“Precision health” is a hot topic in healthcare today as a strategy for managing high-risk, high-cost patients. For example, two physicians who wrote in The American Journal of Managed Care last year argued creating “comprehensive data networks with information on medical claims, clinical factors (including genomics), and social determinants of health” would be required to more effectively manage higher-risk…
The National Association of Accountable Care Organizations (NAACOS) today launched a new taskforce to help doctors and hospitals understand and prepare for new value-based payment models. The nonprofit organization, which represents hundreds of organizations participating in new payment and delivery models, announced the formation of its direct contracting task force that will offer tools to providers to…
The healthcare industry must explore how their own institutions are contributing to major social issues such as institutional racism in order to really tackle the “monsters” of social determinants on health. That was a key message from Donald Berwick, the president emeritus and senior fellow at the Institute for Healthcare Improvement during the group’s annual forum this…
Healthcare in the United States is changing rapidly, and within the next few years, it will look very different than it does today. If your first thought while reading that statement was, “I’ve heard that before – and nothing actually ever changes,” your skepticism is well founded, as industry experts have been purporting significant transformation…
The proportion of value-based payments from the commercial sector to physicians and hospitals increased from 10.9 percent in 2012 to 53.0 percent in 2017. However, an overwhelming majority of those alternative payments were built on a fee-for-service foundation. Those were the findings captured in the latest National Scorecard on Payment Reform, released in December 2019 by…
The healthcare sector faces economic pressures as consumers assume greater financial responsibility for their care and government payers roll out aggressive, value-based reimbursement models. These factors are pushing providers to deliver more integrated, team-based, coordinated care. To achieve these goals, healthcare systems must transform their IT, processes and organizational infrastructures, as well as their organizational…
Americans deserve high-quality, affordable health care choices, and value-based care arrangements play a critical role in delivering on that commitment. Health insurance providers are focused on delivering value to patients, and Prominence Health Plan’s experience with a value-based shared-savings program underscores this. Prominence operates seven Accountable Care Organizations (ACOs) that reward physicians who lower health care costs and improve…
A new, independent evaluation has found that accountable care organizations (ACOs), Medicare’s dominant value-based care initiative serving nearly 11 million seniors, lowered spending by $3.53 billion from 2013 to 2017 and saved $755 million after paying shared savings. The research is the latest in a series of analyses that has demonstrated ACOs’ value to Medicare,…
Accountable care organizations (ACOs) lowered Medicare spending by $755 million from 2013 to 2017, a new analysis found. The analysis, released Tuesday by analytics firm Dobson, DaVanzo & Associates, comes as ACOs are working to meet new federal regulations from the Centers for Medicare & Medicaid Services (CMS) to make them take on financial risk…
Fourteen healthcare industry groups, including the American Hospital Association (AHA) and the American Medical Association (AMA), recently backed the campion to Senate legislation that would alter accountable care organization (ACO) benchmarking in Medicare’s largest ACO program. The Accountable Care in Rural America Act (H.R. 5212) would change title XVII of the Social Security Act to…