So, Do Transparency Tools Actually Work?
By DEVON HERRICK
A new report by economist Jon Gabel and his colleagues at NORC, a research center affiliated with the University of Chicago, looked at the use of transparency tools in an employer health plan. The analysis found the use of price transparency tools to be spotty. For instance, 75 percent of households either did not log into the transparency tool or did so only one time in the 18-month period of study. Fifteen percent did so twice; but only 1 percent logged in 6 times or more. The authors concluded:
It could very well be that we are asking too much of a single tool, no matter how well-designed. Consumer inf...
Source: The Health Care Blog - September 14, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Devon Herrick JAMA Transparency Source Type: blogs
Plans For the Quality Payment Program in 2017: Pick Your Track
By ANDY SLAVITT
As the baby boom generation ages, 10,000 people enter the Medicare program each day. Facing that demand, it is essential that Medicare continues to support physicians in delivering high-quality patient care. This includes increasing its focus on patient outcomes and reducing the obstacles that make it harder for physicians to practice good care.
The bipartisan Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) offers the opportunity to advance these goals and put Medicare on surer footing. Among other policies, it repeals the Sustainable Growth Rate formula and its annual payment cliffs, streamlin...
Source: The Health Care Blog - September 9, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Making Dental Care A Part Of ACOs
Editor’s note: For more on this topic, stay tuned for the December issue of Health Affairs, which will feature a cluster of articles on oral health.
Dental and medical care have almost always been delivered separately and disjointedly. That division of care could now change. Provisions in the Affordable Care Act (ACA) offer new opportunities to bring medical and dental care delivery closer to one another in two ways.
First, the ACA includes pediatric oral health benefits among its list of essential health benefits, giving insurance plans the opportunity to embed pediatric dental benefits within the medical plan. Second,...
Source: Health Affairs Blog - September 7, 2016 Category: Health Management Authors: Beau Meyer and Sue Tolleson-Rinehart Tags: Costs and Spending Featured Insurance and Coverage Medicaid and CHIP Payment Policy Population Health Public Health Quality ACOs Alternative Payment Models fee-for-service Oral Health preventative health triple aim Source Type: blogs
The Need For Additional Flexibility In Medicare Advantage
The Centers for Medicare and Medicaid Services (CMS) has recently exercised its Section 1115A waiver authority to allow Medicare Advantage plans in seven states to offer benefit flexibility in the form of Medicare Advantage Value Based Insurance Design (MA-VBID). The model will launch on January 1, 2017 and run for five years.
The intent of the MA-VBID model is to incentivize high value utilization of health care by restructuring enrollee cost sharing and other benefits to be more clinically nuanced. Under VBID, enrollees face low or no cost for high-value clinical services but may have higher out-of-pocket costs for low-v...
Source: Health Affairs Blog - August 29, 2016 Category: Health Management Authors: Megan Katherine McGrath and Kenneth Thorpe Tags: Costs and Spending Insurance and Coverage Medicaid and CHIP Medicare Quality Aging Medicare Advantage Patient-Centered Medical Home Program of All-Inclusive Care for the Elderly Social Determinants of Health value-based insurance desig Source Type: blogs
Defund “ Medical Homes ” , Fund Primary Care
By KIP SULLIVAN
In the first article in this three-part series I reviewed the findings in CMS’s latest report on one of its “medical home” experiments – the second-year evaluation of the Multi-Payer Advanced Primary Care (MAPCP) Demonstration.We saw that the “patient-centered medical homes” (PCMHs) in that demo have failed to cut costs or improve quality during the first two years of the demo. We also saw that the sloppy definition of “medical home” put the author of the report, RTI International, in a bind: They did not identify a single feature of PCMHs to treat as an independent variable, and were forc...
Source: The Health Care Blog - August 14, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Are CMS ’s “Medical Homes” Underfunded or Unfocused?
By KIP SULLIVAN
“[We are supposed to gather information from patients] prior to the physician going into the room. It doesn’t happen. I’m going to be honest – the reality … is … we also are responsible for telephone triage, walk-in emergencies, diabetic meter teaching, I mean, the list goes on and on.” (Brackets in the original)
That is a quote from an interview with a “care coordinator” for a “medical home” in Minnesota. Minnesota is one of the eight states that participated in the Multi-Payer Advanced Primary Care Practice (MAPCP) Demonstration, which is one of three experiments CMS has cond...
Source: The Health Care Blog - August 3, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Three Steps Congress Can Take To Accelerate Medicare ’s Delivery Transformation
The pace of change in the United States’ health care system is accelerating. Building on work by private and public payers, Centers for Medicare and Medicaid Services (CMS) officials are pursuing a transformation of how our health care system pays for care, spurred on by the passage of last year’s bipartisan sustainable growth rate (SGR) reform legislation and Health and Human Services (HHS) Secretary Sylvia Mathews Burwell’s own payment reform goals. The destination is a wholesale transition away from the incentives for volume over value inherent in fee-for-service medicine.
But even as recent press coverage and HHS...
Source: Health Affairs Blog - August 2, 2016 Category: Health Management Authors: John Rother and Larry McNeely Tags: Costs and Spending Featured Insurance and Coverage Long-term Services and Supports Medicare Organization and Delivery Payment Policy Quality ACOs Alternative Payment Models CMMI Medicare Advantage Primary Care Telemedicine valu Source Type: blogs
Absolution
By ANISH KOKA, MD
Like many cities, Philadelphia is a city defined by its neighborhoods. I practice in two neighborhoods separated by a few miles but leagues apart in every other way. One of the hospitals is a tertiary care facility in the heart of Center City – a well to do upcoming part of town – and the other is a small community hospital a few miles South. The patients at the two locations are quite different, and the mechanism of health care delivery is also starkly different. Medical care at the Center City campus is provided mostly by employed physicians, and care at the community hospital is provide...
