- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Consumer Choice, Performance Measurement are Top Challenges for ACOs
Meeting accountable care initiatives under the healthcare law is presenting challenges for its accountable care organization (ACO) participants.
Even though the Centers for Medicare & Medicaid Services relaxed the final performance measures from a proposed 65 to 33, meeting those performance measures is no small feat.
The federal program might not be easy for its Pioneers, who have long been fueled by health plans, noted. The new approach will require utilization management functions, such as disease management, complex case management, preauthorization services, specialty referral management and other analytic tools, Lynn Dong, a principal consulting actuary with Milliman, explained.
Sharp HealthCare, one of the 32 federal Pioneer ACOs, said it already has experience in providing coordinated care and population-based payments, but the San Deigo-based health system--like other Medicare ACOs--faces the challenge of consumer choice.
Read more at: http://tinyurl.com/7myrcpu
Source: FierceHealthcare
Managed Care Reflections: A Q&A With Hoangmai H. Pham, MD, MPH
April 1st 2025To mark the 30th anniversary of The American Journal of Managed Care® (AJMC®), each issue in 2025 will include a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The April issue features a conversation with Hoangmai H. Pham, MD, MPH, a member of AJMC’s editorial board and the president and CEO of the Institute for Exceptional Care (IEC).
Read More
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
Listen
Bridging Care Gaps With a Systemwide Value-Based Care Strategy
March 29th 2025Mapping care management needs by defining patient populations and then stratifying them according to risk and their needs can help to spur the transformation of a siloed health care system into an integrated system that is able to better provide holistic, value-based care despite the many transitions that continue among hospital, primary, specialty, and community care environments.
Read More
