Accountable Health Communities And Expanding Our Definition Of Health Care
In 1965, Dr. Jack Geiger founded one of the first two community health centers in the U.S. in a desperately poor area of the Mississippi Delta. So many of his patients presented with malnutrition that he began writing prescriptions for food — patients could take the prescriptions for milk and meat, fruits and vegetables to the local supermarket, which would fill the prescriptions and charge the clinic pharmacy.
When the Office of Economic Opportunity, which was funding Geiger’s clinic, found out, they were furious — and sent an official down to Mississippi to inform Geiger that they expected their dollars to ...
Source: Health Affairs Blog - March 2, 2016 Category: Health Management Authors: Rocco Perla and Rebecca Onie Tags: Equity and Disparities Featured Health Professionals Hospitals Population Health Public Health Quality Accountable Health Communities Community Health Food and Health safety-net organizations Social Determinants of Health Source Type: blogs
Let’s fix performance measurement for physicians
A guest column by the American College of Physicians, exclusive to KevinMD.com.
I have a “like-hate” relationship with clinical metrics, performance measurements, and other such things. By now, almost all physicians live with them in the form of insurer “report cards,” PQRS, and “meaningful” use. Some of us have even more exposure to them by participating in patient-centered medical homes and accountable care organizations.
Why “like”? Because I believe they can help you to know how you’re doing. Happy patients, full schedules, phones ringing off the hook with new patient requests, and the belief that you...
Source: Kevin, M.D. - Medical Weblog - March 2, 2016 Category: Journals (General) Authors: Yul Ejnes, MD Tags: Physician Primary care Source Type: blogs
Health Care Consumerism: Can The Tail Wag The Dog?
In September 2012, The Los Angeles Times ran a story suggesting that the Affordable Care Act (ACA) would usher in a new age of health care consumerism powered by on-line tools, cost calculators, and armies of engaged consumers. In the intervening years, what has been repeatedly pronounced is that we want consumers to “have skin in the game” and for them to “buy value” by considering both price and quality when purchasing health care services.
Our respective employers, the Health Care Cost Institute (HCCI) and Consumers Union, endorse efforts to increase consumers’ effective use of price and quality information an...
Source: Health Affairs Blog - March 2, 2016 Category: Health Management Authors: Amanda Frost, David Newman and Lynn Quincy Tags: Costs and Spending Featured Insurance and Coverage Quality Consumers Union Florida HCCI price variation shoppable services Source Type: blogs
How Not to Research ACOs
By KIP SULLIVAN
In Part I of this series I noted that we have almost no useful information on what ACOs do that affects cost and quality. I described two causes of that problem: The amorphous, aspirational “definition” of ACOs, and the happy-go-lucky attitude toward evidence exhibited by ACO proponents and many analysts. I showed how the flabby “definition” of ACO makes it impossible to operationalize this thing – to reduce it to testable components. And I asked why the health policy community let ACO proponents get away with such a vague description of the ACO. I said the answer lies in the permi...
Source: The Health Care Blog - February 22, 2016 Category: Consumer Health News Authors: Simon Nath Tags: Featured THCB Kip Sullivan Source Type: blogs
Understanding Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APM’s)
Discussion
MACRA enshrines the concept of value vs. volume and a seismic shift from fee for service to value based payments. There will be tremendous need for education for today's clinicians to further understand MACRA and all its ramifications. Big questions need to be answered such as what the rule will look like, what does it mean to bear more than nominal financial risk, what will be included in value, will MIPS Meaningful Use, PQRS and Value Based Modifiers be similar to the current system .
Fortunately, there will be opportunities to let your voice be heard on this very important program.
&#...
Source: Policy and Medicine - February 18, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
CBO Releases Report On Private Health Insurance Premiums And Federal Policy (Updated)
Implementing Health Reform (February 16 update on quality measures). On February 16, 2016, the Centers for Medicare and Medicaid Services (CMS) released a set of core quality measures developed by The Core Quality Measure Collaborative. The Collaborative includes representatives from CMS, America’s Health Insurance Plans, the National Quality Forum, national physician groups, employers, and consumers. The core quality measures apply to accountable care organizations, patient centered medical homes, and primary care (21 measures); cardiology (30 measures), gastroenterology (eight measures), HIV and Hepatitis C (eight mea...
Source: Health Affairs Blog - February 12, 2016 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage Affordable Care Act Physicians premiums Private Health Insurance quality measures Source Type: blogs
Health Wonk Review is up at Medicare Resources
It’s the Money Changes Everything edition of the Health Wonk Review over at MedicareResources.org.
Head over to learn more about the Super Bowl, executive compensation, medical homes and more.
(Source: Health Business Blog)
Source: Health Business Blog - February 12, 2016 Category: Health Management Authors: dewe67 Tags: Announcements Blogs Policy and politics Source Type: blogs
Pediatric Vaccination: Who Bears The Burden?
Editor’s note: For more on this topic, check out the February issue of Health Affairs on vaccines.
The United States benefits from generally high childhood vaccination rates, the cost savings of immunizations for both individuals and society are soundly documented, and health care professionals overwhelmingly support the need for vaccination. But the burden on the private sector to deliver this public health benefit is increasing, with little recognition or support from the public sector.
