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ACO Accountable care organizations

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https://www.readbyqxmd.com/read/27913910/a-randomized-trial-of-displaying-paid-price-information-on-imaging-study-and-procedure-ordering-rates
#1
Alyna T Chien, Lisa Soleymani Lehmann, Laura A Hatfield, Kate E Koplan, Carter R Petty, Anna D Sinaiko, Meredith B Rosenthal, Thomas D Sequist
BACKGROUND: Prior studies have demonstrated how price transparency lowers the test-ordering rates of trainees in hospitals, and physician-targeted price transparency efforts have been viewed as a promising cost-controlling strategy. OBJECTIVE: To examine the effect of displaying paid-price information on test-ordering rates for common imaging studies and procedures within an accountable care organization (ACO). DESIGN: Block randomized controlled trial for 1 year...
December 2, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27870686/era-of-a-single-population-based-payment-to-a-cancer-center-delivering-the-value-of-interventional-oncology-in-accountable-care-organizations
#2
Jemianne B Jia, Riccardo Lencioni, Howard P Forman, Hyun S Kim
To curtail increasing health care costs, the government has ushered in the era of the Accountable care organization (ACO). The purposes of this review are to evaluate the effects the ACO will have on the practice of interventional oncology and its role in cancer care and to explore methods to assimilate. Proposed action points include integration into the modern-day cancer center, adoption of an outpatient clinic, mandatory performance measures, and workflow and cost analysis. If adaptations are made, interventional oncology can continue its role in cancer treatment, will provide more effective care, and reach more patients in the new ACO...
November 2016: Cancer Journal
https://www.readbyqxmd.com/read/27834253/housing-transportation-and-food-how-acos-seek-to-improve-population-health-by-addressing-nonmedical-needs-of-patients
#3
Taressa Fraze, Valerie A Lewis, Hector P Rodriguez, Elliott S Fisher
Addressing nonmedical needs-such as the need for housing-is critical to advancing population health, improving the quality of care, and lowering the costs of care. Accountable care organizations (ACOs) are well positioned to address these needs. We used qualitative interviews with ACO leaders and site visits to examine how these organizations addressed the nonmedical needs of their patients, and the extent to which they did so. We developed a typology of medical and social services integration among ACOs that disentangles service and organizational integration...
November 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27707589/future-considerations-for-clinical-dermatology-in-the-setting-of-21st-century-american-policy-reform-accountable-care-organizations
#4
Harrison P Nguyen, John S Barbieri, Howard P Forman, Jean L Bolognia, Marta J VanBeek
An Accountable Care Organization (ACO) is a network of providers that collaborates to manage care and is financially incentivized to realize cost savings while also optimizing standards of care. Since its introduction as part of the 2010 Patient Protection and Affordable Care Act, ACOs have grown to include 16% of Medicare beneficiaries and currently represent Medicare's largest payment initiative. Although ACOs are still in the pilot phase with multiple structural models being assessed, incentives are being introduced to encourage specialist participation, and dermatologists will have the opportunity to influence both the cost savings and quality standard aspects of these organizations...
October 1, 2016: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/27704322/an-agent-based-simulation-model-of-patient-choice-of-health-care-providers-in-accountable-care-organizations
#5
Abdullah Alibrahim, Shinyi Wu
Accountable care organizations (ACO) in the United States show promise in controlling health care costs while preserving patients' choice of providers. Understanding the effects of patient choice is critical in novel payment and delivery models like ACO that depend on continuity of care and accountability. The financial, utilization, and behavioral implications associated with a patient's decision to forego local health care providers for more distant ones to access higher quality care remain unknown. To study this question, we used an agent-based simulation model of a health care market composed of providers able to form ACO serving patients and embedded it in a conditional logit decision model to examine patients capable of choosing their care providers...
October 4, 2016: Health Care Management Science
https://www.readbyqxmd.com/read/27702959/acos-holding-commercial-contracts-are-larger-and-more-efficient-than-noncommercial-acos
#6
David Peiris, Madeleine C Phipps-Taylor, Courtney A Stachowski, Lee-Sien Kao, Stephen M Shortell, Valerie A Lewis, Meredith B Rosenthal, Carrie H Colla
Accountable care organizations (ACOs) have diverse contracting arrangements and have displayed wide variation in their performance. Using data from national surveys of 399 ACOs, we examined differences between the 228 commercial ACOs (those with commercial payer contracts) and the 171 noncommercial ACOs (those with only public contracts, such as with Medicare or Medicaid). Commercial ACOs were significantly larger and more integrated with hospitals, and had lower benchmark expenditures and higher quality scores, compared to noncommercial ACOs...
