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ACO Accountable care organizations

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https://www.readbyqxmd.com/read/28806586/the-new-frontier-of-strategic-alliances-in-health-care-new-partnerships-under-accountable-care-organizations
#1
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...
May 2, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28801468/minnesota-integrated-health-partnership-demonstration-implementation-of-a-medicaid-aco-model
#2
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
#3
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...
May 25, 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
#4
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
#5
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...
July 20, 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
#6
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)...
July 17, 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
#7
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...
July 12, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28693337/systems-opportunities-to-reduce-ed-crowding-from-nonemergency-referrals
#8
Carolyn Joy Sachs, Charles K Yu, Peter C Nauka, David L Schriger
Emergency department (ED) crowding threatens patient safety and is associated with increased mortality. This study explored the role of nonurgent referrals to the ED in crowding and collaborated on a large quality initiative with the study institution's accountable care organization (ACO) to provide timely alternatives to such referrals. Fifty-two percent of nonemergent ED patients report contacting a medical provider prior to coming to the ED, with 70% of those providers directing the patient to go to the ED...
March 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28686787/barriers-and-facilitators-of-colorectal-cancer-screening-for-patients-of-rural-accountable-care-organization-clinics-a-multilevel-analysis
#9
Hongmei Wang, Fang Qiu, Abbey Gregg, Baojiang Chen, Jungyoon Kim, Lufei Young, Neng Wan, Li-Wu Chen
PURPOSE: This study examines multilevel factors related to colorectal cancer (CRC) screening in a rural Accountable Care Organization (ACO) setting. METHODS: The study used electronic medical record data from 8 rural ACO clinics in Nebraska. The final sample included 15,866 average-risk patients aged 50-75 years who visited participating clinics at least once from June 2014 to May 2015. Logistic regression was conducted to examine simultaneous effects of patient, provider, and county characteristics on CRC screening after accounting for provider-county-level correlation using a generalized estimating equations method...
July 7, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28685850/return-on-investment-roi-analyses-of-an-inpatient-lay-health-worker-model-on-30-day-readmission-rates-in-a-rural-community-hospital
#10
Roberto Cardarelli, Gregory Bausch, Joan Murdock, Michelle Renee Chyatte
PURPOSE: The purpose of the study was to assess the return-on-investment (ROI) of an inpatient lay health worker (LHW) model in a rural Appalachian community hospital impacting 30-day readmission rates. METHODS: The Bridges to Home (BTH) study completed an evaluation in 2015 of an inpatient LHW model in a rural Kentucky hospital that demonstrated a reduction in 30-day readmission rates by 47.7% compared to a baseline period. Using the hospital's utilization and financial data, a validated ROI calculator specific to care transition programs was used to assess the ROI of the BTH model comparing 3 types of payment models including Diagnosis Related Group (DRG)-only payments, pay-for-performance (P4P) contracts, and accountable care organizations (ACOs)...
July 7, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28647442/the-impact-of-the-transition-from-volume-to-value-on-heart-failure-care-implications-of-novel-payment-models-and-quality-improvement-initiatives
#11
REVIEW
Dushyanth Srinivasan, Nihar R Desai
In response to wide variation in quality and outcomes as well as escalating health care costs, the U.S. health care system is moving away from a volume-based payment system to a quality- and value-based system. Medicare, the largest insurer and payer of health care, has accelerated the movement toward value-based care with the development and implementation of myriad alternate payment models and pay-for-performance programs as part of the Affordable Care Act. Given that heart failure affects a significant number of Medicare patients and that these patients account for a disproportionate amount of health care utilization and spending, heart failure has become a focal point for these initiatives...
June 21, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28641166/care-coordination-at-a-pediatric-accountable-care-organization-aco-a-qualitative-analysis
#12
Baria Hafeez, Sophia Miller, Anup D Patel, Zachary M Grinspan
OBJECTIVE: Care coordinators may help manage care for children with chronic illness. Their role in pediatric epilepsy care is understudied. We aimed to qualitatively describe the content of a care coordination intervention for children with epilepsy. METHODS: We conducted nine semi-structured interviews and one focus group with care coordinators at a pediatric accountable care organization (ACO) in Ohio. The care coordinators used a modified version of a published care coordination checklist for children with epilepsy (Patel AD, 2014)...
June 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28637558/travel-time-influences-readmission-risk-geospatial-mapping-of-surgical-readmissions
#13
Florence E Turrentine, Patrick J Buckley, Min-Woong Sohn, Michael D Williams
The University of Virginia (UVA) has recently become an Accountable Care Organization (ACO), intensifying efforts to provide better care for individuals. UVA's ACO population resides across the entire Commonwealth, with a large percentage of patients living in rural areas. To provide better health for this population, the central tenet of the ACO mission, we identified geographic risk factors influencing hospital readmission. We analyzed the relationship between the distance of patients' residence to the nearest hospital and 30-day readmission in general surgery patients...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28614267/regional-cost-and-experience-not-size-or-hospital-inclusion-helps-predict-aco-success
#14
John Schulz, Matthew DeCamp, Scott A Berkowitz
The Medicare Shared Savings Program (MSSP) continues to expand and now includes 434 accountable care organizations (ACOs) serving more than 7 million beneficiaries. During 2014, 86 of these ACOs earned over $300 million in shared savings payments by promoting higher-quality patient care at a lower cost.Whether organizational characteristics, regional cost of care, or experience in the MSSP are associated with the ability to achieve shared savings remains uncertain.Using financial results from 2013 and 2014, we examined all 339 MSSP ACOs with a 2012, 2013, or 2014 start-date...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28560783/end-of-life-care-planning-in-accountable-care-organizations-associations-with-organizational-characteristics-and-capabilities
#15
Sangeeta C Ahluwalia, Benjamin J Harris, Valerie A Lewis, Carrie H Colla
OBJECTIVE: To measure the extent to which accountable care organizations (ACOs) have adopted end-of-life (EOL) care planning processes and characterize those ACOs that have established processes related to EOL. DATA SOURCES: This study uses data from three waves (2012-2015) of the National Survey of ACOs. Respondents were 397 ACOs participating in Medicare, Medicaid, and commercial ACO contracts. STUDY DESIGN: This is a cross-sectional survey study using multivariate ordered logit regression models...
May 30, 2017: Health Services Research
https://www.readbyqxmd.com/read/28528171/accountable-care-organizations-and-the-use-of-cancer-screening
#16
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...
August 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
#17
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
#18
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
#19
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...
July 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
#20
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...
June 1, 2017: JAMA Internal Medicine
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