In a survey of the NEJM Catalyst Insights Council sponsored by Optum, respondents express enthusiasm for value-based care but have conflicting opinions about just how far along that path they should go.
Accountable Care Organizations (ACO)
When doctors, hospitals, and other providers come together to form an Accountable Care Organization, high quality, affordably managed care for Medicare patients is the intended outcome. Can the best intentions yield the best outcomes?
Article by Alice Murray, Ashish K. Jha & Thomas H. Lee
The surgeon has a crucial role in defining value for patients in a population — and not just when that patient is in need of the surgeon’s knife.
Article by Adam L. Beckman, Laura Chmar, Travis Broome, Bob Kocher & Farzad Mostashari
A care and payment model that engages primary care physicians in an aligned model built on trust and value could result in better patient care at lower costs.
Article by J. Michael McWilliams, Laura A. Hatfield, Bruce E. Landon, Pasha Hamed & Michael Chernew
After 3 years of the MSSP, participation in shared-savings contracts by physician groups was associated with savings for Medicare that grew over the study period, whereas hospital-integrated ACOs did not produce savings (on average) during the same period.
Article by Poonam L. Alaigh
The integration of primary care and specialty care physicians through adoption of both payment models will lead to synergistic value.
Article by Carmel Shachar
To realize the true potential of value-based care, we must update the underlying assumptions in our fraud and abuse regulatory system.
Case Study by Christiana Beveridge, A. Sofia Warner, Greg Leya & Thomas W. Feeley
A focus on bundled payments for specific episodes of care — versus the broad changes required in an ACO model — may be a more effective method for ACO participants to develop capabilities required to measure utilization, cost, and revenue metrics.
How Oak Street Health, a full-risk, value-based primary care model and social determinants practice, embeds itself in the community to keep its elderly population, “happy, healthy, and out of the hospital.”
Article by Roslyn Murray, Andréa E. Caballero & Suzanne F. Delbanco
Despite some successes among the many efforts to execute value-oriented payment models, the lack of rigorous independent research studies impedes robust progress.
Roundtable by Donald M. Berwick, Melinda B. Buntin, Patrick H. Conway, Raymond P. Vara, Jr. & Edward Prewitt
A discussion from the Institute for Healthcare Improvement National Forum. Part 2 of a two-part series.