keyword
MENU ▼
Read by QxMD icon Read
search

ACO Accountable care organizations

keyword
https://www.readbyqxmd.com/read/29161521/lessons-from-the-camden-coalition-of-healthcare-providers-first-medicaid-shared-savings-performance-evaluation
#1
Aaron Truchil, Natasha Dravid, Stephen Singer, Zachary Martinez, Teagan Kuruna, Scott Waulters
Accountable Care Organizations (ACOs) aim to reduce health care costs while improving patient outcomes. Camden Coalition of Healthcare Providers' (Camden Coalition) work already aligned with this aim before receiving state approval to operate a certified Medicaid ACO in New Jersey. Upon its formation, the Camden Coalition ACO partnered with UnitedHealthcare and, through state legislation, Rutgers Center for State Health Policy (CSHP) was established as its external evaluator. In evaluating the Camden Coalition ACO, Rutgers CSHP built on the Medicare Shared Savings model, but modified it based on the understanding that the Medicaid population differs from the Medicare population...
November 21, 2017: Population Health Management
https://www.readbyqxmd.com/read/29135767/implementing-accountable-care-organizations-lessons-from-a-qualitative-analysis-of-four-private-sector-organizations
#2
Daniel M Walker, Jennifer L Hefner, Lindsey N Sova, Brian Hilligoss, Paula H Song, Ann Scheck McAlearney
Accountable care organizations (ACOs) are emerging across the healthcare marketplace and now include Medicare, Medicaid, and private sector payers covering more than 24 million lives. However, little is known about the process of organizational change required to achieve cost savings and quality improvements from the ACO model. This study applies the complex innovation implementation framework to understand the challenges and facilitators associated with the ACO implementation process. We conducted four case studies of private sector ACOs, selected to achieve variation in terms of geography and organizational maturity...
November 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/29090623/care-transformation-strategies-and-approaches-of-accountable-care-organizations
#3
Valerie A Lewis, Katherine I Tierney, Taressa Fraze, Genevra F Murray
Although accountable care organizations (ACOs) proliferate, little is known about the activities and strategies ACOs are pursuing to meet goals of reducing costs and improving quality. We use semistructured interviews with executives at 16 ACOs to understand ACO approaches. We identified two overarching ACO approaches to changing clinical care: a practice-based transformation approach, working to overhaul care processes and teams from the inside out; and an overlay approach, where ACO activities were centralized and delivered external to physician practices...
October 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29058518/recent-evidence-on-the-inclusion-of-hospice-and-palliative-care-physicians-in-medicare-shared-savings-program-accountable-care-organization-networks
#4
Julia Driessen, Turner West
OBJECTIVE: To document the presence of hospice and palliative physicians in Medicare Shared Savings Program (MSSP) ACOs. BACKGROUND: End-of-life care exhibits extreme variation in quality, cost, and patient experience. This baseline creates opportunities for improvements that would be financially rewarded in the new value-based reimbursement environment, such as the accountable care organization (ACO) model. Little is known about how ACOs have responded to this opportunity by including hospice and palliative providers in their formal provider networks...
October 23, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29053177/early-effect-of-medicare-shared-savings-program-accountable-care-organization-participation-on-prostate-cancer-care
#5
Tudor Borza, Samuel R Kaufman, Phyllis Yan, Lindsey A Herrel, Amy N Luckenbaugh, David C Miller, Ted A Skolarus, Bruce L Jacobs, John M Hollingsworth, Edward C Norton, Vahakn B Shahinian, Brent K Hollenbeck
BACKGROUND: Accountable care organizations (ACOs) can improve prostate cancer care by decreasing treatment variations (ie, avoidance of treatment in low-value settings). Herein, the authors performed a study to understand the effect of Medicare Shared Savings Program ACOs on prostate cancer care. METHODS: Using a 20% Medicare sample, the authors identified men with newly diagnosed prostate cancer from 2010 through 2013. Rates of treatment, potential overtreatment (ie, treatment in men with a ≥75% chance of 10-year mortality from competing risks), and Medicare payments were measured using regression models...
October 20, 2017: Cancer
https://www.readbyqxmd.com/read/29035338/integrating-medication-therapy-management-mtm-services-provided-by-community-pharmacists-into-a-community-based-accountable-care-organization-aco
#6
Brian Isetts
(1) Background: As the U.S. healthcare system evolves from fee-for-service financing to global population-based payments designed to be accountable for both quality and total cost of care, the effective and safe use of medications is gaining increased importance. The purpose of this project was to determine the feasibility of integrating medication therapy management (MTM) services provided by community pharmacists into the clinical care teams and the health information technology (HIT) infrastructure for Minnesota Medicaid recipients of a 12-county community-based accountable care organization (ACO)...
