Premier recently announced that its Medicare accountable care organizations (ACOS) thru the Population Health Management Collaborative have outperformed other programs and could’ve saved Medicare $1.36 billion. Read more here. (Source: Jacqueline Belliveau, RevCycleIntelligence, […]
What Are the True Costs of ACOs and Medical Homes?
This article takes a deeper look at the CMS's proposed MACRA rule, and how poorly Medicare ACO's and "homes" have performed. Are they saving money? Are they making money? Are they costing money? Learn more here. (Source: Kip Sullivan, The Health Care Blog, 6/22/16) […]
ACOs Do Not Work and Here is Why
Accountable care organizations (ACO's) came with a promise to save us! Save the government, save physicians, save patients and save money! Read more here on why this is not what is happening. (Source: Anish Koka, The Health Care Blog, 4/25/16) […]
Lowering Costs and Improving Care in ACOs
In a recent session at AMCP Managed Care & Specialty Pharmacy Annual Meeting, presenters highlighted the role of the pharmacist in ACOs. How can integrating pharmacists into accountable care organizations (ACOs) help lower costs and increase quality care? See more here. (Source: First Report […]
Is Your Doctor Spending More Time With You?
Value-based reimbursement is helping physicians spend more time with patients. Find out how, here. (Source: Aine Cryts, Managed Healthcare Executive, 2/19/16) […]
What is an Accountable Care Organization?
Download this infographic for a definition and explanation of what an Accountable Care Organization (ACO) is and more. (Source: National Pharmaceutical Council) […]
More on How Not to Research ACOs
Part II of a series examines a paper recently published by the Center for Health Care Strategies (CHCS), Accountable Care Organizations: Looking back and Moving Forward, to address two problems; The vague definition of ACOs, and the loose standards of evidence. More here. Stay tuned for part III. […]
Where is the Useful Research on ACOs?
After almost a decade since the conception of ACOs, we know remarkably very little about ACOs performance, and what they do for their patients that non-ACO providers do not. More here on two reasons for this information vacuum. (Source: Kip Sullivan, The Health Care Blog, 2/16/16) […]
Aetna to Move to Value-Based Payment Model
Aetna Inc and the Delaware Valley Accountable Care Organization (DVACO) have recently reached an agreement aimed to improve quality, efficiency, and the patient experience. Learn more. (Source: First Report Managed Care, 2/3/16) […]
CMS Proposes Changes to ACO Benchmarks
The CMS wants to change the way it evaluates whether accountable care organizations (ACOs) actually save money, by analyzing trends in regional fee-for-service costs. Read more. (Source: Virgil Dickson, Modern Healthcare, 1/28/16) […]
Medicare ACOs Show Difficulty Slowing Spending
Medicare recently released 2014 results for 353 accountable care organizations (ACOs), finding 3 out of 4 failed to slow health spending enough to earn bonuses. Read more here. (Source: Melanie Evans, Modern Healthcare, 8/25/15) […]
Making Healthcare Data More Accessible, Useful and Available in the U.S.
The National Quality Forum recently released a white paper, Data Needed for Systematically Improving Healthcare, highlighting strategies to help make healthcare data and analytics more available and usable for providers and consumers. Rob Saunders, senior director at the National Quality Forum, […]
How is Claims Data Being Used in the Marketplace?
