Value-Based Care

The quality bonus payments tied to CMS' star ratings makes it critical that health plans receive a 4 or better, Jonathan Harding, MD, chief medical officer of the Senior Products Division at Tufts Health Plan, said at the America's Health Insurance Plan's National Conferences on Medicare and Medicaid, and Dual Eligibles Summit in Washington, DC, from September 28 to October 2.

How a health plan performs in the CMS star ratings to going to have a bigger impact on their finances in the coming years, Snezana Mahon, PharmD, senior director of Medicare solutions at Express Scripts, said.

Financial results from the first 2 years of the Pioneer ACO Model reveals the gains and losses of the 32 organizations that started the program, and illuminates why just 19 remain.

Nationwide, Pioneer ACOs saved the government $96 million last year, compared with $87.6 million in 2012, the Centers for Medicare and Medicaid Services said last month.

At the America's Health Insurance Plans' National Conference on Medicare and Medicaid and Dual Eligibles Summit in Washington, DC, Patrick Conway, deputy administrator for innovation and quality and chief medical officer for CMS, spoke on the future of delivery system reform.

The accountable care organization, or ACO, can be a mechanism for employers to achieve healthcare savings, according to a just-published article in The American Journal of Accountable Care, the publication of The American Journal of Managed Care dedicated to healthcare reform.