Report From the LDI Norman Wall Memorial Lecture
The Tension Between Care Coordination and Conflicts of Interest
Should providers participating in accountable care organizations (ACOs) be exempt from existing regulations that prevent financial conflicts of interest in physician referrals? On the one hand, these regulations, collectively known as the Stark Law, can impede efforts to coordinate care across providers and facilities. On the other hand, ACOs and other alternative payment and delivery models do not necessarily obviate the need for regulations that prohibit physician kickbacks or self-referrals.
Does Accountable Care Worsen Health Disparities?
Health system reforms, such as value-based payment, can worsen or improve existing health care disparities, even if policy changes do not target the disparities themselves.
Penn DC Forum Envisions the Future of Bundled Payments
Just as Medicare launched its new voluntary bundled payment program, LDI Senior Fellows Amol Navathe, MD, PhD, and Ezekiel Emanuel, MD, PhD, hosted a forum in Washington, DC to discuss current evidence and best practices around payment transformation.
Making Value-Based Payment Work in Medicaid
If value-based payment models can work in Medicare, can they also work in Medicaid? Not without significant changes, according to LDI Senior Fellows Joshua Liao and Amol Navathe and colleague Benjamin Sommers in a NEJM Perspective.
Effect of Hospital and Post-Acute Care Provider Participation in Accountable Care Organizations on Patient Outcomes and Medicare Spending
Divyansh Agarwal and Rachel M. Werner
Abstract [from journal]
Objective: To test for differences in patient outcomes when hospital and post‐acute care (PAC) providers participate in accountable care organizations (ACOs).
Data/Setting: Using Medicare claims, we examined changes in readmission, Medicare spending, and length of stay among patients admitted to ACO‐participating hospitals and PAC providers.
Design: We compared changes in outcomes
Do Changes in Post-Acute Care Use at Hospitals Participating in an Accountable Care Organization Spillover to All Medicare Beneficiaries?
Amol S. Navathe, Alexander M. Bain, Rachel M. Werner
Abtract [from journal]
Background
While early evidence suggests that Medicare accountable care organizations (ACOs) may reduce post-acute care (PAC) utilization for attributed beneficiaries, whether these effects spill over to all beneficiaries admitted to hospitals participating in ACOs stray is unknown.
Objective
The objective of this study was to evaluate whether changes in PAC use and Medicare spending spill over to all beneficiaries admitted to hospitals participating in the Medicare
Value Based Payment: Is This Time Actually Different?
Practice transformation and payment reform are defining features of contemporary health policy debates. The story goes like this: new provider organizations, such as Accountable Care Organizations (ACOs) are transforming care delivery from fragmented and volume driven to integrated and optimized for quality; meanwhile, innovative payment models, such as bundled payments and risk-based contracting, herald a national transition from fee-for-service (FFS) to value-based payments.
Capturing the Value of Payment Reform
At LDI’s 50th Anniversary Symposium, participants in the panel “The Future of Payment Reform” characterized and evaluated different alternative payment models (APMs) such as bundled payments and accountable care organizations (ACOs).
How a Heated National Policy Debate Benefited Medicaid's Future
The “value” of value in gynecologic oncology practice in the United States: Society of Gynecologic Oncology evidence-based review and recommendations
David E. Cohn, Emily Ko, Larissa A. Meyer, Jason D. Wright, Sarah M. Temkin, Jonathan Foote, Nathaniel L. Jones, Laura J. Havrilesky
In Gynecologic Oncology, David Cohn and colleagues, including Emily Ko, examine trends in gynecologic oncology health care expenditures, and assess how costs may be affected by new models of health care delivery and payment. The authors conduct a review on behalf of the Society of Gynecologic Oncology, and discuss the financial burden of increasing co-payments for cancer patients. They emphasize the need for gynecologic oncology practitioners to prepare for new models of cancer care delivery, such as Oncology Patient-Centered Medical Homes (OCPHM), as well as newer pay for...
Issues at the Heart of Advancing the De-Adoption of Low-Value Care
A diverse set of national leaders and stakeholders representing industry, think-tanks, provider and patient groups, and academic experts discussed how health systems, payers, and providers can spur the ‘de-adoption’ of medical practices and technologies no longer considered valuable.
Effects of the ACA on Health Care Cost Containment
This brief reviews the evidence on how key ACA provisions have affected the growth of health care costs. Coverage expansions produced a predictable jump in health care spending, amidst a slowdown that began a decade ago. Although we have not returned to the double-digit increases of the past, the authors find little evidence that ACA cost containment provisions produced changes necessary to “bend the cost curve.” Cost control will likely play a prominent role in the next round of health reform and will be critical to sustaining coverage gains in the long term.
Who We Talk About When We Talk About Value
The notion of value is at once one of the most widely invoked and variably interpreted in American health care.
To improve health care value, we need to know what we are paying for
[cross-posted from the Health Cents blog on philly.com]