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ACO Accountable care organizations

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https://www.readbyqxmd.com/read/28528171/accountable-care-organizations-and-the-use-of-cancer-screening
#1
Christian P Meyer, Anna Krasnova, Jesse D Sammon, Stuart R Lipsitz, Joel S Weissman, Maxine Sun, Quoc-Dien Trinh
Cancer preventive services, when used appropriately, result in improved health, better quality of life and decreased costs. For these reasons, cancer preventive services represent important priorities within the Affordable Care Act (ACA). Among the many provisions to improve access to preventive services the ACA introduced Accountable Care Organizations (ACOs) as trajectory to deliver coordinated, high-quality care. In order to evaluate this benchmark, we analyzed (in 2016/Boston) screening prevalence of breast cancer, a recommended screening test according to the United States Preventive Services Task Force (USPSTF), and prostate cancer, for which screening is no longer recommended by the USPSTF, among traditional Medicare beneficiaries and those enrolled in ACOs...
May 17, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28461355/bending-the-spending-curve-by-altering-care-delivery-patterns-the-role-of-care-management-within-a-pioneer-aco
#2
John Hsu, Mary Price, Christine Vogeli, Richard Brand, Michael E Chernew, Sreekanth K Chaguturu, Eric Weil, Timothy G Ferris
Accountable care organizations (ACOs) appear to lower medical spending, but there is little information on how they do so. We examined the impact of patient participation in a Pioneer ACO and its care management program on rates of emergency department (ED) visits and hospitalizations and on Medicare spending. We used data for the period 2009-14, exploiting naturally staggered program entry to create concurrent controls to help isolate the program effects. The care management program (the ACO's primary intervention) targeted beneficiaries with elevated but modifiable risks for future spending...
May 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28448780/integration-strategies-of-pharmacists-in-primary-care-based-accountable-care-organizations-a-report-from-the-accountable-care-organization-research-network-services-and-education
#3
Tina Joseph, Genevieve M Hale, Sara M Eltaki, Yesenia Prados, Renee Jones, Matthew J Seamon, Cynthia Moreau, Stephanie A Gernant
BACKGROUND: The accountable care organization (ACO) is an innovative health care delivery model centered on value-based care. ACOs consisting of primary care providers are increasingly becoming commonplace in practice; however, medication management remains suboptimal. PROGRAM DESCRIPTION: As experts in medication management, pharmacists perform direct patient care and assist in the transition from one provider to another, which places them in an ideal position to manage multiple aspects of patient care...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28441271/alternative-payment-models-and-urology
#4
Deborah R Kaye, David C Miller, Chad Ellimoottil
PURPOSE OF REVIEW: The Medicare Access and CHIP Reauthorization Act (MACRA) is a historic bill that was recently passed that establishes how quality measurement and practice patterns will affect physician reimbursement. Alternative payment models (APMs) are an essential component of MACRA and Medicare's vision of paying for high-value care. This review describes APMs in the context of MACRA and their impact on urology. RECENT FINDINGS: The majority of urologists will be affected by MACRA...
April 22, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28395006/association-between-hospitals-engagement-in-value-based-reforms-and-readmission-reduction-in-the-hospital-readmission-reduction-program
#5
Andrew M Ryan, Sam Krinsky, Julia Adler-Milstein, Cheryl L Damberg, Kristin A Maurer, John M Hollingsworth
Importance: Medicare is experimenting with numerous concurrent reforms aimed at improving quality and value for hospitals. It is unclear if these myriad reforms are mutually reinforcing or in conflict with each other. Objective: To evaluate whether hospital participation in voluntary value-based reforms was associated with greater improvement under Medicare's Hospital Readmission Reduction Program (HRRP). Design, Setting, and Participants: Retrospective, longitudinal study using publicly available national data from Hospital Compare on hospital readmissions for 2837 hospitals from 2008 to 2015...
April 10, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28385025/private-sector-accountable-care-organization-development-a-qualitative-study
#6
Ann Scheck McAlearney, Brian Hilligoss, Paula H Song
OBJECTIVES: To explore accountable care organizations (ACOs) as they develop in the private sector, including their motivation for development, perspectives from consumers regarding these emerging ACOs, and the critical success factors associated with ACO development. STUDY DESIGN: Comprehensive organizational case studies of 4 full-risk private sector ACOs that included in-person interviews with providers and administrators and focus groups with local consumers...