First, the cost to vaccinate is not adequately compensated by the public sector. Second, administrative burdens on providers to parti...
Source: Health Affairs Blog - February 9, 2016 Category: Health Management Authors: Christoph Diasio Tags: Drugs and Medical Technology Featured Global Health Population Health Public Health Children Immunization vaccines Source Type: blogs
A Payment Reform Conundrum: Reconciling Conflicting Policy Goals
In early 2015, the Secretary of the Department of Health and Human Services (HHS), Sylvia Burwell, announced goals for shifting Medicare payment from fee-for-service (FFS) to alternative payment models (APMs). Qualifying APMs include, among others, accountable care organizations (ACOs), medical homes, and episode-based bundled payments.
Congress, by large bipartisan majorities, endorsed payment reform in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which establishes incentives for physicians to join new payment models. Many private purchasers, insurers, and providers are likewise committed to payment r...
Source: Health Affairs Blog - January 27, 2016 Category: Health Management Authors: Glenn Hackbarth Tags: Costs and Spending Featured Hospitals Insurance and Coverage Medicare Organization and Delivery Payment Policy Population Health Quality ACOs Alternative Payment Models MACRA Medicare Advantage Source Type: blogs
Integrating Specialty Care Into Accountable Care Organizations: Perspectives From The Field
Integrating specialty care can be key for high performance and financial success for ACOs, as the most complicated and costly patient care usually is managed by specialists. A large portion of the cost in our health care system is driven by specialists. Specialists are responsible for most medical and surgical procedures, involving both inpatient and outpatient care. Even for office visits, spending for specialists is higher than for primary care physicians. For example, while 45.7 percent of visits to office-based physicians in 2009 were to primary care physicians in general practice, family practice, internal medicine, o...
Source: Health Affairs Blog - January 19, 2016 Category: Health Management Authors: Leslie Korenda and Sarah Thomas Tags: Costs and Spending Health Professionals Innovations in Care Delivery Organization and Delivery Accountable Care Organizations ACOs healthcare leaders Primary Care specialty care Source Type: blogs
Paying Providers For Value: The Path Forward
The release of the Alternative Payment Model (APM) Framework White Paper earlier this week is an important milestone in the progress of the Health Care Payment Learning & Action Network (LAN) toward its goal: driving new and innovative health care payment models that promise to improve the quality and value of health care.
The White Paper was developed over the course of several months by the LAN’s Alternative Payment Model Framework and Progress Tracking (APM FPT) Work Group and its Guiding Committee (GC), representing a wide range of private payers, large employers, providers, patients, consumer groups, and state...
Source: Health Affairs Blog - January 14, 2016 Category: Health Management Authors: Samuel Nussbaum, Mark McClellan, Mark D. Smith and Patrick H. Conway Tags: Costs and Spending Featured Health Professionals Payment Policy Population Health Public Health Quality ACOs Alternative Payment Models patient-centered care patient-centered medical homes Source Type: blogs
AMA Adds Twenty Schools to Their Accelerating Change in Medical Education Consortium
With medicine and health care delivery in the United States constantly changing in new and exciting ways, the American Medical Association is focused on trying new, innovative ways to ensure the physicians and health care professionals of the future are receiving a medical education that is keeping pace with the changes.
In 2013, the AMA created the Accelerating Change in Medical Education Consortium, with eleven founding schools: Indiana University School of Medicine; Mayo Medical School; New York University School of Medicine; Oregon Health & Science University School of Medicine; Pennsylvania State University Colle...
Source: Policy and Medicine - December 18, 2015 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
7 new Medicare codes primary care doctors can use to increase payments
The fact that primary care is undervalued by Medicare and other payers has been long understood to be driving the precipitous decline in the numbers of new physicians choosing primary care internal medicine or family practice, and a growing exodus of established primary care physicians.
Efforts to address this undervaluation have traditionally been to, 1) bump up the payments (relative value units) for the office visit codes traditionally billed by primary care physicians; 2) explicitly fund, usually on a temporary basis, higher payments for primary care that do not require offsets from others, like was the case with t...
Source: Kevin, M.D. - Medical Weblog - December 14, 2015 Category: Journals (General) Authors: Bob Doherty Tags: Policy Primary care Source Type: blogs
CoC Oncology Medical Home Accreditation Pilot Program
The Commission on Cancer (CoC) has an Oncology Medical Home (OMH) Accreditation Pilot Program and plans to pilot this accreditation process in 50 oncology practices beginning in 2016. What is an Oncology Medical Home (OMH)?An Oncology Medical Home (OMH) focuses on delivering, ensuring, and measuring quality cancer care and relies on a physician-led, team-based health care model that provides comprehensive and continuous care to cancer patients with a goal of obtaining maximized health outcomes. This patient-focused system delivers coordinated and efficient cancer care and is designed to meet the needs of patients, payers, ...
Source: Medicine and Technology by Dr. Joseph Kim - December 11, 2015 Category: Information Technology Source Type: blogs
