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Category Archives: Payment Reform

The Evolution of Accountable Care Organizations and the Role of Pharmacists

By Rachel Regan and John Toussaint, MD, as posted at Pharmacy Times Accountable care organizations (ACOs) are groups of doctors, hospitals, and other health care providers, such as pharmacists, who come together voluntarily to give coordinated high-quality care to their Medicare patients. The goal of coordinated care is to ensure that patients, especially the chronically […]

Creating The Next Generation: The Payment Model We Need From Medicare

Four years of nation-wide testing by The Centers for Medicare and Medicaid Services (CMS) has now proven that the current shared savings payment models do not work effectively for low-cost Accountable Care Organizations (ACOs). High-cost ACOs have more room to improve and therefore more opportunity for savings. In this Health Affairs blog, David Krueger, M.D., […]

ACO Model Should Encourage Efficient Care Delivery

This article by John Toussaint, David Krueger, Stephen M. Shortell, Arnold Milstein, and David M. Cutler, is available at http://authors.elsevier.com/a/1RhPA7tCW1aw~q Abstract The independent Office of the Actuary for CMS certified that the Pioneer ACO model has met the stringent criteria for expansion to a larger population. Significant savings have accrued and quality targets have been met, so the […]

Making a Case for Healthcare Innovation

Posted on by CATALYSIS

A Selected Case Study in Healthcare Innovation and Transformation Looking Beyond Fee for Service by Rachel Regan Program Description: Until now, experiments using alternative payment methods to meet similar objectives have shown mixed results. Wisconsin’s Statewide Value Committee (SVC), a multi-stakeholder group working to accelerate the improvement of the healthcare system, began new discussions to […]

Investigative Report: How Much Hospitals Charge

Posted on by CATALYSIS

GREEN BAY – As a cost-conscious consumer, you wouldn’t pay $3 a gallon for gas if across town you could buy it for $2.50. But whether you realize it or not that’s what you’re doing with health care. FOX11 Investigates found hospitalization cost figures, provided by Green Bay’s four hospitals, show a wide range of […]

Medicare Announces its Intention of Moving the “Over 65” Population Toward a Value Payment Model

Posted on by CATALYSIS

HHS has set a goal of tying 30 percent of traditional, or fee-for-service, Medicare payments to quality or value through alternative payment models, such as Accountable Care Organizations (ACOs) or bundled payment arrangements by the end of 2016, and tying 50 percent of payments to these models by the end of 2018.  HHS also set […]

‘America’s Bitter Pill’ Makes Case For Why Health Care Law ‘Won’t Work’

Posted on by CATALYSIS

While reporting on the rollout of the Affordable Care Act, journalist Steven Brill was diagnosed with a life-threatening condition that required heart surgery. “There I was: a reporter who had made hospital presidents and hospital executives and health care executives and insurance executives sweat because I asked them all kinds of questions about their salaries […]

Nemours’ CEO Describes How Healthcare is Broken

Posted on by CATALYSIS

Doing the right thing for the health of a population – in this case improving the health of children with asthma – illustrates exactly why our healthcare system must change. David Bailey, a doctor and CEO of Healthcare Value Network member Nemours, shares his experience with an experiment that brought together a community and improved […]