Value-Based Care

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

With 6 years under his belt, Patrick Conway, MD, is the longest serving chief medical officer in CMS history. During those 6 years, he has seen alignment with private payers increasing, Conway said during a plenary session at the fall meeting of the National Association of Accountable Care Organizations.

This week, the top stories in managed care included 2 reports on the fight against addiction, researchers have learned more about the effects of healthy living on avoiding cancers, and a study finds fitness trackers do not help people lose more weight.

CMS announced on Thursday that it would award $347 million in contracts to various hospital associations and quality improvement organizations as part of its ongoing effort to reduce hospital-acquired conditions and readmissions in the Medicare program. The Hospital Improvement and Innovation Network agreement sets high goals in hopes of continuing the progress that has already been made in patient safety.

During a session of the National Association of Accountable Care Organizations, panelists discuss the benefits of integrating behavioral health and the role accountable care organizations can play.

What we're reading, September 30, 2016: HHS prioritized payments to Obamacare insurers over the Treasury; the CDC is concerned flu vaccinations may be down; and UnitedHealth Group and University of California come together for new partnership.

Digital health programs like telehealth have already made progress in fields like mental health by expanding access and lowering costs, but there are opportunities to achieve much more in the future, according to Susan Dentzer, president and CEO of The Network for Excellence in Health Innovation.

During the fall meeting of the National Association of Accountable Care Organizations (NAACOS) in Washington, DC, speakers from the government and from various ACOs across the country shared their insights into the success and opportunities of these delivery models. Here are 5 takeaways from the NAACOS fall conference.

During the plenary session on the first day of the fall meeting of the National Association of Accountable Care Organizations, CMS' Sean Cavanaugh discussed the outcomes of the Medicare ACO programs and members of 2 successful ACOs joined him on stage to provide their input.

During the most recent web-based seminar of The American Journal of Managed Care’s ACO & Emerging Healthcare Delivery Coalition, experts discussed a digital test that can help primary care physicians assess patients’ cognitive abilities and detect impairment sooner.

CMS reached its goals for value-based payments in part because of providers’ enthusiasm for new programs, said Kate Goodrich, MD, director of the Quality Measurement and Value-Based Incentives Group in CMS.

This week, the top managed care stories included another boost to the Cancer Moonshot initiative, results from an accountable care organization in the Medicare Shared Savings Program, and coverage of new and emerging therapies in Evidence-Based Diabetes Management.

This article provides a detailed description of a Medicare Shared Savings Program accountable care organization (ACO)'s actions and results, to increase understanding of the challenges and opportunities facing ACOs-particularly those comprised of independent practices.

Accountable care organizations are becoming increasingly common in the United States, but they are more likely to be formed in regions of the country with populations that have a higher socioeconomic status.

The Medicare Shared Saving Program benchmark can be improved by following the example of Next Generation accountable care organizations, but with a larger adjustment level.

The authors’ survey of providers in a new accountable care organization reports that initial perceptions of this care model are ambivalent and vary among participating practices.

Highlights of our peer-reviewed research in the healthcare press.

A private accountable care organization model with an embedded care coordinator and a list of recommended providers yields cost savings similar to initiatives with risk-based contracts.

While speaking at the National Association of Accountable Care Organizations Spring 2016 Conference, Stephen Nuckolls, CEO of Coastal Carolina Quality Care, said that care coordinators have played an important role in his ACO to reach out to the patient and motivate them to become more engaged in their care. What makes a difference is showing the patient how much you care, he added.

In a series of video interviews, Donald M. Berwick, MD, MPP, president emeritus and senior fellow of the Institute for Healthcare Improvement, discussed the lessons learned from the Aligning Forces for Quality initiative.

While Joe Antos, PhD, the Wilson H. Taylor Scholar in Health Care and Retirement Policy at the American Enterprise Institute, believes that the ACO model is here to stay, he said that the way these organizations operate are likely to change.

Medicare accountable care organizations have either not yet focused on mental illness or have been, for the most part, unsuccessful in early efforts to improve their management of it.

Maximizing the utility of technology platforms and making them meaningful to ensure quality cancer care was the underlying theme of Emerging Issues and Opportunities in Health Information Technology, a National Comprehensive Cancer Network Policy Summit, held June 27, 2016, in Washington, DC.

Many accountable care organizations are beginning to adopt various programs or strategies into their framework to increase patient access to behavioral health care, but several challenges remain.

Stephen Nuckolls, CEO of Coastal Carolina Quality Care, explained during his presentation at the National Association of Accountable Care Organizations Spring 2016 Conference that the more physicians read and learn about value-based care, the more they are accepting the change. He added that as the idea has become more accepted, ACOs are beginning to evolve as well.

Critics of the Hospital Compare "Star" ratings ask whether the failure to take patient wealth into account unfairly penalizes hospitals that care for larger numbers of poor patients.

As the healthcare industry moves from volume to value, new healthcare delivery models are being tested and promoted, and CMS has put a lot of faith into the accountable care organization. So has Aledade.