing against themselves and transitions so ACOs have to be better than others in their region, Farzad Mostashari, MD, chief executive officer of Aledade, explained at the National Association of ACOs Spring 2016 Conference.

As the most advanced accountable care organization (ACO) model, Next Generation ACO has its appeal. However, it is the riskiest model, and one ACO explains why it decided to stay with the Medicare Shared Savings Program.

High costs associated with specialty pharmacy will necessitate the evolution of a new specialized model to help ensure that patients are receiving the financial assistance they need and adhering to their treatment, according to Steve Miller, MD, senior vice president and chief medical officer of Express Scripts.

Accountable care organizations have to work more on engaging physicians in meaningful leadership roles and should focus on learning about patient goals, said James Whitfill, MD, chief medical officer of Scottsdale Health Partners.