In 2012, a total of 32 organizations entered the Pioneer accountable care organization (ACO) program, in which providers can share savings with Medicare if spending falls below a financial benchmark. Performance differences associated with characteristics of Pioneer ACOs have not been well described. The researchers used a difference-in-differences analysis of Medicare fee-for-service claims, to compare Medicare spending for beneficiaries attributed to Pioneer ACOs (ACO group) with other beneficiaries (control group) before (2009 through 2011) and after (2012) the start of Pioneer ACO contracts, with adjustment for geographic area and beneficiaries’ sociodemographic and clinical characteristics.
The growing number of consumers using less traditional methods for accessing their health care is prompting many hospital systems to explore expanding their walk-in clinics and online access. Additionally, many hospital systems are exploring new ways to provide less expensive but still high quality care and are making investments in new ways to measure patient outcomes. A recent article in The New York Times highlights how the Cleveland Clinic is responding to these changes.
To make smart choices about their health care, individuals need accurate and timely information about quality and price. States have broad responsibilities for the regulation of health insurance and the provision of medical care and are also major purchasers of health care for their employees. Thus, states have important roles in fostering price transparency.
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.