Value-Based Care

In a Tuesday session at the American College of Rheumatology’s 2017 Annual Meeting in San Diego, California, Greg Mertz, MBA, FACMPE, managing director for Physician Strategies Group, LLC, presented a talk title “Value Contracting: Opportunities of Fantasy?” in which he outlined the current landscape for performance-based contracting.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

Following the transition year and ahead of the full implementation in year 3, CMS made provisions to the Quality Payment Program to make it easier for clinicians to participate in the program, reduce burden, and to get clincians ready for full implementation.

During the final panel at the fall meeting of the ACO & Emerging Healthcare Delivery Coalition® in Nashville, Tennessee, panelists discussed the progress specialties have made in moving to value-based payment models, as well as the challenges facing the industry as a whole. The panel consisted of 3 individuals who provided perspectives from specific specialties, and 1 with an overall policy perspective.

CMS just released 2016 data on the Medicare Shared Savings Program and the information proves that patience pays off, savings don't have to happen at the expense of quality, and that physician-led accountable care organizations are more successful.

At the fall ACO & Emerging Healthcare Delivery Coalition®, Clay Alspach, JD, principal at Leavitt Partners, discussed navigating the current political and payment reform landscape, making sense of the uncertainty, and preparing for the unexpected.

A back to back session and panel at the falls’ ACO & Emerging Healthcare Delivery Coalition focused on the importance of utilizing integrated healthcare to treat individuals with addiction and ensuring physicians are educated on understanding addiction.

This fall's ACO & Emerging Healthcare Delivery Coalition

David V. Axene, FSA, FCA, CERA, MAAA, outlined how more accurately measuring and evaluating the performance of accountable care organizations (ACOs) can help both health plans and providers succeed in their risk sharing contracts during a session at the National Association of Managed Care Physicians Fall Managed Care Forum 2017.

Before physicians will be more willing to take on 2-sided risk, there needs to be clearer metrics that the physicians know will be achievable, said Sarah Cevallos, chief revenue cycle officer at Florida Cancer Specialists.

Global patient satisfaction was positively associated with quality of stroke care and higher discharge information satisfaction may be linked to worse outcomes. Additionally, improvements in satisfactions were linked to higher costs.

With confusion surrounding the meaning of “savings” with regard to ACO programs, authors writing in Health Affairs outlined 3 different types of savings.

A more integrated approach to managing complex member populations starts by moving beyond clinical care settings and extending services into the community. Community-based care drives more predictable costs, and goes a long way to making members’ lives better.

An in-depth look into a nationwide collaborative initiative to standardize and improve oncology dispensing practices for the benefit of patient/provider education, adherence, and overall care.

Brian Marcotte, president and CEO of the National Business Group on Health, offers recommendations for employers that are considering accountable care organizations (ACOs) and describes situations when an ACO is not a good fit.

Despite their large and growing reach, accountable care organizations (ACOs) are still learning how to manage their populations and are slowly accepting more financial risk, according to the results of the Annual ACO Survey from the National Association of ACOs and Leavitt Partners.

Contrary to popular belief, low-cost, low-value health services cost nearly double the amount of high-cost, low-value health services.

The event will offer presentations on addiction care and payment reform

Current and potential Bundled Payment for Care Initiative (BPCI) participants are looking for answers to 3 key operational questions about BPCI Advanced. Here, we discuss what to look for in terms of quality metrics, gainsharing rules, and evaluation and participation periods.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

Key lessons learnt at the National Comprehensive Cancer Network's policy meeting: Redefining Quality Measurement in Oncology.

Ensuring access to appropriate data and then using the information to improve healthcare outcomes remains an ongoing challenge-this was the conclusion drawn by panelists participating at the National Comprehensive Cancer Network’s Oncology Policy Summit on Redefining Quality Measurement in Oncology.

This week, the top managed care stories included the end of the latest attempt to repeal the Affordable Care Act; a call to better include the patient's voice in cancer quality metrics; and an argument for caution regarding the newly approved CAR T-cell therapy, Kymriah.

Financial barriers to behavioral health integration in Oregon Medicaid accountable care organizations (ACOs) limit opportunities to expand integrated care, but state and organizational opportunities exist.

At the National Comprehensive Cancer Network's Oncology Policy Summit, a physician administrator from the MD Anderson Cancer Center discussed weaving the patient focus into outcomes measurements.

What hurricanes and floods reveal about the shortcomings in value-based care policy.

An evaluation of the use of predictive modeling for primary care resource allocation demonstrated reduced spending and improved quality and patient experience for publicly insured adults.

To promote future partnerships among colleges of pharmacy and accountable care organizations, this article describes several initial challenges to partnership formation, including those related to agenda setting and resource utilization.

Having employers and accountable care organizations agree on expectations is necessary for better alignment of care offered, explained Brian Marcotte, president and CEO of the National Business Group on Health.