Value-Based Care

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.

Although the term "accountable care organization" (ACO) may not be here to stay, value-based organizations are here to stay based on the direction CMS is headed, said Jeb Dunkelberger, vice president of accountable care services at McKesson and clinical & commercial operations at ACO Partner.

Analyzes whether hospital participation in accountable care organizations is associated with a hospital’s quality and cost improvement outcomes in other Medicare value-based payment programs.

The president predicts that in 20 years, the nation will look back on "Obamacare" as a moment of courage that has improved people's lives.

In the most recent Web-based session of The American Journal of Managed Care’s ACO & Emerging Healthcare Delivery Coalition, speakers examined 3 practice transformation models.

Coverage from Patient-Centered Diabetes Care, April 7-8, 2016. Presented by The American Journal of Managed Care and Joslin Diabetes Center.

More than 58% of healthcare payers’ businesses have already shifted to full value-based reimbursement models, a 10% increase since 2014.

A new analysis by the Dartmouth Institute has found that Medicare accountable care organizations (ACOs) are making modest yet increasing gains when treating patients with comorbidities.

Carolinas HealthCare System created a behavioral health service line to drive transformation in value-based healthcare. Four projects are described, which demonstrate that modest investment in behavioral health pays dividends in reduced cost and increased quality and experience.

For 2 successive years, the Hackensack Alliance Accountable Care Organization achieved cost savings and maintained quality by using physicians with patient-centered medical homes and nurse care coordinators focused on high-risk patients.

An expert panel at The Community Oncology Conference: Innovation in Cancer Care, held in Orlando, Florida, April 13-15, 2016, provided insight on current transitions in healthcare reform, and their predictions for the future.

Many large, well-integrated medical groups with infrastructure to manage care effectively continue to receive a majority of revenue from fee-for-service and pay physicians based on productivity.

Poster presentations at the American Diabetes Association Scientific Sessions compared canagliflozin, an SGLT2 inhibitor, to sitagliptin, a popular DPP-4 inhibitor, using claims data.

As the most advanced accountable care organization (ACO) model, Next Generation ACO has its appeal. However, it is the riskiest model, and one ACO explains why it decided to stay with the Medicare Shared Savings Program.

In order for accountable care organizations to overcome short-term thinking they must be careful with their fee-for-service codes and ensure that people are using the system responsibly, Farzad Mostashari, MD, chief executive officer of Aledade, said at the National Association of ACOs Spring 2016 Conference.

At the spring live meeting of the ACO & Emerging Healthcare Delivery Coalition in Scottsdale, Arizona, attendees heard presentations and participated in workshops that discussed better integration of care, improved use of technology, and the future of healthcare and the Affordable Care Act.

Accountable care organizations can improve outcomes and patient experience while reducing costs through integrated care and better use of technology.

Scottsdale Health Partners’ success is derived from its physician engagement, care coordination and transformation, and meaningful IT usage, explained James Whitfill, MD, chief medical officer. The organization has also learned that direct contact with both patients and provider is critical to continuing that success.

As healthcare moves to value-based arrangements and delivery models like accountable care organizations (ACOs), the benefit of incorporating a pharmacist can be overlooked. Tina Joseph, PharmD, BCACP, and Reena Jones, PharmD, CPh, both from Nova Southeastern University, outlined how pharmacists can be integrated into ACOs in order to improve care and patient satisfaction, while reducing cost.

The National Quality Forum’s Measure Applications Partnership recently released guidelines on measures for the new Merit-Based Incentive Payment System and on cross-cutting issues for all federal healthcare programs.

If accountable care organizations (ACOs) are going to be successful, they need to learn from another and have meetings like the ACO & Emerging Healthcare Delivery Coalition's Spring Live Meeting, being held April 28-29 in Scottsdale, Arizona, to exchange good information, explained Michael Chernew, PhD, co-editor-in-chief of The American Journal of Managed Care. Dr Chernew will also sit on a panel discussion about the future state of healthcare in the United States during the ACO Coalition's meeting.

One of the greatest challenges for the healthcare industry as it moves to value-based payments is shifting from a short-term to a long-term mode of thinking, Farzad Mostashari, MD, chief executive officer of Aledade, explained at the National Association of ACOs Spring 2016 Conference.

The top stories in managed care include a recap of Patient-Centered Diabetes Care, the case for the Oncology Medical Home, UnitedHealth leaves Affordable Care Act exchanges in 2 states, and CMS expands alternative payment model for primary care.