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Encouraging Continued Participation in the Medicare Shared Savings Program
CMS has proposed several possible changes to the Medicare Shared Savings Program in an effort to attract new participants and to encourage current participants to continue with the program beyond their initial 3-year commitment.
With more than 400 accountable care organizations (ACOs) enrolled, the Medicare Shared Savings Program is one of the most visible health care delivery reform efforts of the Affordable Care Act. Through the program, physicians, hospitals, and other healthcare providers are given incentives to invest in infrastructure and redesigned care processes to foster higher-quality and more efficient care.
In an effort to attract new participants and to encourage current participants to continue with the program beyond their initial 3-year commitment, CMS has proposed several possible changes designed to make it easier for ACOs to take on financial risks as well as reap rewards.
Read more: http://bit.ly/18VimLM
Source: The Commonwealth Fund
Comparing Breast Cancer Treatment Outcomes Between Fee-for-Service and Medicare Advantage
April 4th 2025This study examined postdiagnosis breast cancer treatment outcomes for Medicare Advantage vs fee-for-service (FFS) Medicare in Ohio and found no significant differences overall but disparities for Black patients with FFS Medicare.
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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.
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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).
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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.
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