Palliative Care and ACOs: A Perfect Fit
April 22nd 2015Accountable care organizations were created under the Affordable Care Act to improve healthcare delivery to a defined population. As writers in the new issue of Evidence-Based Oncology discuss, while palliative care exists to raise the quality of life for the seriously ill, it can also speak to the value equation of delivering care that patients want at a lower cost.
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Creating Value Metrics in Cancer Care From the Bottom Up
April 21st 2015Measuring value in cancer care matters, but so does creating a structure that makes sense to stakeholders who use it. The current issue of Evidence-Based Oncology features an article on how a regional consortium of providers, payers, patient partners and researchers developed a set of metrics together, from the bottom up.
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Rethinking the Term "Managed Care" for the 21st Century
April 20th 2015In April, Commonwealth Fund CEO David Blumenthal, MD, and David Squires, MA, senior researcher to the president of the fund, offer the latest in a series of guest commentaries marking the 20th year of publication of The American Journal of Managed Care. They call for a retooling of the term "managed care" to better reflect its current meaning.
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Measuring Population Health, Meeting Individual Needs in Diabetes Care
April 19th 2015In its third year, Patient-Centered Diabetes Care, which took place April 16-17, 2015, in Boston, showed how new payment models, new therapies, and new approaches to patient engagement are changing care for persons with diabetes. The American Journal of Managed Care and Joslin Diabetes Center presented this year's meeting.
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Health Plans Drive Innovation, With More to Come
March 31st 2015To mark its 20th year of publication, The American Journal of Managed Care has invited guest contributors to comment on the state of healthcare from their perspective. This month, Karen Ignagni, MBA, president and CEO of America's Health Insurance Plans and consistently rated as one of healthcare's most important voices, writes how health plans are supporting value-based care and promoting consumer choice.
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Type of Insurance Drives Emergency Room Visits, AJMC Study Finds
March 31st 2015Being uninsured has long been linked to a higher likelihood of trips to the emergency room. But a new study in The American Journal of Managed Care finds that the type of health coverage can also affect whether a person goes to the ER for non-emergent care.
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Coalition Looks at ACO Formation, Safer IT, and Healthcare of the Future
March 18th 2015The ACO and Emerging Healthcare Delivery Coalition, an initiative of The American Journal of Managed Care, launched a little over a year ago to give stakeholders focused on accountable care opportunities to share ideas on how to move from volume- to value-based models. The Coalition's most recent Web-based session shows how meetings have evolved to highly detailed discussions of how organizations are making those transitions.
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As The American Journal of Managed Care marks its 20th year of publication, the editors invited Margaret O'Kane, the founding and current president of the National Committee on Quality Assurance, to address today's retail environment for healthcare consumers. In 2015, NCQA marks its 25th year of improving healthcare quality through measurement, transparency, and accountability.
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A year after Sovaldi's $1,000-a-pill price tag set off a national discussion, new entrants in the market to cure the hepatitis C virus have allowed pharmacy benefit managers to bring down its cost for health plans. Experts convened by The American Journal of Managed Care said this should expand who gets treatment, but they also say this won't be last of the high-cost specialty drugs.
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The Patient Access Network or PAN Foundation formed more than 10 years ago, partially in response to the Medicare Part D benefit. It helps patients meet cost-sharing requirements across dozens of diseases, including 25 in oncology; Evidence-Based Oncology, a publication of The American Journal of Managed Care, invited PAN Foundation President and CEO Dan Klein to discuss its role in immuno-oncology.
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Suzanne F. Delbanco, PhD, MPH, executive director of Catalyst for Payment Reform, will be the keynote speaker at the spring meeting of the ACO and Emerging Healthcare Delivery Coalition, to be held April 30 and May 1, 2015, in San Diego, California. The ACO Coalition, an initiative of The American Journal of Managed Care, brings together stakeholders from across the healthcare spectrum interested in sharing best practices relative to the changing delivery and payment models.
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For Stakeholders in Immuno-Oncology, Is the Third Time the Charm?
February 27th 2015Evidence-Based Oncology, an indexed publication of The American Journal of Managed Care, devotes its current issue to immuno-oncology and the interests of many stakeholders. In a commentary that draws on 30 years of waiting on the promise of immuno-oncology, Bruce Feinberg, DO, outlines the key issues facing payers, oncologists, policymakers and patients themselves.
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Minnesota's McCullough to Serve as Guest Editor for AJMC's 5th Annual Special Issue on Health IT
February 19th 2015Jeffrey S. McCullough, PhD, who writes frequently on the intersection of health information technology (IT) and quality, will serve as guest editor for the 5th annual special issue of The American Journal of Managed Care devoted to research and commentary on health IT. Dr McCullough's services come during AJMC's celebration of its 20th year as the leading peer-reviewed journal covering healthcare delivery systems.
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Patient-Centered Diabetes Care 2015 Details Outstanding Agenda
February 16th 2015Sessions on clinical, behavioral and technological advances will cover all aspects of diabetes care April 16-17 in Boston, when The American Journal of Managed Care and Joslin Diabetes Center will partner to present Patient-Centered Diabetes Care 2015. The program and faculty of this conference, to be held at the Renaissance Waterfront Boston, are not to be missed.
