HIMSS Analytics Survey Demonstrates Awareness and Usage of Remote Health Monitoring DevicesMarket Watch - February 21, 2012
Survey of Consumers and Health IT Executives Notes Benefits of Leveraging Mobile Health Care Devices and Barriers to Overcome in Consumer Perception
Rules of the road: Annual survey highlights execs' priorities as they try to steer through the shifting regulatory landscape for health IT
Modern Healthcare - Joseph Conn - February 18, 2012
Meaningful use is once again the main concern of hospital and medical group practice leaders in the information technology sphere as expressed by those who participated in the 22nd annual Modern Healthcare/Modern Physician Survey of Executive Opinions on Key Information Technology Issues. But the regulatory backdrops for meaningful use and another major issue measured on this year's survey—achieving compliance with the ICD-10 code sets—remain in flux.
Data is key to population health management
Healthcare IT News - John Andrews - February 17, 2012
There are many ways to go about addressing the issue of population health management, but the starting point is with information technology and data, says Carol Cassell, client services executive with Buffalo, N.Y.-based CTG.
Giving Providers a Head Start with ACOs
Health Data Management - February 12, 2012
Anthem Blue Cross Blue Shield has five large medical groups participating in its ACO efforts. As a first step in launching the projects, the payer took three years of claims data and downloaded it to the respective databases of the groups
ACOs And Inequity: Lessons From No Child Left Behind
Health Affairs Blog - Abdulrahman El-Sayed - February 17, 2012
Policy analysts contend that ACOs can contain costs and promote good outcomes because they align patient and practitioner incentives. By rewarding outcomes rather than the volume of health services performed, providers maximize their profits by improving patient health, which avoids unnecessary health services that increase cost. At once cutting costs and improving outcomes, ACOs seem like the magic bullet. But there’s a catch: ACOs do little to address a crucial third issue in the healthcare dilemma—health equity. In fact, they may even exacerbate the problem.
15 Tough Questions Doctors Ask About ACOs
Medscape - Wayne J. Guglielmo - February 16, 2012
Many hospitals, health centers, large physician groups, and insurers are working toward or considering forming ACOs, and physicians are being approached to participate. But although the final rule eased the requirements, doctors still have some skeptical questions about how ACOs will work, how physicians will be paid, and how compensation gets decided, among other matters. To sift through these complexities, Medscape spoke to Anders M. Gilberg, senior vice president of Government Affairs, Medical Group Management Association (MGMA).
Cartoon Solves Health Care Puzzler: What The Heck Is An ACO?
CommonHealth - Carey Goldberg - February 10, 2012
WBUR’s CommonHealth blog has put together a video animation that walks viewers through how ACOs work and what that means for consumers.
Sharp's Pioneering ACO May Raise Bar in San Diego
California Healthline - Lisa Zamosky - February 16, 2012
Sharp HealthCare's selection as the only San Diego-based provider and one of six in California to participate in the federal Pioneer Accountable Care Organization program could raise the bar for health care providers throughout San Diego County.
Reform Of the Health Care System That Is Overdue
Forbes - William Winkenwerder - February 15, 2012
Health care expert William Winkenwerder seeks a better incentive structure in the health care system as a way of increasing efficiency, lowering costs, and achieving better health outcomes.
Prince George’s County survey intended to gauge state of health care
Washington Post - Miranda S. Spivack - February 15, 2012
A survey is underway in Prince George’s County, MD. Officials expect the data to give them a detailed look at the state of health and health care in the county, where conditions such as diabetes and heart disease are much more common than in the rest of the region and most of the state. At the same time, they hope that the information will help determine how to build a new regional hospital and primary-care network that would attract residents from a broad range of incomes and ethnic backgrounds.
Partners at the ACO table: Pharmacists to play integral role in these new provider models
Drug Topics - Monica Shah - February 15, 2012
The diversity in the organization of U.S. healthcare often leads to fragmented patient care, payment, and delivery systems. In many settings, the responsibility of steering the health of a community or a patient is disseminated across many sites. One potential solution is the accountable care organization (ACO), a new form of provider, which was established with the passage of the Affordable Care Act.
