Value-Based Care

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.

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

The proposed changes to the Medicare Shared Savings Program that move accountable care organizations (ACOs) to take on risk in just 2 years is not going to be enough time for most ACOs, although some may be ready in that time, said Stephen Nuckolls, CEO of Coastal Carolina Quality Care.

Contracts for accountable care organizations (ACOs) can be very different depending on who the payer is, according to Katherine Schneider, MD, MPhil, FAAFP, president and CEO of Delaware Valley ACO.

CMS’ accountable care organization program, the Medicare Shared Savings Program (MSSP), could potentially be undergoing some big changes. During the recent fall 2018 meeting of the National Association of ACOs (NAACOS), the proposed changes were top of mind. Attendees were most concerned about how the faster timeline to taking on risk would impact participation, but were pleased with changes to the benchmark and risk adjustment.

At the National Association of ACOs Fall 2018 conference, private payers discussed how they are working with accountable care organizations (ACOs) to create new opportunities in the commercial market.

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, discusses how Mount Sinai’s accountable care organizations (ACOs) will have to adjust to the proposed CMS Medicare Shared Savings Program (MSSP) changes.

Physician practices intending to join Medicare accountable care organizations (ACOs) in 2012 had greater capabilities in health information technology, care management processes, and quality improvement methods than those not intending to join, but they still were far from using all recommended behaviors to manage risk.

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.

Accountable care organizations (ACOs) often care for patients with complex, chronic conditions that can lead to high expenditures and utilization of care. During a session at the National Association of ACOs Fall 2018 conference, being held October 3-5 in Washington, DC, panelists discussed how ACOs can design and implement strategies that deliver high-quality, low-cost care for these patients.

This week, the top managed care news included the Nobel Prize in Medicine was awarded to 2 people for research into immunotherapy; physician-run accountable care organizations bring savings for Medicare; research highlights the health impacts of sexual harassment and assault.

More frequent electronic health record (EHR) message forwarding in primary care teams is associated with worse outcomes and higher medical costs for patients with diabetes.

At the National Association of ACOs Fall 2018 conference, being held October 3-5 in Washington, DC, panelists shared successful innovative initiatives that have been developed by their accountable care organizations (ACOs). What worked and what did not was the focus of the conversation led by Debbie Welle-Powell, chief population health officer, Essentia Health.

The proposed CMS regulation to change the Medicare Shared Savings Program (MSSP) so that accountable care organizations (ACOs) take on risk faster creates a one-size-fits-all model that doesn’t allow for variability, said Joe Antos, PhD, the Wilson H. Taylor Resident Scholar in Health Care and Retirement Policy at the American Enterprise Institute.