Value-Based Care

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

In a webinar, experts outlined challenges providers face amid the coronavirus disease 2019 (COVID-19) pandemic and the benefits of increased access to high-value care during the outbreak and beyond.

A complex care management program implemented at 5 Next Generation accountable care organizations reduced all-cause inpatient admissions and total medical expenditures for participating beneficiaries.

This study compares health care costs and health services utilization patterns of patients receiving care in accountable care organization (ACO), patient-centered medical home (PCMH), hybrid (ACO + PCMH), and standard (neither ACO/PCMH) facilities.

During the National Association of Accountable Care Organizations Virtual 2020 Spring Conference, panelists discussed how data sharing can be implemented in health care systems and spur the evolution of population health management.

Coverage of our peer-reviewed research and news reporting in the health care and mainstream press.

Coverage of our peer-reviewed research and news reporting in the health care and mainstream press.

Since 2015, the majority of new accountable care organizations (ACOs) have been led by physician groups rather than hospital systems. This shift requires policies that address the characteristic strengths and weaknesses of physician-led ACOs.

This week, the top managed care news included a report that accountable care organizations may drop out of the Medicare Shared Savings Program; states and healthcare plans address unemployment brought on by COVID-19; a sneak peek of the virtual 2020 Community Oncology Conference.

Differences in patients’ clinical and social complexity and accountable care organization (ACO) network configuration highlight why specific strategies may have variable effectiveness in different types of ACOs.

Investments in technology infrastructure are necessary for accountable care organization (ACO) success. When the proper tools are in place, improvements in care delivery and cost savings are achievable.

Analysis of spending differences among accountable care organizations (ACOs) may help identify cost savings opportunities. We examined the magnitude and sources of spending variation among ACOs over 4 years.

As the cost of oncology drugs only continues to rise, incorporating clinical pathways into cancer care helps streamline the integration of evidence-based best practices while improving quality and reducing costs for patients and payers.

Improving relational coordination and reducing structural barriers to collaboration may enhance quality of care for chronic obstructive pulmonary disease (COPD) and other chronic conditions.

When effectively integrated into healthcare systems, well-vetted and scientifically backed healthcare quality measures can have significant impacts on patient health, stressed Shantanu Agrawal, MD, president and CEO of the National Quality Forum, at the New Jersey Health Care Quality Institute’s Quality Breakfast on February 6.

The newly sworn in FDA commissioner faces tobacco regulation challenges; CMS announces changes in hospital quality ratings; soldiers with traumatic brain injuries are more likely to develop mental health disorders.

Accountable care organization (ACO) participation in the Medicare Shared Savings Program (MSSP) remained flat this year, according to a press release from the National Association of Accountable Care Organizations issued Friday, January 10.

Amy Ellis, director of quality and value-based care at Northwest Medical Specialties, and Amanda Hodges, director of implementation for ReVital Cancer Rehabilitation, who acts as a bridge between the oncology world and the rehabilitation world, discuss overcoming barriers in practices to help patients with cancer get the rehab care they need, how patients with cancer can benefit from rehab, and defining value.

Health systems will improve postacute outcomes when CMS begins sharing its performance data on nursing facility chains.

One delivery system’s healthcare utilization in its Medicare Advantage product was notably less than in its Pioneer accountable care organization or in a traditional Medicare comparison group.

Prominence Health Plan announced that its 7 Universal Health Services (UHS) Accountable Care Organizations (ACOs) revealed a continued trend of increased cost savings and improved quality in 2018 results.

Accountable care organizations (ACOs) face a learning curve before they start achieving savings. David Carmouche, MD, president of the Ochsner Health Network and executive director of the Ochsner Accountable Care Network, explains how the Ochsner ACO was able to find success and how other ACOs can get over the learning curve to achieve savings.

Patient-centered practice infrastructure was associated with better care quality only among physicians who scored well on their Maintenance of Certification exam.

Artificial intelligence based on medical claims data outperforms traditional models in stratifying patient risk.

During a panel discussion on defining, standardizing, and reporting quality in cancer care during the National Comprehensive Cancer Network Policy Summit held September 12 in Washington, DC, it became clear that stakeholders of all backgrounds have set their focus on one type of metric in particular: patient-reported outcomes.

Oregon’s Medicaid accountable care organizations led to reductions in preventable hospital admissions, especially unscheduled admissions, among female beneficiaries aged 15 to 44 years.

Following the release of the latest accountable care organization (ACO) participation numbers from the CMS, the National Association of ACOs (NAACOS) authored its own take on the latest data around the Medicare Shared Savings Program, Medicare’s largest and most prominent value-based payment program serving 11 million patients.

Medicare Shared Savings Program accountable care organization (ACO) network comprehensiveness is associated with stable patient assignment year to year. Panel stability was significantly associated with improved diabetes and hypertension control in the short term.

Health plans on the Affordable Care Act (ACA) exchanges will be required to display quality ratings starting with the 2020 plan year, according to an announcement from CMS, which is expanding the 5-star rating system it uses on Medicare plans to the health insurance exchanges.