Value-Based Care

For many, a bill for more than a quarter million dollars is nothing to scoff at-but while treating those with cancer, these costs are all too common.

Katherine Baicker, PhD, professor of health economics, Department of Health Policy and Management, Harvard School of Public Health, says that Medicare Advantage Plans still hold promise to deliver high-value, better-tailored care to beneficiaries.

Not surprisingly, Thomas Merrill, lead researcher, Center for Accountable Care Intelligence, Leavitt Partners, LLC, said that cost is a major work flow challenge associated with Accountable Care Organizations.

Since 2010, the growth and proliferation of accountable care organizations (ACOs) has increased, and the rise of this collaborative care model is not without reason. Lack of consumer engagement, lack of competition, and misaligned incentives have made care less affordable.

Richard Stefanacci, DO, chief medical officer, The Access Group, said that it is necessary for retail pharmacists to break out of their silo. Dr Stefanacci noted that retail pharmacists are being utilized within practices and stepping out of their normal roles.

Hospital CEOs' pay isn't linked to their hospital's benefit to the community. Nor is it linked to the quality of care the hospital provides, a new study found.

The success of accountable care organizations (ACOs) and patient-centered medical homes (PCMHs) will depend upon physicians who embrace the concept of managing care across the care continuum and leading teams of professionals committed to evidence-based medicine while delivering on continuous quality improvement.

ACOs are groups of providers that have been assigned a projected budget per patient. If the cost of caring for the patient comes in below that level, the group shares the savings. The idea is that doctors will better coordinate care to prevent wasteful or ineffective treatment. Pilot programs suggest the jury is still out on ACOs' ability to drive this kind of behavior.

The nation's largest health plans say they are rapidly moving toward transparency and away from paying doctors and hospitals on a fee-for-service basis, four insurance executives said this morning at Forbes Healthcare Summit 2013.

Expansion or not, it is obvious that states must consider how to make their Medicaid programs more sustainable.

Joseph Antos, the Wilson H. Taylor Scholar in Health Care and Retirement Policy, American Enterprise Institute, says the federal Medicare program not only has a spending problem, but a delivery system problem that the fee-for-service model has not solved.

In five markets around the country, accountable care organizations were providing care to more than half the Medicare patients in the traditional fee-for-service program, a new study found. In addition, ACOs were more likely to be found in markets with greater consolidation by hospitals and doctors.

In the past few years, efforts to lower costs and improve care have proliferated.

Having access to a computer and the Internet may seem like a basic commodity for most Americans, but for the economically challenged, this is not always the case.

Melanie Bella, director, Medicare-Medicaid Coordination Office, Centers for Medicare & Medicaid Services, says the sole focus of the Medicare-Medicaid Coordination Office is to increase coordination and access to services from many fronts.

The concept of the Patient-Centered Medical Home (PCMH) has received plenty of attention, but its foundation is built on understanding who will be the repeat customers. Finding the best yardstick to determine that is the subject of a study published this month by The American Journal of Managed Care.

While more than 35 million people worldwide are living with dementia, that number is expected to reach more that 115 million by 2050.

Access to affordable, quality healthcare for poor Americans varies dramatically among the states, according to a new study that found a wide disparity in measures of health between states with the best healthcare systems and those with the worst.

States are increasingly turning to insurance companies to provide coverage for people on Medicaid in hopes of saving money and improving care.

A new study suggests that primary care providers participating in an accountable care organization (ACO) and having greater engagement with patients transparency into the cost of services and procedures have the ability to bend the healthcare cost curve by an 8 to 1 margin in terms of return on investment (ROI).

As healthcare delivery evolves to be more efficient and cost-effective, health technology continues to show the biggest promise.

The ability to treat cancer in a growingly aging population is reaching a near crisis level in the healthcare community.

Medicine is unique in being the one profession that never teaches even its recruits how they, or the services they deliver, are paid and importantly, by whom.

Accountable care organizations (ACOs) and other coordinated care models present opportunities for improving quality as well as offering incentives that will drive lower-cost decision making among providers

Amitabh Chandra, PhD, says health reform affects patient-centered diabetes care through two different interventions.

Susan Dentzer, senior policy adviser, Robert Wood Johnson Foundation, says there are many trends that are transforming today's health insurance marketplace.

Driving value-based care through incentives that reward lower-cost delivery measures showed promising results in a recent study.

Medicare may enjoy the fruits of the growing and varied work among private payers and providers to boost value in healthcare, though the benefits will come sooner to costs than quality, a study suggests.

Adhering to the best practices in cancer care may be the answer many oncologists have been looking for, at least according to one hospital's findings.

Bruce Feinberg, DO, Vice President and Chief Medical Officer, Cardinal Health Specialty Solutions, says cancer treatment is more than clinical guidelines, protocols, or individual drugs.