Value-Based Care

Working together to reduce low-value care, stakeholders can help eliminate wasteful spending and deliver on their goal to improve the health of Americans by delivering higher-quality care at lower cost.

This paper describes a replicable process for standardizing disparate databases and methods to calculate cost and quality measures within and across states.

Transforming a practice to become proactive in delivering care, rather than reactive, will be crucial in improving patient care and reducing costs, said Thomas Graf, MD, president, Ascension Medical Group, at the spring session of the National Association of Accountable Care Organizations, held April 24-26 in Baltimore, Maryland.

Among HealthPartners plan members, musculoskeletal, psychosocial, and neurologic conditions create the greatest burden to current health; diet offers the greatest opportunity to improve future health scores; and 42% report a high level of well-being.

The authors determined whether Minnesota health systems responded to competitors’ publicly reported performance. Low performers fell further behind high performers, suggesting that reporting was not associated with quality competition.

A session at the 68th American College of Cardiology Scientific Session continues the ongoing debate whether a CMS reimbursement model has contributed to rising mortality in patients with heart failure.

A new study published in the latest issue of The American Journal of Managed Care® found that Medicare annual wellness visits were associated with lower overall healthcare costs and improved clinical care quality for senior patients at two of Aledade’s physician-led accountable care organizations.

In the context of 2 primary care physician–led accountable care organizations, Medicare Annual Wellness Visits were associated with lower healthcare costs and improved clinical care quality for beneficiaries.

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

This study presents an example of a population health initiative in a limited-resource primary care setting that led to significant improvements in preventive care quality metrics in the context of major insurance payers.

This article describes how one accountable care organization (ACO) created a risk-adjusted algorithm to evaluate current and potential candidates for skilled nursing facility partnerships.

There is a lot involved if an accountable care organization (ACO) decides to switch from Medicare Shared Savings (MSSP) to Medicare Advantage, but Medicare Advantage offers more benefit design flexibility, explained Kim Kauffman, MPH, vice president of value-based care at Summit Medical Group.

Improving the quality of care while also reducing costs has become a centerpiece for transforming the US healthcare system. As efforts across the country continue to be introduced, accountable care organizations (ACOs) have emerged as an effective way to address these 2 issues.

Data published in JAMA Internal Medicine are the latest to sound the alarm on the emerging crisis in primary care.

The Institute for Accountable Care has a massive database to understand which accountable care organizations (ACOs) are successful and why, as well as how best to implement accountable care programs, explained Rob Mechanic, MBA, senior fellow at the Heller School of Social Policy and Management at Brandeis University and executive director of the Institute for Accountable Care.

Physician-level medication adherence is a strong predictor of patient health and should be considered as a measure of physician quality.

As CMS prepares to implement its new Pathways to Success program (formerly Medicare Shared Savings Program) for accountable care organizations (ACOs), some ACOs may consider Medicare Advantage a more beneficial arrangement, explained Kim Kauffman, MPH, vice president of value-based care at Summit Medical Group.

Cost-benefit analysis for quality measures has emerged as the cornerstone of CMS’ Meaningful Measures initiative.

While not every doctor is successful in value-based contracts, there is a shift in the right direction to more value-based care, explained Scott Hewitt, vice president, payment strategy and innovation, UnitedHealthcare.

Compared with other payment models, like bundled payments or the Comprehensive Primary Care Program, accountable care organizations (ACOs) have done a better job of saving money, said Rob Mechanic, MBA, senior fellow at the Heller School of Social Policy and Management at Brandeis University and executive director of the Institute for Accountable 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.