Source: The Health Care Blog - August 2, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
CMS ’s Latest Report Is Bad News For Medical Homes
Conclusion
RTI should never have promised CMS and its readers it would identify factors associated with “outcomes,” improved or otherwise. The definition of the PCMH offered by leading “home” advocates is flabby enough. Trying to test such a wobbly concept in eight states when each state is allowed to use a different definition is just a wild goose chase.
Is there anything at all we can learn from such a poorly designed experiment? I’ll attempt to answer that question in subsequent comments.
[1] A bizarre feature of this report is the use of two control groups. RTI, perhaps at CMS’s insistence, set up one contr...
Source: The Health Care Blog - July 30, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized CMS Source Type: blogs
Don’t rant about MACRA. Propose solutions instead.
Recently, ACP offered practical solutions to physicians’ concerns about Medicare’s proposal to implement the new payment system created by the Medicare Access and CHIP Reauthorization Act (MACRA).
The College’s detailed recommendations, summarized here in a press statement that is linked to the comment letter itself, would replace CMS’s proposed and unnecessarily complex quality scoring system with a much simpler and understandable approach as developed by the College.
We challenge CMS to completely revamp how health information technology is reported to make it less burdensome and more clinically relevant to cli...
Source: Kevin, M.D. - Medical Weblog - July 20, 2016 Category: Journals (General) Authors: Bob Doherty Tags: Policy Medicare Primary care Source Type: blogs
Don ’t rant about MACRA. Propose solutions instead.
Recently, ACP offered practical solutions to physicians’ concerns about Medicare’s proposal to implement the new payment system created by the Medicare Access and CHIP Reauthorization Act (MACRA).
The College’s detailed recommendations, summarized here in a press statement that is linked to the comment letter itself, would replace CMS’s proposed and unnecessarily complex quality scoring system with a much simpler and understandable approach as developed by the College.
We challenge CMS to completely revamp how health information technology is reported to make it less burdensome and more clinically relevant to cli...
Source: Kevin, M.D. - Medical Weblog - July 20, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/bob-doherty" rel="tag" > Bob Doherty < /a > Tags: Policy Medicare Primary care Source Type: blogs
Health Expenditure Projections: When Does ‘New’ Become ‘Normal’?
The Centers for Medicare and Medicaid Services (CMS) has released its latest forecast of medical spending for the next decade. The headline number is that medical care as a share of gross domestic product (GDP) is expected to increase from its current 17.5 percent of GDP to 20.1 percent by 2025, resuming an upward increase after a several year slowdown.
Forecasting is an inexact science. To make guesses about the future, analysts typically examine the past. The history of medical spending can roughly be described using Fuchs’ law: medical spending increases have exceeded GDP increases by about 2.5 percentage points annua...
Source: Health Affairs Blog - July 13, 2016 Category: Health Management Authors: David Cutler Tags: Costs and Spending Featured Insurance and Coverage Medicaid and CHIP Medicare Payment Policy ACA ACOs Alternative Payment Models MACRA spending projections Source Type: blogs
Does your primary care physician actually provide your primary care?
You’ve
just moved to a new city for a new job, and before you can find a primary care
practice, you get sick. So you visit an
urgent care center. The doctor examines
you, treats you, and urges you in not-so-subtle (and sometimes judgmental)
terms to quickly find and follow up with a PCP.
And so the search begins.
Step
1: Consult Google. Find 150 doctors
within 50 miles. Realize you know
nothing about any of the doctors on the list.
Step
2: Ask colleagues for recommendations.
Receive great reviews of 2 doctors.
Step
3: Call the recommended doctors. None
are taki...
Source: blog.bioethics.net - July 11, 2016 Category: Medical Ethics Authors: Bioethics Today Tags: Health Care Doctor-Patient Relationships patient care syndicated Source Type: blogs
Value Based Reimbursement: The Rock Thrown Into The Health Care Pond
Editor’s note: This post is part of a series based on the 5th Forum: Learning from each other – Scaling ideas up to the next level. The forum was held in Berlin, Germany on June 9 and 10, 2016 and organized by the Center for Healthcare Management.
Value-based reimbursement (VBR), it seems to be everywhere. Launched by the Patient Protection and Affordable Care Act (ACA), a multitude of new payment models and organizations are rapidly reshaping the health care system in ways that are known and, as the ripples of change radiate out from the ACA, in ways that are yet to be understood.
For too many years, the traditiona...
Source: Health Affairs Blog - July 8, 2016 Category: Health Management Authors: Bruce Merlin Fried and Jeremy David Sherer Tags: Costs and Spending Featured Insurance and Coverage Medicaid and CHIP Medicare Organization and Delivery Payment Policy Quality Center for Healthcare Management 5th Forum fee-for-service MACRA value-based insurance design value-base Source Type: blogs
Focusing on Primary Care for Better Health
By ANDY SLAVITT
In the United States, we have historically invested far more in treating sickness than we do in maintaining health. The result of this imbalance is not only poorer health, but more money spent in institutions, hospitals, and nursing homes.
The road to a better health care system means correcting this imbalance. We should reinvest in what we value — primary care — as a practice, as a profession, and as an abundant resource for patients. In recent years, we have begun taking a number of meaningful steps to begin this reinvestment process. Today, we are proposing significant actions to improve how we pay p...
Source: The Health Care Blog - July 7, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
