Increasingly, health plans, employers, and other payers are developing tiered provider networks, which rank and stratify providers according to cost and quality performance. In a HCFO-funded study, Meredith Rosenthal, Ph.D., and Anna Sinaiko, Ph.D., from the Harvard School of Public Health examined the effect of a three-tiered network on patients’ choice of physician or health plan.
As Americans shoulder more health care costs, Public Agenda research suggests that many are hungry for more and better price information. However, some obstacles remain to increasing the number of Americans who compare prices before getting care.
A recent article in USA Today explores potential reasons for price variation across geographic locations and highlights how consumers can use this information to make better decisions about their health care. Price transparency will be the focus of an upcoming summit sponsored by the Robert Wood Johnson Foundation, March 16-18, in Washington, DC.
In 2012, the ABIM Foundation announced the Choosing Wisely initiative under which more than 60 specialty societies have developed lists of five evidence-based recommendations of tests and treatments that physicians and patients should question and discuss. In a HCFO-funded study, Carrie Colla, Ph.D., and colleagues created claims-based algorithms to examine 11 services identified on one or more Choosing Wisely lists.
- Paying for Value: Momentum Surges while Evidence Lags November 2014
A recent Health Affairs Blog post explored the dramatic increase in the percent of commercial sector payments tied to value. Recent and ongoing HCFO-funded work provides insights into the challenges and opportunities of these value-based payment arrangements.
While the United States has made great progress in reducing the number of uninsured children, coverage remains fluid for the many children who transition between public and private insurance. In a HCFO-funded study, Thomas Buchmueller, Sean Orzol, and Lara Shore-Sheppard analyzed the relationship between a child’s health insurance stability and a child’s access to medical care.
- Choosing Wisely: Prevalence and Correlates of Low-Value Health Care Services in the United States November 2014
Specialty societies in the United States identified low-value tests and procedures that contribute to waste and poor health care quality via implementation of the American Board of Internal Medicine Foundation’s Choosing Wisely initiative. The researchers used Medicare data from 2006 to 2011, to created claims-based algorithms to measure the prevalence of 11 Choosing Wisely-identified low-value services and examine geographic variation across hospital referral regions (HRRs).
- Assessing the Impact of Hospital Value-Based Purchasing on Clinical Quality and Patient Experience October 2014
Questions are arising about the impact of hospital value-based purchasing on clinical quality and patient experience. It is important for the medical community to understand the impact of this program.
- A decision exercise to engage cancer patients and families in Deliberation about Medicare Coverage for advanced Cancer Care July 2014
Concerns about unsustainable costs in the US Medicare program loom as the number of retirees increase and experience serious and costly illnesses like cancer. Engagement of stakeholders, particularly cancer patients and their families, in prioritizing insured services offers a valuable strategy for informing Medicare coverage policy. The researchers designed and evaluated a decision exercise that allowed cancer patients and family members to choose Medicare benefits for advanced cancer patients.