Value-Based Care

A recent poll given to doctors showed that while they admit having some effect on healthcare costs, they felt the majority of health price control remained in the hands of lawyers, health insurance companies, hospitals, pharmaceutical companies, and patients.

In Miami, a new healthcare model - the ACO - rewards physicians for patient health, controlling costs

Karen Ignagni, President and Chief Executive Officer, America's Health Insurance Plans (AHIP), says health plans are doing a number of things to reduce cost and improve value, as they know the two go hand in hand.

Accountability will continue to be a key element in the future of healthcare reform. Whether in accountable care organizations, patient-centered medical homes (PCMHs), or other innovative programs for coordinating care-finding a way to drive quality-focused care is essential.

The authors present a brief summary of the types of payment arrangements that early accountable care organizations are adopting.

Jan Berger, MD, MJ, President & CEO, Health Intelligence Partners, and editor-in-chief of The American Journal of Pharmacy Benefits, says the triple aim consists of cost, quality, and access. Additionally, the largest benefit that healthcare consumers can use is their health pharmacy benefit.

First year results are in - all 32 participants in the Pioneer Accountable Care Organization (ACO) initiative showed success in improving quality. However, not as much success was made in cost savings.

In a push for value-based care, UnitedHealth is pledging to double its provider payment in relation to quality and cost efficiency by up to $50 billion within the next 5 years.

Pharmaceuticals companies continue to weigh options for their role in Accountable Care Organizations (ACOs).

Insurer UnitedHealth Group recently noted it will more than double payments made to physicians who participate in accountable care contacts. ACOs have already demonstrated an immense positive growth in quality care, and a reduction in medical costs.

With new models of care delivery, reformation of outdated fee-for-service payment systems, and collaboration of groundbreaking provider-payer partnerships, the changing landscape of the healthcare industry is irrefutable. Yet, the integration of health information technology (HIT) continues to be an area of deliberation for many managed care professionals.