Advocates of “accountable care organizations” (ACOs) are careful to avoid the terminology of “managed care,” which is widely viewed as a failed model from the 1980s and 1990s. But, there are obvious similarities between ACOs and managed care. Both involve an organization taking responsibility for the quality and cost of care for a defined population.
As described in a recent article in American Medical News, the Mayo Clinic and the Cleveland Clinic are both independently offering medium to large groups of specialist physicians an opportunity to use their esteemed brand names and a variety of other resources formerly only available to employed physicians. In return, the group has to pay
On top of the Medicare Shared Savings Program (the original ACO initiative) and the Pioneer ACO Program, CMS is now adding four more optional approaches for providers to get reimbursed for Medicare services. The new models all involve bundled payments, where a single negotiated payment covers all professional and facility services for a particular type
A new study published in the Annals of Internal Medicine compared the economic outcomes of hospital episodes managed by hospitalists to those managed by the patients’ primary care physicians in a Medicare population. Previous studies focused only on the cost of the hospital stay itself, and showed that hospitalists were able to reduce length of stay
Guidelines for the use of mammograms to screen for breast cancer have been the topic of one of the fiercest and longest-running debates in medicine. Back in the early 1990s, I participated in that debate as the leader of a guideline development team at the Henry Ford Health System. We developed one of the earliest
The 5th Annual Predictive Modeling Summit is described by conference organizers as the “leading forum on predictive analytics applied to key health care functions, settings and populations.” Dr. Ward will be giving a presentation entitled “Using Intervention Models and Predictive Models to Optimize Patient Selection for Care Management in ACOs” at 1pm on November 9,
This morning, I read the results from a clinical trial of ovarian cancer screening in JAMA. The trial showed that ovarian cancer screening was not effective in saving lives. I was interested in the article because I was one of the investigators in that trial, which began in the early 1990s. Henry Ford Health System
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Few things in my work life are better than finding mind-blowing information from other industries and figuring out the implications for healthcare. I recently read a set of slides by Paul Adams, a user experience designer that worked at Google and Facebook. Although Adams’ presentation had 224 slides, the main thesis was relatively simple and
Ron Klar, MD, MPH is a health care consultant with a long history of involvement in federal health care policy and health plan innovation. He published a recent series of three posts regarding the draft rules for the Medicare Shared Savings Program (MSSP) in the Health Affairs Blog, an influential forum for debating health policy issues.
Klar 4: Why is it important for CMS to Share Claims Data with ACOs? Read More »
