Value-Based Care

The shared savings payments were for specialists in hip and knee replacements, knee arthroscopy, and pregnancy. These areas have been among CMS' top targets for savings, while New Jersey has been focused on reducing its high rate of C-sections.

A collaboration led by CMS and America’s Health Insurance Plans released 7 core sets of quality measures created to reduce complexity, decrease cost burden, and ensure high-quality care.

Howard C. Springer, the administrative director of strategy for accountable care services for Swedish Medical Center in Seattle, explained that the benefit he got out of attending one of the past ACO and Emerging Healthcare Delivery Coalition live meetings was the knowledge from people who have been in the business for a while.

Patrick Conway, MD, MSc, deputy administrator for innovation and quality and chief medical officer at CMS, describes the proposed changes to the Medicare Shared Savings Program and how they will assist accountable care organizations transitioning to tracks with more risks.

While the pace of payment reform is moving quickly, Patrick Conway, MD, MSc, deputy administrator for innovation and quality and chief medical officer at CMS, said he thinks about how to maintain that pace.

CMS has proposed changes to accountable care organizations benchmarks in the Medicare Shared Savings Program, as well as a way to better facilitate the transition to performance-based risk.

Accountable primary care is essential in lowering healthcare costs as a whole and making it care more accessible to patients. Debbie Zimmerman, MD, chief medical officer of Lumeris, discussed how to improve primary care and get primary care physicians aligned with the delivery of accountable care.

For the second year, Anthony D. Slonim, MD, DrPH, is in the running for Modern Healthcare’s 50 Most Influential Physician Executives and Leaders. Recently, he discussed what it means to be a physician leader, the industry’s move to population health, and more.

The profile of high-cost patients in a Massachusetts ACO differed greatly, depending on their enrollment in Medicare, Medicaid, or a commercial plan.

Farzad Mostashari, MD, co-founder and CEO of Aledade, discusses the benefits of Aledade’s technology, combined with its strategies and analytics, and how these tools are implemented among the practices with which Aledade is working.

All this week, the healthcare industry, especially analysts and investors, focused their attention on presentations by CEOs and CFOs at the 34th annual JP Morgan Healthcare Conference.

Medicare's accountable care organization (ACO) initiatives now include a total of 477 participants across 4 different model types, including the 21 just announced as part of the new Next Generation ACO Model.

The most read articles from The American Journal of Accountable Care explore the future of healthcare delivery as the United States moves to value-based care.

Mobile health clinics represent promising vehicles through which high quality, cost-effective care can be delivered to patients, especially in underserved areas.

Considerable attention has been devoted to managing populations around the value proposition. Children, as a population, have received little attention in the accountable care organization (ACO) realm. This manuscript contrasts some of the similarities and differences between adult and pediatric ACOs.

For several reasons, including meeting the HHS Secretary’s Medicare quality and value payment goals, the ACO program needs to reformed to equate with Medicare Advantage.

Initial adoption of clinical pathways grew from payers mandating their use with individual providers, but there is now greater interest from accountable care organizations and others to use pathways to reduce variation and cost while improving outcomes, explained Robert Dubois, MD, PhD, chief science officer and executive vice president of the National Pharmaceutical Council.

The future of medicine will be creating partnerships with other providers and other healthcare organizations that are like-minded and looking to enter into value-based modes of care to create networks taht aren't narrow but are coordinated and high performing, said Farzad Mostashari, MD, former National Coordinator of Health Information Technology and co-founder and chief executive officer of Aledade.

The Medicare Shared Savings Program is the perfect way for primary care physicians to get involved with alternative payments as Medicare moves to replace fee-for-service, explained Hymin Zucker, MD, chief medical officer of the Triple Aim Development Group.

The government is leading the charge toward value-based care and no matter how slowly, everyone else will follow, said Jacque Sokolov, MD, chairman and CEO of SSB Solutions, during the opening keynote presentation at the Fall Managed Care Forum 2015.

When accountable care organizations first started forming, the country thought it would be easier than it has been, but finding the right partner is crucial, said Pam Halvorson, regional vice president of clinic operations with Trinity Pioneer ACO.

As the healthcare industry moves toward population health and improving quality and value, The American Journal of Managed Care (AJMC) is in a good position to help lead the change, according to Rose Maljanian, RN, MBA, chairman and chief executive officer of HealthCAWS and a member of the AJMC editorial board.

Getting health information technology (IT) to work in one provider system can be difficult enough, but in ACOs, they have multiple systems on different platforms, explained Joseph Gifford, MD, chief executive officer of the Providence-Swedish Health Alliance.

While there are reports of high patient satisfaction and well-managed costs in the Medicare program, the next 50 years will be full of new challenges, said Andrew Slavitt, acting CMS administrator, during the opening session at America's Health Insurance Plans' National Conference on Medicare.

Now that accountable care organizations are up and running, the key will be engaging those with the greatest potential to make or break their bottom lines-patients. Last week's meeting of the ACO and Emerging Healthcare Delivery Coalition, an initiative of The American Journal of Managed Care, examined why changing mindsets may matter more than technology or measurement.

A new study in JAMA Internal Medicine has found that financial integration between physicians and hospitals has led to higher spending in outpatient care.

What we're reading October 19, 2015: Clinton campaign leads rivals in pharma donations, lawmakers in North Carolina open to provider-led organizations and managed care, big surge in Medicare spending on hepatitis C drugs.

As the country moves from volume to value, accountable care organizations (ACOs) can play a key role during the transition from fee-for-service. How well do you know ACOs?

Gaps in accountable care measure sets can be addressed efficiently using priority measure types and innovative approaches to measurement.

Taking aim at payment models for patients on dialysis is the latest attempt to target high-cost areas of Medicare spending.