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Accountable Care Organizations: A Health Experiment in Progress
ACOs are groups of providers that have been assigned a projected budget per patient. If the cost of caring for the patient comes in below that level, the group shares the savings. The idea is that doctors will better coordinate care to prevent wasteful or ineffective treatment. Pilot programs suggest the jury is still out on ACOs' ability to drive this kind of behavior.
A patient goes to the doctor's office with vague back pain. He gets the most expensive scan on the market, which suggests surgery might be needed. Better be safe than sorry; he has the surgery. But a closer look would have revealed that cheaper physical therapy would have been just as effective.
The dollars wasted on that patient contribute to a key problem with the health care system: soaring costs that haven't been accompanied by a commensurate increase in quality. Obamacare is trying to fix the problem of expensive, unnecessary care in several ways, the most well-known of which are accountable care organizations.
ACOs are groups of providers that have been assigned a projected budget per patient. If the cost of caring for the patient comes in below that level, the group shares the savings. The idea is that doctors will better coordinate care to prevent wasteful or ineffective treatment. Pilot programs suggest the jury is still out on ACOs' ability to drive this kind of behavior.
Read the full story here: http://bit.ly/1bgjepw
Source: National Journal
From MSSP ACOs to Employer Value: Translating Value-Based Principles to Self-Insured Plans
December 12th 2025Value-based care adoption in employer insurance requires replacing fragmented point solutions with unified, at-risk performance contracts that align vendors, providers, and members around total cost and quality goals.
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Blister Packs May Help Solve Medication Adherence Challenges and Lower Health Care Costs
June 10th 2025Julia Lucaci, PharmD, MS, of Becton, Dickinson and Company, discusses the benefits of blister packaging for chronic medications, advocating for payer incentives to boost medication adherence and improve health outcomes.
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From Complexity to Clarity: A Path to Value in Employer Health Plans
December 12th 2025Employers struggle to define value from health care spending amid complexity and misaligned incentives. Achieving measurable outcomes requires transparency, incentive realignment, and gradual, employee-centered change.
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