Value-Based Care

Zirui Song, MD, PhD, resident at Massachusetts General Hospital, discussed his research interests, which center on strategies to control healthcare spending while improving the quality of care. He also expressed the importance of examining health equity within the United States healthcare system.

Researchers at the University of Pennsylvania have recognized that narrow provider networks are quite likely to exclude National Cancer Institute—Designated Cancer Centers or National Comprehensive Cancer Network Cancer Centers, which could prevent patient access to high-quality cancer care.

The National Quality Forum (NQF) has issued a report detailing the results of its experiment with including social risk factors in its risk adjustment models for performance measures.

The Government Accountability Office (GAO) recommended that CMS should take steps to prevent lower quality hospitals from qualifying for value-based bonuses, after a report by the office found that some bonuses in recent years had rewarded poorly-rated hospitals.

Public and private payment reforms such as accountable care organization contracts have shown some initial evidence of changes in physician behavior, but their full promise remains to be seen, according to Zirui Song, MD, PhD, resident at Massachusetts General Hospital.

In the June issue of The American Journal of Accountable Care®, authors described how their accountable care organization achieved impressive shared savings.

Oncologists envision a move towards using data to become a learning health system, which is aided by the changing landscape emphasizing quality and value, explained Bobby Green, MD, MSCE, senior vice president of clinical oncology at Flatiron Health.

This study identifies practices and perceptions around public reporting of “roll-upâ€

In response to trepidation from clinicians, CMS has announced a proposal to alter the rules of the Quality Payment Program established by the Medicare Access and CHIP Reauthorization Act (MACRA). The changes will exempt thousands of physicians from quality reporting requirements and allow small practices to form “virtual groups” with one another.

Coverage from the 2017 Spring Live Meeting of the ACO & Emerging Healthcare Delivery Coalition® on May 4-5, 2017, in Scottsdale, Arizona.

This qualitative study draws on interviews with clinical staff to examine health workforce use within accountable care organizations and identifies common roles that support value-based care.

Increasing accountable care organization savings is dependent on maximizing quality scores and increasing the number of beneficiaries while maintaining a low per-capita spend through efficiencies of care.

Ongoing legislative developments and the latest experiences with implementing alternative payment mechanisms are just some of the reasons Clifford Goodman, PhD, senior vice president and director at the Center for Comparative Effectiveness Research at the Lewin Group, is looking forward to the fall meeting of the ACO & Emerging Healthcare Delivery Coalition.

Amidst a turbulent political climate as Republicans endeavor to enact the American Health Care Act, the shift to value-based contracts will continue due to the other market forces in play, explained Clifford Goodman, PhD, moderator at the ACO Coalition spring live meeting in Scottsdale, Arizona, and senior vice president and director at the Center for Comparative Effectiveness Research at the Lewin Group.

Thresholds can be useful to focus the conversation around the value of treatments in healthcare even if stakeholders have different views on what thresholds should be, explained Steve Pearson, MD, MSc, president of the Institute for Clinical and Economic Review.

The provision in the Affordable Care Act to remove cost sharing for preventive care visits created a shift in how Medicare pays with a greater emphasis on prevention and managing chronic diseases, and less on treatment of acute illness, said Mariétou Ouayogodé, PhD, post-doctoral fellow at The Dartmouth Institute for Health Policy and Clinical Practice at the Geisel School of Medicine at Dartmouth.

Heather Zacker, MS, senior director of Care Alliances of Joslin Innovation at Joslin Diabetes Center, discussed several ways primary care offices can transform their practices to provide optimal diabetes care. These include quality improvement, data analysis, and benchmarking initiatives to make the office more diabetes-friendly.