October 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27687917/determinants-of-success-in-shared-savings-programs-an-analysis-of-aco-and-market-characteristics
#7
Mariétou H Ouayogodé, Carrie H Colla, Valerie A Lewis
BACKGROUND: Medicare's Accountable Care Organization (ACO) programs introduced shared savings to traditional Medicare, which allow providers who reduce health care costs for their patients to retain a percentage of the savings they generate. OBJECTIVE: To examine ACO and market factors associated with superior financial performance in Medicare ACO programs. METHODS: We obtained financial performance data from the Centers for Medicare and Medicaid Services (CMS); we derived market-level characteristics from Medicare claims; and we collected ACO characteristics from the National Survey of ACOs for 215 ACOs...
September 27, 2016: Healthcare
https://www.readbyqxmd.com/read/27668560/the-central-role-of-physician-leadership-for-driving-change-in-value-based-care-environments
#8
Adam Lustig, Michael Ogden, Robert W Brenner, Jerry Penso, Kimberly D Westrich, Robert W Dubois
BACKGROUND: In 2013, it was reported that about 1 of every 3 U.S. adults has hypertension. Of these 70 million individuals, approximately 50% have their blood pressure under control. Achieving hypertension control, especially in at-risk populations, requires a multipronged approach that includes lifestyle modifications and pharmacological treatment. As provider groups, hospital systems, and integrated delivery networks optimize their care processes to promote population health activities in support of the accountable care organization (ACO) model of care, managing hypertension and other chronic diseases will be essential to their success...
October 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27666768/cytomegalovirus-cmv-in-gastrointestinal-mucosal-biopsies-should-a-pathologist-perform-cmv-immunohistochemistry-if-the-clinician-requests-it
#9
Gordana Juric-Sekhar, Melissa P Upton, Paul E Swanson, Maria A Westerhoff
Cytomegalovirus (CMV) causes clinically significant gastrointestinal (GI) injury. CMV inclusions can be identified on routine hematoxylin and eosin (H&E) stain, but immunohistochemistry (IHC) is also available for identifying CMV in tissue. The advent of accountable care organization (ACO) models of care bring into question whether it is cost-effective for immunohistochemistry to be performed upfront at the request of clinicians and whether the quality of viral detection is compromised when the diagnosis of CMV is predicated on histologic review...
September 22, 2016: Human Pathology
https://www.readbyqxmd.com/read/27662219/the-opportunities-and-challenges-of-the-mssp-aco-program-a-report-from-the-field
#10
Farzad Mostashari, Travis Broome
In this article, we seek to provide the first detailed description of a Medicare Shared Savings Program (MSSP) accountable care organization (ACO)'s actions and results to help increase understanding of the challenges and opportunities facing ACOs, and in particular, those comprised of a network of independent practices. Whether ACOs have been successful in delivering value has been the subject of much debate and speculation. What has been missing from this discussion is a look at the program from the frontlines and those who are launching and running MSSP ACOs...
September 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27646860/impact-of-medicare-shared-savings-program-accountable-care-organizations-at-screening-mammography-a-retrospective-cohort-study
#11
Anand K Narayan, Susan C Harvey, Daniel J Durand
: Purpose To evaluate the impact of accountable care organizations (ACOs) on use of screening mammography in the Medicare Shared Savings Program (MSSP), the largest value-based reimbursement program in U.S. HISTORY: Materials and Methods Institutional review board approval was waived, as the study used publicly available unidentifiable data. Medicare data were retrospectively obtained for participating ACOs from 2012 to 2014. Baseline information and the ACO-20 measure (percentage of women aged 40-69 years who underwent screening mammography within 24 months) were obtained...
September 20, 2016: Radiology
https://www.readbyqxmd.com/read/27637820/do-accountable-care-organizations-acos-help-or-hinder-primary-care-physicians-ability-to-deliver-high-quality-care
#12
Robert A Berenson, Rachel A Burton, Megan McGrath
BACKGROUND: Many view advanced primary care models such as the patient-centered medical home as foundational for accountable care organizations (ACOs), but it remains unclear how these two delivery reforms are complementary and how they may produce conflict. The objective of this study was to identify how joining an ACO could help or hinder a primary care practice's efforts to deliver high-quality care. METHODS: This qualitative study involved interviews with a purposive sample of 32 early adopters of advanced primary care and/or ACO models, drawn from across the U...
September 2016: Healthcare
https://www.readbyqxmd.com/read/27625745/oncologist-support-for-consolidated-payments-for-cancer-care-management-in-the-united-states
#13
Siva Narayanan, Emily Hautamaki
BACKGROUND: The cost of cancer care in the United States continues to rise, with pressure on oncologists to provide high-quality, cost-effective care while maintaining the financial stability of their practice. Existing payment models do not typically reward care coordination or quality of care. In May 2014, the American Society of Clinical Oncology (ASCO) released a payment reform proposal (revised in May 2015) that includes a new payment structure for quality-of-care performance metrics...