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AJMC Editors Highlight Key Studies as Publication Begins Look Back at 20 Years of Contributions
January 30th 2015The American Journal of Managed Care arrived in 1995, in the aftermath of the last major effort to remake the US healthcare system, and quickly became the most important forum of its type. Today, with the country implementing the Affordable Care Act, Editors-in-Chief A. Mark Fendrick, MD, and Michael Chernew, PhD, examine the impact of the journal's contributions to healthcare delivery transformation.
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AJMC Editors Highlight Key Studies as Publication Begins Look Back at 20 Years of Contributions
January 29th 2015The American Journal of Managed Care arrived in 1995, in the aftermath of the last major effort to remake the US healthcare system, and quickly became the most important forum of its type. Today, with the country implementing the Affordable Care Act, Editors-in-Chief A. Mark Fendrick, MD, and Michael Chernew, PhD, examine the impact of the journal's contributions to healthcare delivery transformation.
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AJMC, Joslin Diabetes Center Join Forces to Host Patient-Centered Diabetes Care in Boston
January 16th 2015The leading peer-reviewed journal in managed care and the world leader in diabetes research and clinical care will present the conference at the Renaissance Boston Waterfront April 16-17, 2015. Faculty presentations and panel discussions will cover clinical, behavioral and technological aspects of care for persons with type 1 and type 2 diabetes mellitus.
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AJMC, Joslin Diabetes Center Join Forces to Host Patient-Centered Diabetes Care in Boston
January 16th 2015The leading peer-reviewed journal in managed care and the world leader in diabetes research and clinical care will present the conference at the Renaissance Boston Waterfront April 16-17, 2015. Faculty presentations and panel discussions will cover clinical, behavioral and technological aspects of care for persons with type 1 and type 2 diabetes mellitus.
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Authors Discuss How to Pay for Telehealth in Managed Care in AJMC Publications
December 29th 2014The main barrier to widespread use of telehealth isn't technology or consumer acceptance; it's figuring out how to pay for it. Authors writing for The American Journal of Managed Care and The American Journal of Accountable Care discuss why today's payment models for accountable care organizations are a better fit for telehealth, and why regulatory changes make sense.
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The Affordable Care Act and a federal parity law have already helped persons with mental illness get access to proper care. But a leading advocate, a medical director for Cigna, and a psychiatrist who has studied innovative care delivery models say more can be done to improve screening, to ensure the correct diagnosis, and to provide better access to services.
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AJMC Takes an Early Glimpse Into ACO Contracts
December 22nd 2014Accountable care organizations (ACOs) are still a new creature in the world of managed care, and not all are alike. As the authors of a new comparative analysis in The American Journal of Managed Care outline, Medicare contracts dominate the ACO landscape, with only half of these entities having a contract with a private payer.
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AJMC Session Traces Evolution of ACO Growth, Mental Health Delivery Models
December 17th 2014How do ACOs reach the point of delivering both savings and better care? The recent online session of the ACO and Emerging Healthcare Delivery Coalition, sponsored by The American Journal of Managed Care, covered how ACOs evolve, how that process applies to oncology care, and how managed care can benefit from a better model for mental health delivery.
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AJMC Stakeholder Summit Explores Challenges in Using Data to Make Decisions in Oncology
November 30th 2014What makes a cancer therapy effective may be in the eye of the stakeholder, even though everyone involved in healthcare decisions relies on evidence-based information. Evidence-Based Oncology, a publication of The American Journal of Managed Care, this month publishes a condensed version of the discussion among payers on how to improve collection and use of collection of data to make better evidence-based decisions in oncology.
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AJMC Study Finds CMS Fee Schedule Doesn't Pay Doctors Enough to Care for Complex Patients
November 27th 2014The call for value-based care is propelled by the shortage of family physicians and the disparity connection between the time it takes to care for the sickest patients and what Medicare and Medicaid pay. A study in this month's issue of The American Journal of Managed Care tracks just how bad things are, by looking at a normal day in a family practice.
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AJMC Article Explores Reducing the Confusion Between Branded and Generic Drugs
November 25th 2014A commentary in this month's issue of The American Journal of Managed Care explores whether allowing generic versions of medications to look like branded equivalents would be better for consumers and improve adherence.
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The toughest topics in cancer care will be on tap November 13-14, 2014, in Baltimore, Maryland, when AJMCLive presents Patient-Centered Oncology Care. If you've followed the discussion among pharmaceutical leaders, oncologists, and payers over access to care, you'll want to join stakeholders to discuss how to ensure patients get what they need while controlling costs.
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Reducing Hospital Readmissions May Prove Tougher than CMS Expects, AJMC Study Finds
October 16th 2014The Centers for Medicare and Medicaid Services wants hospitals to find ways to keep patients from returning to the hospital, and the agency has created rewards and punishments in pursuit of this goal. A study in The American Journal of Managed Care is just one of a pair of recent clinical trials that finds readmissions may be beyond some hospitals' control, and policymakers might need to rethink their approach.
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With a shortage of primary care physicians and the costs that come with a trip to the emergency room, can retail clinics fill the gap? A study published today in The American Journal of Managed Care finds they can, offering care that is just as good or better for common ailments like ear infections or strep throat.
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