AJMC® in the Press, May 19, 2017

An article on RevCycleIntelligence.com discussed a commentary from the April issue of The American Journal of Managed Care^® (AJMC^®). In “Real-World Evidence and the Behavioral Economics of Physician Prescribing,” Bruce Feinberg, DO, suggested an explanation for why alternative payment models (APMs) have not had the desired effect on prescribing patterns. According to Feinberg, behavioral economic theories “may explain the irrational economic actors in regard to physician prescribing, including heuristics, framing, and defaults.”

RevCycleIntelligence.com reported that 10 health industry groups penned a letter to HHS Secretary Tom Price, MD, imploring him to include Medicare Advantage (MA) plans as Advanced APMs under the Medicare Access and CHIP Reauthorization Act. The article cited a study from the January issue of AJMC^® to demonstrate the benefits of MA plans. “Value-Based Contracting Innovated Medicare Advantage Healthcare Delivery and Improved Survival” found that MA enrollees had a 6% higher survival rate and fewer emergency department visits and inpatient admissions. The same study was also mentioned in a Healthcare Informatics article about the letter to Price.

Another RevCycleIntelligence.com article referenced an AJMC^® study to provide context for its advice on implementing population-based APMs. “Risk Contracting and Operational Capabilities in Large Medical Groups During National Healthcare Reform,” a study from June 2016, found that around one-third of healthcare groups received more than half of their revenue from a risk-based APM. According to RevCycleIntelligence.com, this reveals the apprehension some health systems feel about switching to risk-based models.

“Strong care coordination is one of the core necessities for effective chronic disease management,” a PatientEngagementHIT.com article declared. To back up this assertion, it cited the findings of a 2015 study published in AJMC^®. The authors of “Care Fragmentation, Quality, and Costs Among Chronically Ill Patients” found that highly fragmented primary care was associated with $4542 higher healthcare costs and increased rates of preventable hospitalizations among patients with chronic disease.

A HealthITAnalytics.com article announced that CMS is expanding the Comprehensive Primary Care (CPC) Plus model to 4 new regions, and referenced a recent AJMC^® research that indicated some of the benefits of the model. Published in AJMC^®’s March issue, “Patient Experience Midway Through a Large Primary Care Practice Transformation Initiative” found that CPC practices received better patient experience ratings than practices that had not made the switch.