Healthcare Reform Is Here, Like It Or Not
InformationWeek - Marianne Kolbasuk McGee - February 15, 2012
Participation in new accountable care organizations isn't for the faint of heart. But healthcare providers that have their IT acts together have a good head start.
Blues, UnitedHealth launch IT initiatives for ACOs, cloud computing
Fierce Health IT- Dan Bowman - February 14, 2012
Looking to increase relationships among patients, payers and providers, health IT vendor Lumeris and three Blues plans--Highmark, Horizon Blue Cross Blue Shield of New Jersey and Independence Blue Cross--announced today an agreement to purchase healthcare communication network NaviNet.
ACO models pass on CMS Shared Savings Program
Fierce Healthcare - Karen M. Cheung - February 14, 2012
Most accountable care organization models are hesitant to apply for the Centers for Medicare & Medicaid Services' Medicare Shared Savings Program, according to a survey released last week from health IT nonprofit eHealth Initiative.
10 Evolving Issues for Hospitals, Health Systems, Physicians & ACOs
Becker's ASC Review - Scott Becker, Drew E. McCormick, Allison L. Harms, Samuel C. Bernstein - February 13, 2012
This article briefly discusses 10 emerging healthcare issues for 2012, focusing principally on hospital and physician issues
Health insurer WellPoint to revamp payment for primary care
Associated Press - January 27, 2012
Health insurer WellPoint Inc. plans to improve primary care reimbursement and start paying for care management that it doesn't currently cover, changes that could give patients more quality time with their doctors.
Support for Accountable Care: Recommended Health IT Infrastructure
E-Health Initiative - February 2012
This report aims to inform the field of accountable care by identifying trends and supporting the development of a robust health information technology infrastructure that supports the needs of an Accountable Care Organizational Model.
Are Health CIOs Ready For Pay For Performance?
InformationWeek - Nicole Lewis – February 9, 2012
With Meaningful Use Stage 2 requirements just around the corner, a CSC report says IT managers should prepare with a more robust system that addresses care coordination and patient engagement.
HIMSS: The Garden State and ACOs
Government Health IT - Thomas S. Keefe - February 9, 2012
The signing of S2443, a bill creating a Medicaid Accountable Care Organization Demonstration Project in the Department of Human Services, gives New Jersey a step forward in the development of ACOs, a key component of healthcare reform.
A Peek into the ACO Crystal Ball
Healthcare Informatics - Jennifer Prestigiacomo - February 8, 2012
Healthcare Informatics Associate Editor Jennifer Prestigiacomo spoke with American Medical Group Association’s John Cuddeback, M.D., Ph.D., chief medical informatics officer of Anceta, AMGA’s collaborative data warehouse, to see what was in store for development of accountable care organizations (ACOs) this year and what care coordination tools will be necessary to lay the groundwork.
Nurses, Care Coordinators Are Gaining Importance in ACOs
ACO Business News - Jennifer Lubell – February 9, 2012
Health plans and providers alike have been touting the benefits of incorporating “embedded nurses” or care coordinators into their ACO framework, reporting that they contribute to improved patient outcomes by providing a significant communication link between the patient and physician. In unveiling recent ACO ventures or achievements in both the Medicare and commercial space, insurers such as Aetna Inc. and Cigna Corp. have highlighted these caregivers as pivotal to the success of their accountable care models.
New Way to Pay Doctors
Wall Street Journal - Anna Wilde Mathews – February 9, 2012
Efforts to change how Americans pay for health care are gathering momentum on a national scale as UnitedHealth Group Inc., the largest U.S. health insurer, becomes the latest carrier to say it is overhauling its fees for medical providers.
AMA Survey Reveals That Physician Interest Lags In ACO Participation
Dark Daily - Pamela Scherer McLeod - February 8th 2012
The American Medical Association (AMA) reports a lagging interest by physicians when they are asked about their participation in an accountable care organization (ACO). Many physicians say they lack specific details about the care model and how it will reimburse providers. This survey found that—although many physicians are familiar with the concept—a significant number of them indicate they will either opt out of an ACO or unsure whether they will participate in an ACO.
