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Private-Payer ACOs Good for Medicare, Study Says
Medicare may enjoy the fruits of the growing and varied work among private payers and providers to boost value in healthcare, though the benefits will come sooner to costs than quality, a study suggests.
Medicare may enjoy the fruits of the growing and varied work among private payers and providers to boost value in healthcare, though the benefits will come sooner to costs than quality, a study suggests.
Harvard University researchers analyzed spending and quality measures for Medicare patients at 11 Massachusetts health systems with Blue and Cross Blue Shield contracts to manage costs and healthcare quality for commercially insured patients. Under these “alternative quality contracts,” which began in 2009 or 2010, spending fell by 1.9% during the first year and 3.3% during the second year for the commercially insured patients and quality improved.
Read the full story here: http://bit.ly/1538iqO
Source: Modern Healthcare
The research, published in the Journal of the American Medical Association, examined the extent to which strategies that lower spending and improve quality for one group of patients would spill over and indirectly benefit other patients. The results show that spending dropped among patients who were not targeted by cost-control strategies, but few quality gains.
What's at Stake as Oral Arguments Are Presented in the Braidwood Case? Q&A With Richard Hughes IV
April 21st 2025Richard Hughes IV, JD, MPH, spoke about the upcoming oral arguments to be presented to the Supreme Court regarding the Braidwood case, which would determine how preventive services are guaranteed insurance coverage.
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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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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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