July 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/27596543/transforming-healthcare-delivery-why-and-how-accountable-care-organizations-must-evolve
#14
REVIEW
Christopher T Chen, D Clay Ackerly, Gary Gottlieb
Accountable care organizations (ACOs) have shown promise in reducing healthcare spending growth, but have proven to be financially unsustainable for many healthcare organizations. Even ACOs with shared savings have experienced overall losses because the shared savings bonuses have not covered the costs of delivering population health. As physicians and former ACO leaders, we believe in the concept of accountable care, but ACOs need to evolve if they are to have a viable future. We propose the novel possibility of allowing ACOs to bill fee-for-service for their population health interventions, a concept we call population health billing...
September 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27587453/including-language-access-into-medicaid-aco-design
#15
Rachel Gershon, Lisa Morris, Warren Ferguson
Quality health care relies upon communication in a patient's preferred language. Language access in health care occurs when individuals are: (1) Welcomed by providers regardless of language ability; and (2) Offered quality language services as part of their care. Federal law generally requires access to health care and quality language services for deaf and Limited English Proficient (LEP) patients in health care settings, but these patients still find it hard to access health care and quality language services...
September 2016: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/27586403/modeling-and-designing-health-care-payment-innovations-for-medical-imaging
#16
Hui Zhang, Christian Wernz, Danny R Hughes
Payment innovations that better align incentives in health care are a promising approach to reduce health care costs and improve quality of care. Designing effective payment systems, however, is challenging due to the complexity of the health care system with its many stakeholders and their often conflicting objectives. There is a lack of mathematical models that can comprehensively capture and efficiently analyze the complex, multi-level interactions and thereby predict the effect of new payment systems on stakeholder decisions and system-wide outcomes...
September 1, 2016: Health Care Management Science
https://www.readbyqxmd.com/read/27574868/the-impact-of-a-home-based-palliative-care-program-in-an-accountable-care-organization
#17
Dana Lustbader, Mitchell Mudra, Carole Romano, Ed Lukoski, Andy Chang, James Mittelberger, Terry Scherr, David Cooper
BACKGROUND: People with advanced illness usually want their healthcare where they live-at home-not in the hospital. Innovative models of palliative care that better meet the needs of seriously ill people at lower cost should be explored. OBJECTIVES: We evaluated the impact of a home-based palliative care (HBPC) program implemented within an Accountable Care Organization (ACO) on cost and resource utilization. METHODS: This was a retrospective analysis to quantify cost savings associated with a HBPC program in a Medicare Shared Savings Program ACO where total cost of care is available...
August 30, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27565005/evaluating-the-impact-of-an-accountable-care-organization-on-population-health-the-quasi-experimental-design-of-the-german-gesundes-kinzigtal
#18
Alexander Pimperl, Timo Schulte, Axel Mühlbacher, Magdalena Rosenmöller, Reinhard Busse, Oliver Groene, Hector P Rodriguez, Helmut Hildebrandt
A central goal of accountable care organizations (ACOs) is to improve the health of their accountable population. No evidence currently links ACO development to improved population health. A major challenge to establishing the evidence base for the impact of ACOs on population health is the absence of a theoretically grounded, robust, operationally feasible, and meaningful research design. The authors present an evaluation study design, provide an empirical example, and discuss considerations for generating the evidence base for ACO implementation...
August 26, 2016: Population Health Management
https://www.readbyqxmd.com/read/27557414/financial-performance-of-rural-medicare-acos
#19
Matthew C Nattinger, Keith Mueller, Fred Ullrich, Xi Zhu
PURPOSE: The Centers for Medicare & Medicaid Services (CMS) has facilitated the development of Medicare accountable care organizations (ACOs), mostly through the Medicare Shared Savings Program (MSSP). To inform the operation of the Center for Medicare & Medicaid Innovation's (CMMI) ACO programs, we assess the financial performance of rural ACOs based on different levels of rural presence. METHODS: We used the 2014 performance data for Medicare ACOs to examine the financial performance of rural ACOs with different levels of rural presence: exclusively rural, mostly rural, and mixed rural/metropolitan...
August 24, 2016: Journal of Rural Health
https://www.readbyqxmd.com/read/27549015/improving-care-transitions-management-examining-the-role-of-accountable-care-organization-participation-and-expanded-electronic-health-record-functionality
#20
Thomas P Huber, Stephen M Shortell, Hector P Rodriguez
OBJECTIVE: Examine the extent to which physician organization participation in an accountable care organization (ACO) and electronic health record (EHR) functionality are associated with greater adoption of care transition management (CTM) processes. DATA SOURCES/STUDY SETTING: A total of 1,398 physician organizations from the third National Study of Physician Organization survey (NSPO3), a nationally representative sample of medical practices in the United States (January 2012-May 2013)...
August 22, 2016: Health Services Research
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