Value-Based Care

Contrary to popular belief, low-cost, low-value health services cost nearly double the amount of high-cost, low-value health services.

The event will offer presentations on addiction care and payment reform

Current and potential Bundled Payment for Care Initiative (BPCI) participants are looking for answers to 3 key operational questions about BPCI Advanced. Here, we discuss what to look for in terms of quality metrics, gainsharing rules, and evaluation and participation periods.

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.

Key lessons learnt at the National Comprehensive Cancer Network's policy meeting: Redefining Quality Measurement in Oncology.

Ensuring access to appropriate data and then using the information to improve healthcare outcomes remains an ongoing challenge-this was the conclusion drawn by panelists participating at the National Comprehensive Cancer Network’s Oncology Policy Summit on Redefining Quality Measurement in Oncology.

This week, the top managed care stories included the end of the latest attempt to repeal the Affordable Care Act; a call to better include the patient's voice in cancer quality metrics; and an argument for caution regarding the newly approved CAR T-cell therapy, Kymriah.

Financial barriers to behavioral health integration in Oregon Medicaid accountable care organizations (ACOs) limit opportunities to expand integrated care, but state and organizational opportunities exist.

At the National Comprehensive Cancer Network's Oncology Policy Summit, a physician administrator from the MD Anderson Cancer Center discussed weaving the patient focus into outcomes measurements.

What hurricanes and floods reveal about the shortcomings in value-based care policy.

An evaluation of the use of predictive modeling for primary care resource allocation demonstrated reduced spending and improved quality and patient experience for publicly insured adults.

To promote future partnerships among colleges of pharmacy and accountable care organizations, this article describes several initial challenges to partnership formation, including those related to agenda setting and resource utilization.

Having employers and accountable care organizations agree on expectations is necessary for better alignment of care offered, explained Brian Marcotte, president and CEO of the National Business Group on Health.

With the comment period now concluded, CMS has received nearly 1300 comments on its proposed amendments to the Quality Payment Program established by the Medicare Access and CHIP Reauthorization Act (MACRA).

Employers understand what accountable care organizations are, but they need a better understanding of how they deliver value better than the market, explained Brian Marcotte, president and CEO of the National Business Group on Health

The Hospital-in-Home program implemented at the Veterans Affairs Pacific Islands Health Care System in Honolulu, Hawaii, is associated with reduced costs with no compromise in quality.

A pair of articles published in JAMA examined the quality of studies used by the FDA to support its accelerated approval decisions and high-risk device modification approvals.

Patients discharged from hospitals may not be fully equipped with the information they need to select a high-quality skilled nursing facility (SNF), according to a new study.

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

Many accountable care organizations participating in the Medicare Shared Savings Program focus on disease control and medication use, but a new study published in JAMA Cardiology has found that the programs have not made any meaningful changes in medication use or adherence.

Zirui Song, MD, PhD, resident at Massachusetts General Hospital, discussed his research interests, which center on strategies to control healthcare spending while improving the quality of care. He also expressed the importance of examining health equity within the United States healthcare system.

Researchers at the University of Pennsylvania have recognized that narrow provider networks are quite likely to exclude National Cancer Institute—Designated Cancer Centers or National Comprehensive Cancer Network Cancer Centers, which could prevent patient access to high-quality cancer care.

The National Quality Forum (NQF) has issued a report detailing the results of its experiment with including social risk factors in its risk adjustment models for performance measures.

The Government Accountability Office (GAO) recommended that CMS should take steps to prevent lower quality hospitals from qualifying for value-based bonuses, after a report by the office found that some bonuses in recent years had rewarded poorly-rated hospitals.

Public and private payment reforms such as accountable care organization contracts have shown some initial evidence of changes in physician behavior, but their full promise remains to be seen, according to Zirui Song, MD, PhD, resident at Massachusetts General Hospital.

In the June issue of The American Journal of Accountable Care®, authors described how their accountable care organization achieved impressive shared savings.

Oncologists envision a move towards using data to become a learning health system, which is aided by the changing landscape emphasizing quality and value, explained Bobby Green, MD, MSCE, senior vice president of clinical oncology at Flatiron Health.

This study identifies practices and perceptions around public reporting of “roll-upâ€

In response to trepidation from clinicians, CMS has announced a proposal to alter the rules of the Quality Payment Program established by the Medicare Access and CHIP Reauthorization Act (MACRA). The changes will exempt thousands of physicians from quality reporting requirements and allow small practices to form “virtual groups” with one another.