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Care Delivery

 

Racial discrimination was by far the most common reason cited by black patients for receiving poor service or treatment from physicians or hospitals, according to a study published in the Journal of General Internal Medicine. White and Hispanic patients, however, also reported “high rates of discrimination” for other reasons such as age, weight or income.

High-deductible health plans have been framed as a way to give healthcare consumers more “skin in the game,” leading them to avoid low-value services as a way to save money. According to researchers from the USC Schaeffer Center for Health Policy and Economics and the RAND Corporation, they’re having little to no impact.

PricewaterhouseCoopers' (PwC) Health Research Institute expects “persistent risks and uncertainties” to impact healthcare in 2017, ranging from policy changes under the Trump administration to how artificial intelligence (AI) will change workflows—and in the end, it may come out stronger because of those challenges.

The goal of accountable care organizations (ACOs), according to CMS, is to better coordinate care for chronically ill patients, avoiding unnecessary services and preventing errors. For ACOs in the Medicare Shared Savings Program (MSSP), however, those weren’t the reasons they saved money, according to a study published in the Dec. 2017 issue of Health Affairs.

The offerings on the Affordable Care Act’s health insurance exchanges for 2018 are dominated by narrow network plans, with higher deductibles for silver- and gold-level plans, according to an analysis from Avalere.

 

Recent Headlines

Early Medicare ACO Results Mixed

According to the Centers for Medicare and Medicaid Services (CMS), one year into the Medicare Accountable Care Organization (ACO) initiative, a little less than half (54) of the 114 participating organizations have achieved savings and of those, just 29 saved enough money to receive “shared savings” bonuses. In addition, an in-depth savings analysis for the 29 participating Pioneer ACOs showed that nine achieved significant savings while also scoring high quality metrics.

21 Hospitals Enter Phase 2 in Bundled Prospective Payment Bet

Among the 232 health care providers that have entered into agreements in the now 1-year-old Centers for Medicare & Medicaid Services (CMS) Bundled Payments for Care Improvement initiative, 21 acute care hospitals have begun the second phase of the payment model that is the cleanest break with traditional fee-for-service.

Medicare Shared Savings ACOs: Crystal Run Shares Lessons Learned

Change isn’t easy, especially when it affects how much you are paid for services rendered. But the writing on the wall is clear: the fee-for-service model, especially for Medicare patients, is slowly but surely disappearing into the Affordable Care Act sunset. What’s a physician to do: work more and get paid less?

Supporting Value-based Care: UPMC’s Telehealth Strategy

Can a physician adequately serve multiple patients—in four or more different locations—in the same morning? Andrew R. Watson, MD, MLitt, FACS, knows the answer is yes because he has done it. Executive director of telemedicine for the University of Pittsburgh Medical Center (UPMC), and a practicing colorectal surgeon, Watson has found that his real world experience prepares him well for the naysayers—but patients are not among the skeptics.

Partner in Population-health Management: Walgreens, Anyone?

When Robert London, MD, received a phone call from an executive recruiter who suggested that he interview for a position at Walgreens, he was flabbergasted. “I wondered what I was going to do,” he recalls. “Would I stand at the door and greet people? Let them know about a new shade of nail polish?”

Peeling Off a Service Line How Hoag Reinvented Orthopedics

If Richard Afable, MD, MPH, president and CEO of Hoag Memorial Hospital Presbyterian, Newport Beach, California, told you he was closing down one of the largest orthopedics programs in California and entering into an orthopedics specialty hospital joint venture with his physicians, you might think about sending him job leads.

ACOs: Help or Headache?

Opinions about health care reform are plentiful, but Thomas H. Lee, MD, would rather hear solutions. When last year’s Affordable Care Act offered a new model called accountable care organizations (ACOs), Lee assessed the entity’s viability in his role as network president of Partners HealthCare System, based in Boston, Massachusetts.

Turnover and Retention Management in the Era of Reform

It's no secret that health care is undergoing tectonic changes, and as health care organizations struggle to keep pace with a rapidly evolving environment, there's never been a more critical time for the industry to develop and grow its competent leaders, says Tim Butler, senior consulting manager for GE Healthcare's Performance Solutions business.

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