Value-Based Care

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.

While speaking at the National Association of Accountable Care Organizations Spring 2016 Conference, Stephen Nuckolls, CEO of Coastal Carolina Quality Care, said that fair and transparent benchmarks are important in creating successful ACO 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.

One of the biggest concerns Farzad Mostashari, MD, chief executive officer of Aledade, has about accountable care organizations, is that they are going to experience backlash similar to what managed care has received in the past.

This week, the top stories in managed care include the largest healthcare fraud takedown, one successful accountable care organization imparted its secrets, and a report identifies pharmacy trends in the public health exchanges.

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.

More insurers are moving towards alternative payment and delivery models, but the transition needs to happen a lot quicker, explained Michael E. Chernew, PhD, during a panel discussion at the ACO & Emerging Healthcare Delivery Coalition Spring Live Meeting.

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

In order to get physicians engaged and involved in accountable care organizations (ACOs), it is important to educate them on the mission and understand that the organization is looking to improve, not ration, care, Stephen Nuckolls, CEO of Coastal Carolina Quality Care, explained at the National Association of Accountable Care Organizations Spring 2016 Conference.

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.

Recently, McKesson Business Performance Services and Blue Cross Blue Shield of Arizona partnered to form ACO Partner, a shared savings program focused on improving outcomes and costs.

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.

Scottsdale Health Partners helps patients with social needs through a complex care coordination program and working with community resources like adult protective services or other city government branches, James Whitfill, MD, chief medical officer, explained at the National Association of ACOs Spring 2016 Conference.

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.

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.

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.

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.

In 2012, electronic health record use and participation in accountable care organization or patient-centered medical home initiatives were associated with performing care processes expected to improve healthcare outcomes.