Health Care Cost

As the most advanced accountable care organization (ACO) model, Next Generation ACO has its appeal. However, it is the riskiest model, and one ACO explains why it decided to stay with the Medicare Shared Savings Program.

What we're reading, May 27, 2016: treatment for pregnant women is often based on guesswork since few drugs are ever tested on them; a new superbug in the US is resistant to even the antibiotic of last resort; and how small physician practices can adapt to new payment models.

Accountable care organizations have to work more on engaging physicians in meaningful leadership roles and should focus on learning about patient goals, said James Whitfill, MD, chief medical officer of Scottsdale Health Partners.

Measuring the quality of oncology care and associating it with reimbursement, and high drug prices remain important concerns of value-based outpatient cancer care. A healthcare economist reviews the current status and suggests a potential path forward.

In order for accountable care organizations to overcome short-term thinking they must be careful with their fee-for-service codes and ensure that people are using the system responsibly, Farzad Mostashari, MD, chief executive officer of Aledade, said at the National Association of ACOs Spring 2016 Conference.

The Medicare Part B demonstration has been controversial since its announcement, but Steven D. Pearson, MD, MSc, president of the Institute for Clinical and Economic Review, considers it a wise move on the part of CMS because it provides an opportunity to learn about different payment structures.

This sweeping proposal is the biggest step yet in shifting reimbursement from a volume-based to a value-based system. Stakeholders offered mixed opinions this week.

One leading expert called the proposal the most substantive change in decades, but some feared CMS is once again hastening the demise of the independent physician.