Central to the controversy about ACOs’ potential for Value-Based Care is whether they actually save enough money and reduce costs fast enough. Researchers and advocates have produced various independent studies of ACO savings, the most generous estimating $1.8 billion in cumulative savings over the first three years of the program, almost double CMS estimates. Many…
Earlier this month, Premier hosted a panel on value-based care (VBC), with providers from across the healthcare continuum discussing its merits and pitfalls. In attendance were members of Congress and their staffers to hear how precisely VBC has been effective and policy changes needed to continue its forward progress. One message came through above all…
Whether they are called patient navigators, advocates, coaches, or community health workers, non-clinical health workers are becoming increasingly important for patient engagement and care coordination. About half of all healthcare workers are non-clinical staff. This includes community health workers, patient navigators, health coaches, and other individuals who interact with patients but do not dispense medical…
Medicare and commercial insurers are adamant about moving providers from Fee-for-Service to financial risk for services, and CMS is losing patience over providers’ reluctance to embrace downside-risk ACOs. Why are providers so worried about accepting risk? Because, they say, provider choice will ruin their potential for savings. With an estimated 25 percent of patients seeking…
As healthcare technology continues to permeate the medical industry, experts are continuing to evaluate how connected health tools can impact patient engagement and the overall patient experience. As noted in a 2013 study in the International Journal of Medicine, connected health includes a broad set of definitions. “Connected Health encompasses terms such as wireless, digital,…
In 2011, the U.S. Department of Health and Human Services (HHS) released new rules under the Affordable Care Act (ACA), aimed at helping doctors, hospitals and other providers better coordinate care by way of accountable care organizations, or ACOs. ACOs provide a framework for rewarding providers financially — in both the public and private sectors…
Controlled studies have shown that some care management interventions, which typically support patients with outreach and regular contact by trained individuals such as nurse case managers or health coaches, can have a positive impact on health quality measures like HbA1c for diabetes. However, the impact of care management on associated costs of care is mixed…
In previous blogs, we have discussed programs whose goals are to improve patient outcomes through quality care while increasing provider efficiency. An additional program provided by CMS to help in these efforts is the Chronic Care Management (CCM) program. CMS has made CCM available to Medicaid ACOs as they seek to create savings for both…
Of the hundreds of conversations I’ve had this year about population health management, there is perhaps no question I get more than how to calculate the ROI of the incredible work many of you are doing to better manage patients and bend the cost curve. Since the impact of care management efforts is often articulated…
Accountable care organizations (ACO) are aimed at decreasing costs while improving quality of care but Massachusetts emergency department directors report an inability to meet ACO goals. Challenges with care coordination often stand in the way of hospitals meeting ACO objectives according to 62% of Massachusetts emergency department (ED) directors that responded to an Annals of…