Value-Based Care

CMS understands that not all physicians will report quality measures under the Medicare Access and CHIP Reauthorization Act or join advanced alternative payment models, especially immediately, said Kate Goodrich, MD, director of the Quality Measurement and Value-Based Incentives Group in CMS. However, there are efforts in place to make it as easy as possible for these providers, which will hopefully increase participation over time.

Physicians have shown great interest in understanding how to transition into value-based processes, especially with the new rules under the Medicare Access and CHIP Reauthorization Act (MACRA), said Roy Beveridge, MD, chief medical officer of Humana. While these transitions take time and effort, they eventually lead to physicians being reimbursed more for longer visit times and improved outcomes.

More hospitals are switching to employment-based affiliations with physicians, but a recent analysis found no association between conversion to an employment model and changes in mortality, readmissions, length of stay, or patient satisfaction rates.

At the fall live meeting of The American Journal of Managed Care®'s ACO & Emerging Healthcare Delivery CoalitionTM, speakers discussed how to care for complex patients, and the latest in reimbursement.

A glimpse at the top 5 articles from The American Journal of Managed Care's® conference coverage that caught reader attention in 2016.

Contributors to AJMC.com bring fresh insight from their real-world experiences to discuss important subjects in managed care, which this year included topics like accountable care organizations, telehealth, and urgent care prescribing. Here are the 5 most-read articles from our contributors in 2016.

With the Medicare Access and CHIP Reauthorization Act (MACRA) set to take effect January 1, 2017, The American Journal of Managed Care has created a resource center, the MACRA Compendium, where payers and providers can find updates on the transition to value-based care.

Understanding the perspectives of clinicians and administrators who are leaders in implementing patient-centeredness in accountable care organizations can help point the way toward implementation by others.

Among Michigan primary care practices, sustained participation in a pay-for-value program appears to contribute to improved utilization outcomes for high-need patients.

This year, the most read articles from The American Journal of Accountable Care® explored how healthcare providers and payers have implemented innovative ideas to reduce spending while maintaining or increasing the quality of care.

CMS is moving full-steam ahead with the transition to value-based care. On Tuesday, the agency announced 3 new bundled payment models in cardiac care, an expansion on the Comprehensive Care for Joint Replacement Model, and the highly anticipated new track in the Medicare Shared Savings Program.

Along with the peer-review research, journal articles, and news coverage, The American Journal of Managed Careâ„¢ (AJMCâ„¢) has a robust multimedia component that brings together stakeholders from across the healthcare industry to discuss important topics in the world of managed care and delve deeper into topics.

What we’re reading, December 20, 2016: Purdue Pharma, which makes OxyContin, plans to expand its sales of the drug in foreign markets; family members blame hospital for not warning them about low-quality nursing home; a project to place blast sensors on soldiers to learn more about concussions has been discontinued.

Integrating behavioral and physical health services within an accountable care organization offers a significant opportunity to address both behavioral health conditions and substance use disorders, as well as to improve outcomes and reduce costs.

Recent election results raise questions about the future of healthcare programs and the coordination of patient care in our nation.

A new accountable care organization (ACO) model announced by CMS aims to improve care and lower costs by allowing beneficiaries enrolled in both Medicare and Medicaid to be covered under a Medicare Shared Savings Program ACO.

The authors describe best practices for Web design in the accountable care organization space in order to enhance engagement with patients and providers.

The Department of Veterans Affairs healthcare system has announced a final rule that will grant full practicing authority to some types of advanced practice registered nurses, with the exception of nurse anesthetists.

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.

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.

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.