Pioneer ACO Update: Q&A With Health IT Leaders from Eastern Maine Healthcare System
Healthcare IT News - Chad Johnson - February 7, 2012
IT leaders from Pioneer ACO Eastern Maine Healthcare System share their experiences participating in the program, about the IT infrastructure they have in place to coordinate the delivery of care, and any advice they would give other health IT professionals working toward creating an ACO.
A Tale of Two ACOs
NJ Spotlight - Joel C. Cantor - February 7, 2012
New Jersey and the federal government have very different takes on ACOs, but both are tasked with driving down the cost of healthcare.
The HIT of ACOs, part 3: Tapping IT to put patients front-and-center
Government Health IT - John Loonsk - January 18, 2012
This article focuses on the patient’s IT view on the ACO and the need to bring together coordinated communications, health record, and care support services. The patient view may include a provider-supported patient portal, patient mobile health tools, home monitoring systems, and communications tools that face the patient as they interact with providers, provider data, and the provision of care.
Sincerest form of flattery: Mimicking Medicare, states want to try accountable care models for Medicaid
Modern Healthcare - Rich Daly - January 9, 2012
At least 11 states are adding initiatives resembling accountable care organizations to their Medicaid programs. And many providers who shied away from the Medicare ACO models are interested in the state versions, many of which lack sanctions for providers who fall short of quality and cost benchmarks.
Eight reasons payer interoperability and data sharing are essential in ACOs
Health Management Technology - Shefali Mookencherry - January, 2012
Payers and providers should commit to reasonable clinical and cost goals, and share resources to minimize expenses and financial risks. It is in the interest of payers to work closely with providers on risk-management strategies because insurers need synergy with ACOs to remain cost competitive. Furthermore, it is in the interest of ACOs to work collaboratively with payers early on to develop reasonable and effective performance benchmarks.
Building Connections on the Care Continuum
Health Data Management - Gary Baldwin - February 1, 2012
For Micky Tripathi, the CEO of the Massachusetts e-Health Collaborative, the longevity of the accountable care organization model-the industry's latest effort to contain costs and improve outcomes by shifting financial incentives-is anyone's guess. "It's a real question mark of whether or not the ACO will work," he says. "The 'AC' part has momentum, but there are open questions around the 'O.'"
Multi-Stakeholder Group Weighs-in on Quality Measures for Use in Federal Healthcare Programs
PRWeb - February 02, 2012
At the request of the Department of Health and Human Services (HHS), the Measure Applications Partnership (MAP) has submitted its first annual review of performance measures being considered this year for use in federal rulemaking. The measures evaluated by MAP will be used in public reporting and performance-based payment programs that help drive system-wide quality improvement and accountability. The measures apply to nearly 20 different federal healthcare programs.
Health insurer WellPoint plans to revamp primary care pay to improve quality, save money
Associated Press - January 27, 2012
Health insurer WellPoint Inc. plans to improve primary care reimbursement and start paying for care management it doesn’t currently cover, changes that could give patients more quality time with their doctors.
The End of Health Insurance Companies
New York Times - Ezekiel J. Emanuel, Jeffrey B. Liebman - January 30, 2012
Here’s a bold prediction for the new year. By 2020, the American health insurance industry will be extinct. Insurance companies will be replaced by accountable care organizations — groups of doctors, hospitals and other health care providers who come together to provide the full range of medical care for patients.
Can Accountable-Care Organizations Improve Health Care While Reducing Costs?
Wall Street Journal - Anna Wilde Mathews – January 23, 2012
A diverse group of health-care policy experts discuss whether ACOs are an answer to what ails the health-care system. The panelists include Donald M. Berwick, who stepped down Dec. 2 as administrator of the Centers for Medicare and Medicaid Services; Tom Scully, the Center for Medicare and Medicaid Services administrator from 2001 to 2004; and Jeff Goldsmith who serves as president of Health Futures Inc., a health-care consulting firm, and an associate professor of public-health sciences at the University of Virginia, in Charlottesville.
