This Week in Managed Care: August 29, 2015

Transcript (slightly modified for readability)

Hello, I’m Justin Gallagher, associate publisher of The American Journal of Managed Care.

Welcome to This Week in Managed Care, from the Managed Markets News Network.

Medicare ACOs Show Mixed Savings Results

Our top story this week comes from CMS, which announced the ACOs that met their targets for 2014. Ninety-seven ACOs will share a total of $422 million in bonus payments for achieving savings goals and quality care scores.

CMS Acting Administrator Andy Slavitt said, “These results show that accountable care organizations as a group are on the path toward transforming how care is provided.”

But with more than 350 groups in the program, the results show that finding savings while meeting delivery high-quality care is not easy. And it isn’t going to get easier, because CMS is setting more ambitious reimbursement goals for 2016 and beyond.

To help ACOs navigate the new landscape, The American Journal of Managed Care created the ACO and Emerging Healthcare Coalition, which brings stakeholders from across healthcare together to share ways to create, grow, and improve these organizations.

Our next meeting is October 15-16 in Palm Harbor, Florida. Learn more and register.

Losing Weight With Physician Involvement

A study published this week found that patients who are trying to lose weight appreciate their doctor’s active involvement.

Results from a two-year trial that appeared in the journal Patient Education and Counseling found that patients who rated their primary care provider’s support as a useful influence lose 6 more pounds on average than those who did not have the same involvement from their provider.

Most of the survey participants were women, with an average BMI of 36, and 40 percent were African American, a group that is at higher risk of obesity.

The study’s lead author, Dr Wendy Bennet of Johns Hopkins School of Medicine, said the results support team-based care models, which are not common.

EHR Trigger for Cancer Diagnosis Follow-Up

When there’s no follow-up to abnormal lab findings, a cancer diagnosis can be delayed, and so can treatment. A patient may experience anxiety for no reason. Findings published this week in the Journal of Clinical Oncology report an algorithm that can prompt a patient’s electronic health record to avoid these delays.

In the study, the algorithm was used to trigger follow-up reviews for patients with possible lung, colorectal or prostate cancer. The authors found the intervention took 96 days off the average time to diagnostic evaluation, compared with the control group, for those with possible colorectal cancer. For those with possible prostate cancer, the intervention took 48 days off the wait time compared with the control group.

Said the study’s author, Dr Hardeep Singh, “Missed or delayed diagnoses are among the most common concerns in outpatient settings, and measuring and reducing them are a high priority. Solutions that harvest and put to use the vast amount of electronic clinical data being collected are essential.”

Colorectal Screening

Finally, The American Journal of Managed Care recently featured 3 papers that highlight important issues on colorectal cancer screening. The Affordable Care Act calls for eliminating out-of-pocket costs for screening for this deadly form of cancer, but the uptake for testing hasn’t been as high as some had hoped. To understand the barriers, costs, and opportunities for screening, you can find this group of papers at ajmc.com

For everyone at the Managed Markets News Network, I’m Justin Gallagher. Thanks for joining us.