March 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28384376/a-two-step-method-to-identify-positive-deviant-physician-organizations-of-accountable-care-organizations-with-robust-performance-management-systems
#7
Alexander F Pimperl, Hector P Rodriguez, Julie A Schmittdiel, Stephen M Shortell
OBJECTIVE: To identify positive deviant (PD) physician organizations of Accountable Care Organizations (ACOs) with robust performance management systems (PMSYS). DATA SOURCE: Third National Survey of Physician Organizations (NSPO3, n = 1,398). STUDY DESIGN: Organizational and external factors from NSPO3 were analyzed. DATA COLLECTION/EXTRACTION METHODS: Linear regression estimated the association of internal and contextual factors on PMSYS...
April 6, 2017: Health Services Research
https://www.readbyqxmd.com/read/28375497/a-direct-experience-in-a-new-accountable-care-organization-results-challenges-and-the-role-of-the-neurosurgeon
#8
Dong H Kim, Christopher Lloyd, Douglas K Fernandez, Amanda Spielman, David Bradshaw
The passage of the Affordable Care Act saw the creation of Accountable Care Organizations (ACOs), a new approach to healthcare delivery moving from fee-for-service toward population health. This paper presents a case study of the Memorial Hermann ACO (MHACO), launched in response to the Medicare Shared Savings Program, with goals to align physician and hospital incentives, practice evidence-based medicine, develop care coordination, and increase efficiency. Building blocks included an affiliated primary care network, a clinical integration program (involving shared electronic medical record platforms and quality data reporting), and significant investments in information technology...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28373330/physicians-in-medicare-acos-offer-mixed-views-of-model-for-health-care-cost-and-quality
#9
Claudia L Schur, Janet P Sutton
Physicians' willingness to change how care is delivered is a key component of the ability of accountable care organizations (ACOs) to transform patient care. Yet physicians participating in Medicare ACOs are only moderately convinced that ACOs are an effective model for delivering cost-effective care.
April 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28373329/substantial-physician-turnover-and-beneficiary-churn-in-a-large-medicare-pioneer-aco
#10
John Hsu, Christine Vogeli, Mary Price, Richard Brand, Michael E Chernew, Namita Mohta, Sreekanth K Chaguturu, Eric Weil, Timothy G Ferris
Alternative payment models, such as accountable care organizations (ACOs), attempt to stimulate improvements in care delivery by better alignment of payer and provider incentives. However, limited attention has been paid to the physicians who actually deliver the care. In a large Medicare Pioneer ACO, we found that the number of beneficiaries per physician was low (median of seventy beneficiaries per physician, or less than 5 percent of a typical panel). We also found substantial physician turnover: More than half of physicians either joined (41 percent) or left (18 percent) the ACO during the 2012-14 contract period studied...
April 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28364355/population-health-management-for-diabetes-health-care-system-level-approaches-for-improving-quality-and-addressing-disparities
#11
REVIEW
Julie A Schmittdiel, Anjali Gopalan, Mark W Lin, Somalee Banerjee, Christopher V Chau, Alyce S Adams
PURPOSE OF REVIEW: Population care approaches for diabetes have the potential to improve the quality of care and decrease diabetes-related mortality and morbidity. Population care strategies are particularly relevant as accountable care organizations (ACOs), patient-centered medical homes (PCMH), and integrated delivery systems are increasingly focused on managing chronic disease care at the health system level. This review outlines the key elements of population care approaches for diabetes in the current health care environment...
May 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28355878/promoting-colorectal-cancer-screening-through-a-new-model-of-delivering-rural-primary-care-in-the-usa-a-qualitative-study
#12
Jungyoon Kim, Lufei Young, Sarbinaz Bekmuratova, Daniel J Schober, Hongmei Wang, Shreya Roy, Soumitra S Bhuyan, Alice Schumaker, Li-Wu Chen
INTRODUCTION: Despite the known benefits of colorectal cancer (CRC) screening, rural areas have consistently reported lower screening rates than their urban counterparts. Alternative healthcare delivery models, such as accountable care organizations (ACOs), have the potential to increase CRC rates through collaboration among healthcare providers with the aim of improving quality and decreasing cost. However, researchers have not sufficiently explored how this innovative model could influence the promotion of cancer screening...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28345256/physician-competition-in-the-era-of-accountable-care-organizations
#13
Michael R Richards, Catherine T Smith, Amy J Graves, Melinda B Buntin, Matthew J Resnick
OBJECTIVE: To calculate physician concentration levels for all U.S. markets using detailed data on integration and accountable care organization (ACO) participation. DATA SOURCE: 2015 SK&A office-based physician survey linked to all commercial and public payer ACOs. STUDY DESIGN: We construct three separate Herfindahl-Hirschman Index (HHI) measures and plot their distributions. We then investigate how prevailing levels of concentration change when incorporating more detailed organizational features into the HHI measure...