Learning Network Co-Chairs Drs. Mark McClellan and Elliott Fisher Submit Comments on Proposed Rulemaking for ACOs
June 6, 2011 - Today the Engelberg Center for Health Care Reform at the Brookings Institution and the Dartmouth Institute for Health Policy & Clinical Practice submitted our comments to CMS on the Medicare Shared Savings Program Notice for Proposed Rule Making (NPRM) and on the waiver designs in connection with the Medicare Shared Savings Program and the Innovation Center. Our comments were based on our work, research, and discussions with our five ACO pilots sites and with many of our ACO Learning Network members.
We have long advocated for the development of new payment models – including the concept of accountable care organizations (ACOs) – in order to support providers deliver better care to patients. We believe the NPRM released by CMS on April 7th represents a comprehensive and thoughtful effort to identify and address a wide range of key issues for Medicare ACOs. Our comments below to CMS and OIG include a number of substantive recommendations to improve the Medicare Shared Savings Program:
Healthcare Associations Submit Comments on Proposed ACO Regulations
- AARP
- American Academy of Actuaries
- American Hospital Association (AHA)
- American Health Care Association (AHCA)
- America's Health Insurance Plans (AHIP)
- American Medical Association (AMA)
- American Medical Group Association (AMGA)
- Campaign for Better Care
- Federation of American Hospitals (FAH)
- Integrated Healthcare Association (IHA)
- Medicare Payment Advisory Commission (MedPAC)
- Medical Group Management Association (MGMA)
- Robert Wood Johnson Foundation
Center for Medicare & Medicaid Innovation (CMMI) Announces Upcoming Open Door Forums
Tuesday, June 7, 2011 at 12:00 p.m. EDT
A review of the Pioneer ACO Model Request for Application
Full transcript available here.
Tuesday, June 14, 2011 from 2:00-3:00 p.m. EDT
Advance Payment Initiative for ACO's entering the Medicare Shared Savings Program
Full transcript available here.
Monarch HealthCare, Anthem Release Patient Notification Letters
May 5, 2011 - Monarch HealthCare and Anthem have sent the first patient notification letters to PPO patients that will participate in an ACO, marking the first ACO patient notification by any of the Brookings-Dartmouth pilot sites. Read the letter and FAQs
Drs. Mark McClellan and Elliott Fisher Provide Initial Reactions to Proposed ACO Regulations in Health Affairs Blog
Washington, D.C. (March 31, 2011) - Dr. Mark McClellan, Director of the Engelberg Center for Health Care Reform at The Brookings Institution, and Dr. Elliott Fisher, Director for Population Health & Policy at The Dartmouth Institute for Health Policy & Clinical Practice, provided their initial reactions to the proposed regulations for Accountable Care Organizations today in a Health Affairs Blog post. Read the commentary
Related content:
The U.S. Department of Health and Human Services has released proposed new rules for the Medicare Shared Savings program, designed to help doctors, hospitals, and other providers form ACOs. CMS has worked closely with other federal agencies, including the HHS Office of the Inspector General, the Department of Justice, the Federal Trade Commission, and the Internal Revenue Service to ensure that providers and suppliers have the clear and practical guidance they need to form ACOs without running afoul of the fraud and abuse, antitrust, and tax laws. These agencies have released concurrent publications alongside the proposed rules addressing these specific issues, available below.
- Proposed rules for the Medicare Shared Savings Program
- Federal Trade Commission/Department of Justice Proposed Statement of Enforcement Regarding Accountable Care Organizations Participating in the Medicare Shared Savings Program
- Office of the Inspector General's Waiver Designs in Connection with the Medicare Shared Savings Program and the Innovation Center
- Internal Revenue Service Notice 2011-20 Requests for Comments on Need for Guidance on Participation by Tax-Exempt Organizations in the Medicare Shared Savings Program
Read CMS Administrator Don Berwick's perspective on launching accountable care organizations in The New England Journal of Medicine
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National Quality Forum Names Norton Healthcare Winner of 2011 NQF National Quality Healthcare Award
Washington, D.C. (March 28, 2011) – The National Quality Forum (NQF) announced today that Norton Healthcare has been named the recipient of the 2011 NQF National Quality Healthcare Award for its exceptional organizational leadership and innovation to achieve quality improvement. The award will be presented in partnership with Modern Healthcare on Sept. 15 at the NQF Leadership Colloquium in Washington, D.C. Read the full release