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Assessment of Accountable Care Organization Strategies: A Qualitative Approach

January 1, 2024Garrett Schmitt

Abstract Accountable care organizations (ACOs) are becoming increasingly popular in healthcare in order to improve quality, reduce costs, and enhance patient outcomes. ACOs are an association of hospitals, healthcare providers and insurers who assume financial and medical responsibility for a patient population. In Saudi Arabia, the Ministry of Health (MOH) has been tasked with delivering…

NIH grant awarded to study effect of Medicaid ACOs on children’s mental healthcare

December 28, 2023Garrett Schmitt

UMass Amherst researcher Sarah Goff, MD, received a five-year, $2.2 million grant from the National Institutes of Health to examine the effects of Medicaid accountable care organizations on the quality of behavioral and mental health for Massachusetts children. Full Article

Value-based payment models and management of newly diagnosed prostate cancer

December 26, 2023Garrett Schmitt

Objective To examine the effect of urologist participation in value-based payment models on the initial management of men with newly diagnosed prostate cancer. Methods Medicare beneficiaries with prostate cancer diagnosed between 2017 and 2019, with 1 year of follow-up, were assigned to their primary urologist, each of whom was then aligned to a value-based payment model…

Using patient-reported outcome measures and patient-reported experience measures to elevate the quality of healthcare

December 26, 2023Garrett Schmitt

The path to exceptional healthcare quality is understanding patients’ experiences and needs and the subsequent integration of these insights into clinical practice [1]. The importance of the patient voice is also reflected in the 2023 World Patient Safety Day theme: ‘Engaging patients for patient safety’. One way to understand patient experiences and needs is by…

Payment integrity in the age of AI and value-based care

December 22, 2023Garrett Schmitt

The payment integrity (PI) industry plays a critical role in US healthcare, ensuring that claims adjudication is accurate and that physicians and health systems are reimbursed correctly for care delivery. We estimate the $9 billion industry has grown at a 7 percent CAGR in recent years, reflecting growth in US healthcare spending and persistent complexity…

Next Steps For Engaging Specialty Care In ACO Models

December 22, 2023Garrett Schmitt

As we described in Part 1 of this article, specialty care providers have had limited opportunities to date for engagement in accountable care models, such as accountable care organizations (ACOs), despite their critical contributions to patient care. This is a missed opportunity for payment reform, given the growing breadth and reach of ACOs and the…

FQHCs Shine in Value-Based Care: MHN Partners Achieve $10M Savings and Perfect Quality Score

December 22, 2023Garrett Schmitt

What You Should Know: – Medical Home Network (MHN), a leading care enablement partner for FQHCs, announced that its partners participating in the NeueHealth Premier ACO achieved $10.1 million in gross savings and a perfect 100% quality score in the 2022 performance year. – This accomplishment, under the ACO Realizing Equity, Access, and Community Health…

Startup Guidehealth buys Arcadia’s value-based care division, plans to build out predictive, gen AI tech

December 22, 2023Garrett Schmitt

Guidehealth, a value-based care enablement startup, bought Arcadia’s managed service organization and value-based care service division to build out its tools and service for providers. Guidehealth also is partnering with Arcadia, a healthcare technology company that provides a data platform to providers and payers, to use the company’s data analytics platform to power its newly acquired offering….

Regulators adjust OneCare budget, look toward new strategy

December 21, 2023Garrett Schmitt

State health care regulators at the Green Mountain Care Board have cut the annual operating budget for OneCare Vermont for the second year in a row, citing ongoing questions about the effectiveness of the accountable care organization and how executives are compensated, as well as about what the organization’s future role in the state will…

Engaging Specialists In Accountable Care: Tailoring Payment Models Based On Specialties And Practice Contexts

December 21, 2023Garrett Schmitt

Accountable care models serve as the cornerstone of value-based approaches to expand access to well-coordinated, high-quality, and longitudinal care. Specialist engagement in these models is critical given the increasing role of specialists in managing care across the patient journey, the growing importance of specialized diagnostics and early disease interventions (such as biologics and cell and…

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