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Accountable Care Organizations (ACO)

When doctors, hospitals, and other providers come together to form an Accountable Care Organization, high quality, affordable care for patients is the intended outcome.

Comparison of Certain Model Features in Blue Cross NC Blue Premier vs Next-Generation ACO Model vs BCBSMA Alternative Quality Contract

New Marketplace

Engineering a Rapid Shift to Value-Based Payment in North Carolina: Goals and Challenges for a Commercial ACO Program

We believe North Carolina can be a model for the nation.

Cautious Optimism That Value-Based Reimbursement Will Become Primary Revenue Model

New Marketplace

Survey Snapshot: What Would Accelerate the Adoption of Value-Based Care?

NEJM Catalyst Insights Council members weigh in on the barriers and path forward to value-based health care.

Fee-for-Service Continues to Account for the Majority of Revenue

New Marketplace

New Marketplace Survey: Transitioning Payment Models: Fee-for-Service to Value-Based Care

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.

Murray02_pullquote surgical care bundled payments accountable care organizations

New Marketplace

Surgical Value — Beyond Bundled Payments

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.

Comparison Between Traditional and Proposed Health Reimbursement Plan for Primary Care Outcomes Model Across Five Key Domains

New Marketplace

Payment Designed for People: Introducing the Primary Care Outcomes Model

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.

Figure 1. Differential Changes in Total Medicare Spending for Patients in Accountable Care Organizations (ACOs), According to the Type of ACO, Year of Entry, and Number of Years of Participation.

New Marketplace

Medicare Spending after 3 Years of the Medicare Shared Savings Program

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.

Alaigh03_pullquote aco and bundled payment co-exist

New Marketplace

ACOs and Bundled Payments: How the Two Can and Should Coexist

The integration of primary care and specialty care physicians through adoption of both payment models will lead to synergistic value.

Shachar01_pullquote value-based care fee-for-service fraud and abuse laws

New Marketplace

Are Fraud and Abuse Laws Stifling Value-Based Care?

To realize the true potential of value-based care, we must update the underlying assumptions in our fraud and abuse regulatory system.

Hospital-based ACOs Key Capabilities Are Different Based on Level of Risk

New Marketplace

Hospital-based ACOs Face Challenges in Tracking Performance Indicators

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.

Griffin Myers Head Shot Oak Street Health

Care Redesign

Rebuilding Health Care as It Should Be: Personal, Equitable, and Accountable

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.”

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