Meeting accountable care initiatives under the healthcare law is presenting challenges for its accountable care organization (ACO) participants.
Even though the Centers for Medicare & Medicaid Services relaxed the final performance measures from a proposed 65 to 33, meeting those performance measures is no small feat.
The federal program might not be easy for its Pioneers, who have long been fueled by health plans, noted. The new approach will require utilization management functions, such as disease management, complex case management, preauthorization services, specialty referral management and other analytic tools, Lynn Dong, a principal consulting actuary with Milliman, explained.
Sharp HealthCare, one of the 32 federal Pioneer ACOs, said it already has experience in providing coordinated care and population-based payments, but the San Deigo-based health system--like other Medicare ACOs--faces the challenge of consumer choice.
Read more at: http://tinyurl.com/7myrcpu
Source: FierceHealthcare
Covered Preventive Services at Risk: V-BID Summit Breaks Down the Braidwood v Becerra Case
March 20th 2024For more than a decade, certain high-value preventive care services have been covered at no cost to patients under the Affordable Care Act, but a current legal challenge has the coverage at risk.
Read More
Oncology Onward: A Conversation With Penn Medicine's Dr Justin Bekelman
December 19th 2023Justin Bekelman, MD, director of the Penn Center for Cancer Care Innovation, sat with our hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, for our final episode of 2023 to discuss the importance of collaboration between academic medicine and community oncology and testing innovative cancer care delivery in these settings.
Listen
Evolution of HDHPs With VBID Components Can Improve Care for Chronic Disease
March 14th 2024Over the course of the last 20 years, high-deductible health plans (HDHPs) have undergone an evolution. Today’s plans, with more high-value services covered predeductible, can improve care for people with chronic diseases, said panelists at the 2024 Value-Based Insurance Design (V-BID) Summit.
Read More
Oncology Onward: A Conversation With Thyme Care CEO and Cofounder Robin Shah
October 2nd 2023Robin Shah, CEO of Thyme Care, which he founded in 2020 with Bobby Green, MD, president and chief medical officer, joins hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, to discuss his evolution as an entrepreneur in oncology care innovation and his goal of positively changing how patients experience the cancer system.
Listen