Value-Based Care

A targeted effort to make hospital cesarean delivery rates transparent and understood by women increased their awareness of this important quality measure, but did not drive them to choose hospitals with lower rates, according to a new study in The American Journal of Managed Care®.

Medicare Advantage (MA) provides accountable care organizations (ACOs) with benefits that aren’t available in Medicare’s ACO program, explained Kim Kauffman, MPH, vice president of value-based care at Summit Medical Group.

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

With a number of difference payment programs being tested, it’s important to have a sophisticated evaluation of these programs to really understand their impact on quality and cost, said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs.

In 2018, articles in The American Journal of Accountable Care® (AJAC) analyzed experiences within accountable care organizations (ACOs), the cost-effectiveness of initiatives to prevent readmissions, and much more. Here are the top 5 most-read articles published in AJAC in 2018.

There are additional areas of improvement for Medicare accountable care organizations (ACOs) beyond what was proposed in the Pathways to Success regulation, said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs (NAACOS).

CMS has finalized “Pathways to Success,” its overhaul of the Medicare Shared Savings Program (MSSP) that will push accountable care organizations to assume risk more quickly. The final rule includes some changes to the proposed rule, which was introduced in August.

Many hospitals penalized for readmissions were given readmission grades of “no different” or “better” than the national rate on the Hospital Compare website.

Disparities in care are a complex issue requiring multiple strategies to solve, including approaches to improve the measurement of quality and reporting stratified performance estimates.

The results of the study demonstrate the potential of provider-led health plans to deliver high-quality care and patient satisfaction. The relationships between these plans and outcomes differed by plan size, nonprofit status, and region.

Pushing accountable care organizations (ACOs) to take on risk faster will likely result in ACOs that aren’t ready just dropping out of the program and could impact participation in value-based care, said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs.

Centralized reminder/recall (R/R) is less costly to deliver than decentralized R/R for both children and adolescents when implemented for patients within an accountable care organization.

Publicly reported Medicare Shared Savings Program accountable care organization (ACO) data can be analyzed to identify cost and medication-related quality performance improvement opportunities to support pharmacist integration into ACO population health services.

The proposed changes to the Medicare Shared Savings Program may put a damper on the accountable care organization (ACO) movement, but ACOs remain the government’s best option for controlling healthcare costs, said Stephen Nuckolls, CEO of Coastal Carolina Quality Care.

There are some proposed changes to the Medicare Shared Savings Program (MSSP) that may be favorably or not depending on the accountable care organization (ACO) and its situation, said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs.

There remain issues with benchmarking, attribution, and risk adjustment that CMS needs to address with accountable care organizations (ACOs), said Rob Fields, MD, assistant profession, family medicine and community health, Icahn School of Medicine at Mount Sinai, and senior vice president, chief medical officer, population health at Mount Sinai Health System.

The shorter timeline to risk and the reduction of shared savings rates are among the 2 greatest challenges accountable care organizations (ACOs) will face as part of the proposed changes to the Medicare Shared Savings Program (MSSP), said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs.

While the proposed changes to the Medicare Shared Savings Program (MSSP) won’t mean a large number of changes to Coastal Carolina Quality Care, the accountable care organization will have to make some changes to respond to the new Enhanced track, said Stephen Nuckolls, CEO of Coastal Carolina Quality Care.

The proposed changes to the Medicare Shared Savings Program could prevent the program from driving broad change to value-based care across the country, according to Katherine Schneider, MD, MPhil, FAAFP, president and CEO of Delaware Valley ACO.

Here are 5 interesting findings from the October 2018 issue of AJMC®.

There are different ways to measure how Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) have saved money, and the way used can drastically affect the amount of savings reported, explained Clif Gaus, ScD, president and CEO of the National Association of ACOs.

Systems, groups, and practices that haven’t yet joined the accountable care organization (ACO) movement will find it harder to do so if the proposed changes to the Medicare Shared Savings Program (MSSP) take effect, said Rob Fields, MD, assistant profession, family medicine and community health, Icahn School of Medicine at Mount Sinai, and senior vice president, chief medical officer, population health at Mount Sinai Health System.

Some of the proposed changes to the Medicare Shared Savings Program align with things the National Association of ACOs had been asking for, said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs.

The proposed changes to the Medicare Shared Savings Program (MSSP) acknowledge the complexity of the program and bring more predictability and stability to MSSP, according to Katherine Schneider, MD, MPhil, FAAFP, president and CEO of Delaware Valley ACO.

The proposed risk adjustment changes to the Medicare Shared Savings Program (MSSP) are welcome but moving accountable care organizations (ACOs) to risk too soon could harm the program, said Stephen Nuckolls, CEO of Coastal Carolina Quality Care.

CMS’ proposed changes to the Medicare Shared Savings Program (MSSP) doesn’t represent a major shift in policy stance toward accountable care organizations (ACOs), said Joe Antos, PhD, the Wilson H. Taylor Resident Scholar in Health Care and Retirement Policy at the American Enterprise Institute.

By encouraging more providers to take on risk faster, the current administration may actually be disincentivizing providers from participating at all, which would reduce the number of accountable care organizations (ACOs), said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs.