The top content published in The American Journal of Accountable Care® (AJAC) covered redesigning health care, value-based care, and novel payment models, like the ACO REACH model.
The American Journal of Accountable Care® (AJAC) strives to be a place to share real-world interventions, pilot projects, and case studies on innovations in health care delivery. In 2022, the top content published in the journal covered virtual care, good practices for high-deductible health plans, advanced care planning, and the next generation of Medicare payment models.
Here is the top AJAC content of 2022.
5. Measuring the Effectiveness and Value of Virtual Health Care
In this article, Linda Schwimmer, JD, of the New Jersey Health Care Quality Institute, and Chuck Amos, MBA, of the National Quality Forum, call for the collection and use of data on virtual health care to help shape equitable telehealth payment models.
During the height of the COVID-19 pandemic, rapid expansion of virtual health visits was crucial and there was payment parity among virtual and in-person visits. Continuing to scale and improve the use of virtual health care requires reimbursement that is appropriate, they noted. Data on virtual care visits will be crucial to determining the quality and safety of these visits compared with in-person visits, as well as knowing how to address any inequities.
4. Adopting Good Practices for High-Deductible Health Plans Can Help Employers Build Better Health Benefits
The use of high-deductible health plans (HDHPs) continues to grow as a less expensive option for employers that incentivizes patients to shop around and make smarter choices about their health care utilization. However, there are drawbacks, authors noted.
The evidence of the impact of HDHPs on cost and utilization is mixed, but studies have identified trends in benefit design. A survey of employers identified 5 good practices for HDHPs that will optimize the benefit of these plans for employees.
3. Thoughts on Redesigning Health Care: Aligning Incentives to Drive Innovation
In response to a letter from AJAC’s editor in chief, Dennis Scanlon, PhD, calling on health systems to innovate and learn in real time, Robert Groves, MD, executive vice president and chief medical officer of Banner | Aetna, described how his organization pushes the limits of innovation through shared learnings and collaboration. Banner | Aetna is the joint collaboration of a payer and a delivery system, which means both sides have the same vested interest in success. Among the avenues explored by the venture was the development of multidisciplinary care teams for patients with serious chronic conditions.
2. End-of-Life Values and Value-Based Care
In another response to Scanlon’s letter, experts from Aledade, a company that helps independent primary care practices succeed in a physician-led accountable care organization (ACO), discussed evidence supporting the cost-effectiveness of an innovative advance care planning (ACP) initiative.
The company worked with a national provider of ACP solutions and a health care–focused artificial intelligence company to create a machine learning algorithm that identifies patients with the highest risk of mortality in the next 12 months and to implement a comprehensive ACP for these patients. This ACP initiative was rolled out across 45 primary care practices and led to reductions in costs per patient.
1. ACO REACH Brings Next Era of Medicare Payment Models
The ACO Realizing Equity, Access, and Community Health (ACO REACH) Model was unveiled by the Biden administration in early 2022 as a redesign of the Global and Professional Direct Contracting Model created under the previous administration. Authors from the National Alliance of ACOs highlighted the positive changes with the new model, including an emphasis on health equity; the addition of more lines of oversight, audits, and beneficiary protections; and a mandate that 75% of governing bodies be made up of participating providers.
Overall, the authors believe ACO REACH provides a great opportunity for the future of value-based care.