Data Sources for Rate-Setting in ACOs, Exchanges and Narrow Networks, part of AIS's Management Insight Series, examines the various ways claims data can be used in the new health insurance marketplace. Available for purchase here. (Source: AISHealth) […]
Don’t Miss This AIS Virtual Conference: Oncology Management 2015
This unique virtual conference can be attended from the convenience of your own office, by your entire management team. Hear from many of the nation's top oncology thought leaders on health plans, oncology provider groups and benefit management companies. More information available here. (Source: […]
Do You Speak My Language? When Patient Care Meets Cost-Effectiveness
Health system innovations are sometimes justified in economic language, but clinicians speak the language of patient care. Advancing reform requires translators who speak both languages. Read more here. (Source: AJMC, 6,12,15) […]
Pioneer ACOs vs Medicare FFS
A recent study was conducted to determine whether fee-for-service (FFS) beneficiaries associated with Pioneer Accountable Care Organizations (ACOs) had less increases in spending and utilization than other FFS beneficiaries - while experiencing the same levels of care. Read more here. (Source: First […]
More Than 75% of ACOs with Commercial Contracts Responsible for Prescription Spending
According to a recent study in the Journal of Managed Care & Specialty Pharmacy, more than 75% of accountable care organizations (ACOs) with commercial contracts have responsibility for prescription drug spending through their largest contract. Read here. (First Report Managed Care, 5/21/15) […]
Value-Based Reimbursement Answer Book: 97 FAQs On Healthcare Models, Measures And Methodology
In this 60-page resource, industry early adoptors weigh in on the structure, data tools and processes at work in delivery models supporting pay-for-value: the patient-centered medical home (PCMH), accountable care organization (ACO), medical neighborhood, and others, as well as emerging incentives […]
97 FAQs on Healthcare Models, Measures and Methodology
The Value-Based Reimbursement Answer Book: 97 FAQs on Healthcare Models, Measures and Methodology, is a 60-page resource, providing a framework for healthcare's new value proposition, with advice from thought leaders steeped in the delivery and reimbursement of value-based care. Information on […]
Implications Of The ACA, New Care Models for Pharmacists
Paul Baldwin, BS, principal, Baldwin Health Policy Group, LLC, recently discussed pharmacists' involvement in ACOs and other care models with an overview of the Patient Protection and Affordable Care Act (ACA) during a session at the ASCP meeting. See what he had to say here. (Source: Eileen […]
What Exactly Is The Health Care Transformation Task Force?
The Department of Health and Human Services announced a goal for Medicare to shift 50 percent of its provider payments into alternative payment arrangements by 2018. Shortly after, Health care giants; Aetna, Blue Cross giant Health Care Services Corporation, Ascension Health and Trinity Health, […]
A Look At The Life Of ACOs
It's been 10 years since the first accountable care organizations (ACOs) were implemented. During a session at the NAMCP forum, Jane DuBose, senior director, Decision Resources Group, discussed the evolution of ACOs and how the ACA has changed the process. Read more here. (Source: Kerri Fitzgerald, […]
Specialty ACOs vs Traditional ACOs – Which Is Right For You?
Accountable Care Organizations (ACOs) have only been around for a few years, but we have already seen their reach broaden and change with creation of Specialty ACOs. What is the difference between specialty ACOs and traditional ACOs - and which would be better for you? See more here. (Source: Susan […]
Which Value-Based Healthcare Delivery Model Is Right For Your Organization?
6 Value-Based Physician Reimbursement Models: Action Plans for Alignment, Analytics and Profitability, is a 40-page resource examining a set of provider compensation models across the collaboration continuum, advising adopters on potential pitfalls and suggesting strategies to survive implementation […]
Humana’s Accountable Care Models – Saving Money & Improving Outcomes
Healthcare Effectiveness Data and Information Set (HEDIS), is used by over 90% of American's health plans to measure performance on defined dimensions of care and service. According to recent HEDIS star scores, accountable care is having a measurable impact on the quality of care experienced by […]
Are Specialty ACOs A Promising Option?
While it’s early to say definitively whether forming or joining a specialty ACO would be a better option than establishing or participating in a traditional ACO, there are some factors managed healthcare executives should consider in their decision-making. Learn more here. (Source: Managed […]
Healthcare Industry Strategies In 2015
Surprisingly, both payers and providers are pursuing similar strategies, with the result that they may end up meeting in the middle. What will their competitive advantage be at that point? See more here. (Source: HIN, November 2014) […]
Improving ACO Patient Outcomes and Costs With Medication Therapy Management
This case study is the first of a series of articles that will address the gaps identified by the ACO Medication Readiness Assessment. NPC and its partners hope that these real-world examples can be helpful to other ACOs seeking to leverage pharmacists and pharmacy services in this new payment and […]
Improving Patient Outcomes and Costs in An ACO
This case study explores the important role that pharmacists can play in ensuring the optimal use of pharmaceuticals and improving patient outcomes in an accountable care organization (ACO). See more here. (Source: National Pharmaceutical Council). […]
How Do We Fill The Gaps In Measuring The Quality And Cost Of Health Care?
New Research from the National Pharmaceutical Council and Discern Health, offers solutions for addressing measure gaps, particularly for specialty care and innovative treatment. Measuring the quality and cost of health care is an integral part of accountable care and this report sheds light on gaps […]