October 16, 2017: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/28984496/spending-carveouts-substantially-improve-the-accuracy-of-performance-measurement-in-shared-savings-arrangements-findings-from-simulation-analysis-of-medicaid-acos
#7
Derek DeLia
Accuracy of spending-based provider performance metrics is limited by random variation and components of spending that are uncontrollable by providers. Such components vary according to the care management focus and operational maturity of each provider group. This study uses data from New Jersey Medicaid accountable care organizations (ACOs) to examine how carving out uncontrollable components of spending affects the accuracy of performance measures in shared savings arrangements. Spending on injury care, custodial care in facilities (CCF), and amounts above $100 000 per patient are used as examples of potentially uncontrollable spending...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28944730/optimization-of-medication-use-at-accountable-care-organizations
#8
Chrisanne Wilks, Erik Krisle, Kimberly Westrich, Kristina Lunner, David Muhlestein, Robert Dubois
BACKGROUND: Optimized medication use involves the effective use of medications for better outcomes, improved patient experience, and lower costs. Few studies systematically gather data on the actions accountable care organizations (ACOs) have taken to optimize medication use. OBJECTIVES: To (a) assess how ACOs optimize medication use; (b) establish an association between efforts to optimize medication use and achievement on financial and quality metrics; (c) identify organizational factors that correlate with optimized medication use; and (d) identify barriers to optimized medication use...
October 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28915166/factors-associated-with-hospital-participation-in-centers-for-medicare-and-medicaid-services-accountable-care-organization-programs
#9
Askar S Chukmaitov, David W Harless, Gloria J Bazzoli, Yangyang Deng
BACKGROUND: In 2012, the Centers for Medicare and Medicaid Services (CMS) initiated the Medicare Shared Savings Program (MSSP) and Pioneer Accountable Care Organization (ACO) programs. Organizations in the MSSP model shared cost savings they generated with CMS, and those in the Pioneer program shared both savings and losses. It is largely unknown what hospital and environmental characteristics are associated with the development of CMS ACOs with one- or two-sided risk models. PURPOSE: The aim of this study was to assess the organizational and environmental characteristics associated with hospital participation in the MSSP and Pioneer ACOs...
September 15, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28885989/the-role-of-health-information-technology-in-advancing-care-management-and-coordination-in-accountable-care-organizations
#10
Frances M Wu, Stephen M Shortell, Thomas G Rundall, Joan R Bloom
BACKGROUND: To be successful, accountable care organizations (ACOs) must effectively manage patient care. Health information technology (HIT) can support care delivery by providing various degrees of coordination. Few studies have examined the role of HIT functionalities or the role of different levels of coordination enabled by HIT on care management processes. PURPOSES: We examine HIT functionalities in ACOs, categorized by the level of coordination they enable in terms of information and work flow, to determine which specific HIT functionalities and levels of coordination are most strongly associated with care management processes...
October 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28885893/does-patient-centered-medical-home-recognition-relate-to-accountable-care-organization-participation
#11
Yi-Ling Lin, Yuan Du, Cristina Gomez, Judith Ortiz
As of April 2015, less than 10% of Medicare Shared Savings Program Accountable Care Organizations (MSSP ACOs) included Rural Health Clinics (RHCs). In order to understand why RHCs are not participating in this ACO model in greater numbers, this study examined the influence of several factors on ACO participation. Data for this study were collected via a survey distributed during the summers of 2012, 2013, and 2014 to all RHCs in 9 states. This study had a cross-sectional design using survey research. The unit of analysis was the RHC; the total sample size was 178...
September 8, 2017: Population Health Management
https://www.readbyqxmd.com/read/28861654/breast-cancer-screening-for-patients-of-rural-accountable-care-organization-clinics-a-multi-level-analysis-of-barriers-and-facilitators
#12
Hongmei Wang, Abbey Gregg, Fang Qiu, Jungyoon Kim, Baojiang Chen, Neng Wan, Dejun Su, Tzeyu Michaud, Li-Wu Chen
Not all women 50-74 years received biennial mammography and the situation is worse in rural areas. Accountable care organizations (ACO) emphasize coordinated care, use of electronic health system, and preventive quality measures and these practices may improve their patients' breast cancer screening rate. Using medical record data of 8,347 women patients aged 50-74 years from eight rural ACO clinics in Nebraska, this study examined patient-, provider-, and county-level barriers and facilitators for breast cancer screening...
August 31, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28854072/acclimating-to-the-increase-in-statin-use-in-accountable-care-organizations-based-on-changes-in-quality-measures-a-report-from-the-accountable-care-organization-research-network-services-and-education
#13
Leah Bensimon, Genevieve Hale
The Accountable Care Organization Research Network, Services, and Education (ACORN SEED), founded by faculty members at Nova Southeastern University College of Pharmacy, is a group of pharmacists that provides unique pharmacy services to accountable care organizations (ACOs), patient-centered medical homes, and management services organizations to help maximize shared savings and target medication-related issues, while promoting the pharmacy profession and unique learning experiences for pharmacy students within these settings...
