Patients who are members of an ACO are not likely to realize it, comments Dennis Scanlon, PhD, Summit moderator. He asks how providers can keep ACO members within the system, avoiding care providers who do not have the same incentives. Ateev Mehrotra, MD, MPH, associate professor of healthcare policy and medicine at Harvard Medical School, and a hospitalist at Beth Israel Deaconess Medical Center, agrees that patients probably do not know what type of system it is or the incentives being used within their ACO.
Coordination of care among any providers (within or outside of the system) improves quality, insists Arthur Vercillo, MD, FACS, a surgeon and regional president of Excellus Blue Cross Blue Shield. This is true of the sickest patients who utilize many services and those members who occasionally use the healthcare system.
Dr Scanlon points out that health information technology is supposed to help in this regard, and legislation (eg, the HITECH Act) and resources have been directed toward improving the utilization of HIT. Yet, he says, “I think critics would say this concept of ‘meaningful use’ has been anything but meaningful in terms of how HIT is being used…all of the investment we’ve made in HIT isn’t sort of moving us in that direction.”
Dr Vercillo notes that the money spent on HIT, the formation of regional health information organizations, “is supposed to reduce redundancy. Empirically, it makes so much sense, but so far, we’re having a hard time proving the ROI is there.”
Reviving the Classics: The Role of Older Medications in Modern Dermatology
March 9th 2025Older, generic medications, including ones for cyclosporine, nicotinamide, and dapsone, can effectively treat patients with various dermatological conditions while helping to reduce insurance and cost barriers.
Read More
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
Listen
Use of AI Lets Health System Find Lung Cancer at Early Stages
March 8th 2025Artificial intelligence (AI) helps a Sarasota, Florida, health system catch lung nodules that appear on CT scans for patients treated for scores of conditions, allowing them to be referred for a possible lung cancer diagnosis.
Read More
Shaping Dermatology's Future by Increasing Access, Data, and Advocacy
March 7th 2025Thy N. Huynh, MD, FAAD, Bruce A. Brod, MHCI, MD, FAAD, and Melissa Piliang, MD, FAAD, discussed expanding access to pediatric dermatology, dermatology data aggregation, and advocacy for Medicare physician payment reform, respectively.
Read More