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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.
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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.
Unlocking Access: Exploring Mental Health Care Among Medicaid Managed Care Enrollees
January 23rd 2025On this episode of Managed Care Cast, we speak with the author of a study published in the January 2025 issue of The American Journal of Managed Care® to examine the association between quantitative network adequacy standards and mental health care access among adult Medicaid enrollees.
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Balancing Innovation and Equity in Oncology Value-Based Care: Panel Discussions
January 27th 2025Discussions also delved into the complexities of value-based oncology care, the growing role of real-world data, and strategies to improve access to care in hematology. Across all sessions, a common theme emerged: the need to balance innovation with patient-centered, equitable, and sustainable care models.
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Executive Orders Suggest Swift Pivot in Managed Care and Health Policy
January 22nd 2025President Donald Trump's initial executive orders target previous efforts to reduce health care costs, pandemic preparedness, and international partnerships, showing a stark contrast to the Biden administration.
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