The American Journal of Accountable Care®'s Most-Read Stories of 2019

From linguistic dissonances of medical terminology to the generation of new care pathways for Medicare patients, the top 5 most-read articles of The American Journal of Accountable Care^® spanned topics relevant to both patients and providers in 2019. Studies on widespread clinician burnout, efficient accountable care organizations, and barriers to population health improvements also topped the list for this year’s most popular stories on the website.

5. Effective Population Health Care Delivery Under Medicare’s Merit-based Incentive Payment System: Realigning Accountability With Capability

In this article, researchers Adam S. Wilk, PhD, and Sanjula Jain, PhD, explore how a misalignment of accountability and capability at the individual clinician level and the provider organization level hinders population health improvements. In order to improve overall population health, effective means of population health management (PHM) must be implemented, argue the authors. PHM includes coordinating networks of community partner organizations and holding each partner accountable for achieving what is needed of them. Shared accountability is paramount in the effort to make meaningful gains in population health, the authors concluded.

Read the full article here.

4. Language Matters: Talking About Low-Value Healthcare With Patients

Providers should take care when describing the "value" of different evidence-based healthcare options to patients, argues Gwen Darien, the executive vice president of patient advocacy and engagement at the National Patient Advocate Foundation. In this article, the author explains how cognitive and sematic associations with the word "value" affect its perceived meaning among providers and patients. A continual effort to provide clarity and increase communication between the 2 parties is essential to establishing trust and ensuring optimal patient outcomes.

Read the full article here.

3. ACO Use of Case Mix Index to Comprehensively Evaluate Postacute Care Partners

Ideal accountable care organizations (ACOs) operate with the aim to improve patient experience and population health at a reduced cost. Authors Mark E. Lewis, MPH, and Avery M. Day, MPH, outline how one Philadelphia area ACO was able to achieve this goal by limiting costs incurred by numerous skilled nursing facilities (SNFs). In this study, researchers outline how cooperation between ACOs and SNFs results in mutually beneficial solutions. The incorporation of a “risk-adjusted approach to ranking, then selecting preferred SNFs” is vital for preserving the function of ACOs.

Read the full article here.

2. Making an Evidence-based Case for Urgent Action to Address Clinician Burnout

The quality and safety of American healthcare is threatened by widespread clinician burnout, according to Bernadette Mazurek Melnyk, PhD. High rates of suicide and alcohol and drug abuse are plaguing medical professionals, leading to high turnover rates and lower reports of job satisfaction. Medical errors, financial losses, and a reduction in overall clinician population health are just a few consequences of this conclusion. One potential solution put forward by the author is the introduction of a chief wellness officer in clinical settings, whose sole responsibility is to enhance the well-being of clinicians in the workplace.

Read the full article here.

1. Improved Cost and Utilization Among Medicare Beneficiaries Dispositioned From the ED to Receive Home Health Care Compared With Inpatient Hospitalization

In our most popular article of 2019, researchers aimed to determine whether the implementation of home-based acute care for patients dispositioned from the emergency department resulted in Medicare cost savings. Patients included in the study exhibited 1 of the 5 following conditions: congestive heart failure, chronic obstructive pulmonary disease, urinary tract infection, pneumonia, or cellulitis. Researchers found that compared with Medicare recipients who were admitted to inpatient settings, patients who transitioned to home health care “had overall cost and utilization advantages.” These findings illustrate a model that could have significant impacts on reducing overall healthcare costs, benefitting the patient, payer, hospital, and home health agency.

Read the full article here.