September 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28806586/the-new-frontier-of-strategic-alliances-in-health-care-new-partnerships-under-accountable-care-organizations
#14
Valerie A Lewis, Katherine I Tierney, Carrie H Colla, Stephen M Shortell
Accountable care organizations (ACOs) and similar reforms aim to improve coordination between health care providers; however, due to the fragmented nature of the US health care system, successful coordination will hinge in large part on the ability of health care organizations to successfully partner across organizational boundaries. Little is known about new partnerships formed under the ACO model. We use mixed methods data from the National Survey of ACOs, Medicare ACO performance data and interviews with executive leaders across 31 ACOs to examine the prevalence, characteristics, and capabilities of partnership ACOs and why and how ACO partnerships form...
October 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28801468/minnesota-integrated-health-partnership-demonstration-implementation-of-a-medicaid-aco-model
#15
Lynn A Blewett, Donna Spencer, Peter Huckfeldt
In recent years, accountable care organizations (ACOs) have become more prevalent in the United States, as a means to provide coordinated care by local providers. This study describes the origins, implementation, and early results of Minnesota's Medicaid ACO payment model, the Integrated Health Partnership (IHP) demonstration project. We describe the structure of the program and present preliminary evaluation results to document the state's important work and to provide lessons for other states interested in implementing Medicaid ACOs...
August 11, 2017: Journal of Health Politics, Policy and Law
https://www.readbyqxmd.com/read/28793967/type-2-diabetes-specialty-clinic-model-for-the-accountable-care-organization-era
#16
Heather Klingeman, Martha Funnell, Amolak Jhand, Sangeeta Lathkar-Pradhan, Israel Hodish
AIMS: A third of the patients with Type 2 diabetes have an advance disease that requires complex pharmacotherapies and advanced expertise, dependent on multiple clinical interactions. Unfortunately, limited providers availability enables only sporadic interactions. Additionally, the expanding Accountable Care Organization (ACO) concept enhances providers' compensation when clinical performance is improving while limiting face-to-face clinic visits. METHODS: We developed an advanced type 2 specialty clinic model, geared toward frequent remote clinical interventions while limiting face-to-face clinic visits...
October 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28748535/financial-incentives-and-physician-practice-participation-in-medicare-s-value-based-reforms
#17
Adam M Markovitz, Patricia P Ramsay, Stephen M Shortell, Andrew M Ryan
OBJECTIVES: To evaluate whether greater experience and success with performance incentives among physician practices are related to increased participation in Medicare's voluntary value-based payment reforms. DATA SOURCES/STUDY SETTING: Publicly available data from Medicare's Physician Compare (n = 1,278; January 2012 to November 2013) and nationally representative physician practice data from the National Survey of Physician Organizations 3 (NSPO3; n = 907,538; 2013)...
July 26, 2017: Health Services Research
https://www.readbyqxmd.com/read/28730518/the-case-for-enrolling-high-cost-patients-in-an-aco
#18
Abraham Graber, Shane Carter, Asha Bhandary, Matthew Rizzo
Though accountable care organizations (ACOs) are increasingly important to American healthcare, ethical inquiry into ACOs remains in its nascent stages. Several articles have raised the concern that ACOs have an incentive to avoid enrolling high-cost patients and, thereby, have an incentive to deny care to those who need it the most. This concern is borne out by the reports of consultants working with newly formed ACOs. This paper argues that, contra initial appearances, there is no financial incentive for ACOs to avoid enrolling high-cost patients...
December 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28712357/medicare-accountable-care-organizations-and-antidepressant-use-by-patients-with-depression
#19
Alisa B Busch, Haiden A Huskamp, Amanda R Kreider, J Michael McWilliams
OBJECTIVE: This study examined whether Medicare accountable care organization (ACO) programs were associated with early changes in antidepressant use or adherence among beneficiaries with depression. METHODS: A difference-in-difference design was used to compare claims from Medicare fee-for-service beneficiaries (2009-2013) and ACO patients with those from local control groups. Outcome measures were total antidepressant days supplied, filling one or more antidepressant prescriptions, and proportion of days covered (PDC) by supply among antidepressant users (adherence)...
November 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28700790/association-of-changes-in-medication-use-and-adherence-with-accountable-care-organization-exposure-in-patients-with-cardiovascular-disease-or-diabetes
#20
J Michael McWilliams, Mehdi Najafzadeh, William H Shrank, Jennifer M Polinski
Importance: Many of the quality measures used to assess accountable care organization (ACO) performance in the Medicare Shared Savings Program (MSSP) focus on disease control and medication use among patients with cardiovascular disease and diabetes. To date, the association between participation in the MSSP by provider organizations and medication use or adherence among their patients with cardiovascular disease or diabetes has not been described. Objective: To assess the association between exposure to the MSSP and changes in the use of and adherence to common antihypertensive, lipid-lowering, and hypoglycemic medications...
September 1, 2017: JAMA Cardiology
keyword
keyword
37400
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"