March 27, 2017: Health Services Research
https://www.readbyqxmd.com/read/28341894/using-a-self-reported-global-health-measure-to-identify-patients-at-high-risk-for-future-healthcare-utilization
#14
Karen J Blumenthal, Yuchiao Chang, Timothy G Ferris, Jenna C Spirt, Christine Vogeli, Neil Wagle, Joshua P Metlay
BACKGROUND: Research studies have shown that patient-reported outcome measures (PROMs) that assess global health are helpful for predicting health care utilization, but less evidence exists that collection of PROMs in routine care can identify patients with high health care needs. OBJECTIVE: To investigate the association between the PROMIS Global Health (PGH) scores and subsequent health care utilization among patients in a large accountable care organization (ACO)...
March 24, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28338515/surgeon-participation-in-early-accountable-care-organizations
#15
Matthew J Resnick, Amy J Graves, Melinda B Buntin, Michael R Richards, David F Penson
OBJECTIVE: We aimed to characterize the landscape of surgeon participation in early accountable care organizations (ACOs) and to identify specialty-, organization-, and market-specific factors associated with ACO participation. BACKGROUND: Despite rapid deployment of alternative payment models (APMs), little is known about the prevalence of surgeon participation, and key drivers behind surgeon participation in APMs. METHODS: Using data from SK&A, a research firm, we evaluated the near universe of US practices to characterize ACO participation among 125,425 US surgeons in 2015...
March 23, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28325486/mri-utilization-and-the-associated-use-of-sedation-and-anesthesia-in-a-pediatric-aco
#16
Joshua C Uffman, Dmitry Tumin, Vidya Raman, Arlyne Thung, Brent Adler, Joseph D Tobias
BACKGROUND AND OBJECTIVES: MRI is commonly used in the pediatric population and often requires sedation or general anesthesia to complete. This study used data from a pediatric accountable care organization (ACO) to investigate trends in MRI utilization and in the requirement for anesthesia to complete MRI examinations. METHODS: The Partners for Kids (PFK) ACO claims database was queried for MRI examination encounters involving patients 0 to 18 years old from 2009 to 2014, with utilization expressed as encounters per 10,000 PFK members-months...
March 15, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28319986/perceived-ethics-dilemmas-among-pioneer-accountable-care-organizations
#17
Craig R Westling, Thom Walsh, William A Nelson
This study of Pioneer accountable care organizations (ACOs) suggests that the ACO model is creating moral distress for physicians and business leaders in seven critical ways:Despite an overall sense of optimism associated with the ACO model, our research identified an underlying sense of moral distress at most sites. A clear opportunity exists for ACOs to use a more comprehensive, coordinated approach to proactively resolving ethical dilemmas while continuing the march toward risk-based contracts.
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28319619/cost-of-diagnosing-psoriasis-and-rosacea-for-dermatologists-versus-primary-care-physicians
#18
Dane Hill, Steven R Feldman
Growing incentives to control health care costs may cause accountable care organizations (ACOs) to reconsider how skin disease is best managed. Limited data have suggested that disease management by a primary care physician (PCP) may be less costly than seeing a specialist, though it is not clear if the same is true for the management of skin disease. This study assessed the cost of seeing a dermatologist versus a PCP for diagnosis of psoriasis and rosacea.
February 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28263208/a-taxonomy-of-hospitals-participating-in-medicare-accountable-care-organizations
#19
Gloria J Bazzoli, David W Harless, Askar S Chukmaitov
BACKGROUND: Medicare was an early innovator of accountable care organizations (ACOs), establishing the Medicare Shared Savings Program (MSSP) and Pioneer programs in 2012-2013. Existing research has documented that ACOs bring together an array of health providers with hospitals serving as important participants. PURPOSE: Hospitals vary markedly in their service structure and organizational capabilities, and thus, one would expect hospital ACO participants to vary in these regards...
March 3, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28217305/redesigning-care-delivery-with-patient-support-personnel-learning-from-accountable-care-organizations
#20
Ksenia O Gorbenko, Taressa Fraze, Valerie A Lewis
INTRODUCTION: Accountable care organizations (ACOs) are a value-based payment model in the United States rooted in holding groups of healthcare providers financially accountable for the quality and total cost of care of their attributed population. To succeed in reaching their quality and efficiency goals, ACOs implement a variety of care delivery changes, including workforce redesign. Patient support personnel (PSP)-non-physician staff such as care coordinators, community health workers, and others-are critical to restructuring care delivery...
September 2016: International Journal of Care Coordination
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