Value-Based Care

The Delaware Valley Accountable Care Organization (ACO) was disappointed to learn that under CMS’ Medicare Access and CHIP Reauthorization Act (MACRA) final rule, the practice would not be categorized as an advanced alternative payment model (APM) and would likely have less of an upside under the Merit-based Incentive Payment System (MIPS), said Katherine Schneider, MD, president of the Delaware Valley ACO. However, Dr Schneider said she understands CMS’ point of view and why it needed to make changes to the final rule.

Hospitals participating in accountable care organizations (ACOs) have greater adoption of health information technology, particularly patient-facing technology and health information exchange, than non-ACO hospitals.

Diabetes educators are well-positioned to help accountable care organizations meet their business, healthcare, and financial goals. The emphasis on primary care in treating chronic disease calls for an increased emphasis on diabetes educators to achieve better healthcare outcomes in a cost-effective manner.

Barry Russo, CEO of The Center for Cancer & Blood Disorders, said that his practice continues to collect quality and claims data from a number of sources, even though it isn’t easy. Russo also said that payers are not particularly interested in participating in a value framework, instead choosing to focus on the oncology care model (OCM).

Though there are many unknowns regarding how the Trump administration will affect policy, there is bipartisan support for lowering costs and increasing quality. The Medicare Access & CHIP Reauthorization Act of 2015 is a separate law that was passed with 92% bi-partisan support in 2015. Read on for tips on creating a strategy that will set you up for success under advanced alternate payment models.

In Hennepin County, Minnesota, which has one-fifth of the state’s population, the government has worked with the healthcare system to create a different way to care for people.

Innovative funding models like value-based payments can change providers’ incentives and drive them to seek solutions like palliative care, said Allison Silvers, vice president of payment and policy at the Center to Advance Palliative Care.

Relationships with accountable care organizations and provider organizations can help payers join in a value-based, holistic approach to improving health within a community, said Harold L. Paz, MD, MS, executive vice president and chief medical officer at Aetna.

The group that represents 5000 hospitals outlined a policy agenda that calls for regulatory reform but also seeks some certainty that patients who gained coverage under the Affordable Care Act will be able to retain it in the future.

Patients who received care for their chronic diseases in a patient-centered medical home had higher rates of medication adherence over 12 months than patients treated elsewhere, according to a study in the Annals of Internal Medicine.

Accountable care organizations are seeking to expand population health management capabilities through relationships with community organizations and patients, according to a new report.

As the healthcare industry moves toward value-based care and accountable care organizations and other new financial models gain greater importance, Aledade is looking to guide physicians to success.

As the healthcare industry continues its transition towards alternative payment models (APMs), some providers might feel apprehensive about keeping up with new requirements like those in the Medicare Access and CHIP Reauthorization Act (MACRA) final rule. However, these providers can use healthcare information technology (IT), data analysis tools, and other resources to adapt to these changes, according to Suzanne Travis, vice president of regulatory strategy at McKesson.

In conjunction with the state of Vermont, CMS announced the Vermont All-Payer Accountable Care Organization (ACO) Model on Wednesday. The new model is the first of its kind and represents an advancement in the goal of redesigning the healthcare delivery system with an emphasis on high-value care and improved health outcomes.

At the fall live meeting of the ACO & Emerging Healthcare Delivery Coalition in Philadelphia, Pennsylvania, attendees heard presentations and participated in workshops that discussed care management, value-driven payment systems, and the future of healthcare.

The opportunities for telehealth to radically transform the healthcare system are enormous, but the foremost priority of these innovations must be the delivery of value, said Reed V. Tuckson, MD, FACP, at the National Committee for Quality Assurance Quality Talks conference in Washington, DC, on Monday.

The healthcare community needs to understand and address the personal and social circumstances that contribute to a patient’s health before they can improve the quality of care, according to 2 presentations in the first segment of the National Committee for Quality Assurance Quality Talks conference in Washington, DC.

The number of accountable care organizations (ACOs) has grown rapidly over the last 4 years, with more than 800 ACOs now covering an estimated 28 million Americans. A study found that commercial ACOs were significantly larger and more integrated with hospitals and had lower benchmark expenditures and high quality scores compared with noncommercial ACOs.

Despite progress, tying healthcare payments to value has proved easier in theory than in practice, according to speakers at this fall’s meeting of the ACO & Emerging Healthcare Delivery Coalition. Experts convened October 20-21, 2016, by The American Journal of Managed Care looked ahead at the challenges the next president will face with the future of the Affordable Care Act.

The innovative strategy of hotspotting, implemented by the Camden Coalition of Healthcare Providers, was the focus of a session and a panel discussion during the first day of the ACO & Emerging Healthcare Delivery Coalition.

Panel members discuss the level of physician awareness regarding changes that will follow the implementation of CMS’ recently released Medicare Access and CHIP Reauthorization Act (MACRA).

In the keynote speech at the ACO & Emerging Healthcare Delivery Coalition, Mark McClellan, MD, PhD, director of the Duke-Margolis Center for Health Policy, started out by providing a broad picture of Medicare reform before narrowing it down to what is happening on the ground.

Healthcare attorney James M. Daniel, Jr, JD, MBA, explained how healthcare providers will be impacted by CMS’ newly released final rule on the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) in a session during the second day of the ACO & Emerging Healthcare Delivery Coalition.

Over the last 4 years, the ACO & Emerging Healthcare Delivery Coalition has continued to grow as a result of the opportunities to hear about innovations in accountable care organizations (ACOs) and to network with a diverse group of people, said Anthony Slonim, MD, DrPH, president and CEO of Renown Health and chair of the ACO Coalition.

The Camden Coalition of Healthcare Providers utilizes hotspotting to identify the most complex and costly patients and enrolls them in a care management program to empower them to take control of their own healthcare.