WayPoint Coordinates

8/1/2014

Employer-Driven ACOs: The Next Big Thing?

Last month, Boeing announced that it is working with ACOs to provide what they believe will be better quality and more affordable care to 27,000 Puget Sound-area employees and some 3,000 retirees. Boeing is the first employer to sign up with the ACO offered jointly by Providence Health & Services and Swedish Medical Center. This approach is believed to be advantageous because the middleman (the payer) is taken out

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6/26/2014

Overcoming Skepticism with Public Reporting: A Real Life Example

Many consumers are skeptical of CINs/ACOs because they are largely unproven. Public reporting to demonstrate services and value can be used to counter this skepticism. Last month we saw a real life example as Texas Health Resources (THR) unveiled its quality metrics. The initial data released includes 15 quality indicators composed of about 200 clinical metrics. THR cited the following benefits of public reporting: Patients and families are provided

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6/26/2014

The Value of Integrated Strategies

The goal of value-based insurance design is to get more out of the healthcare dollar by removing barriers to primary care and increasing the effectiveness of coordinated care. It is a value purchasing strategy, not simply a low-cost purchasing strategy. The patient-centered medical home is certainly an initial step in this process, but just as important is value-based insurance design that aligns outcomes-driven, evidence-based care with financial incentives. Value-based

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4/15/2014

Wellness and Disease Management Programs’ Impact on the ACO

It’s estimated that the number of ACOs will double by the end of 2014, according to a recent Premier Inc. report. Clearly, proactive wellness and disease management programs are vital to patient engagement in the ACO. A recent study by RAND Corporation researchers sheds some light on the ROI of these program’s efforts: chronic disease management returns $3.78 for every dollar invested and wellness/lifestyle programs return $0.48 for every

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4/15/2014

Texas has more independent physicians than national average

Texas physicians tend to maintain independent practices despite the trends of the rest of the nation towards hospital, clinic or large group practices. Steve Jacob of D Healthcare Daily recently authored an article about Texas’ independent physicians. Read more

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3/27/2014

Aetna snags massive public benefits deal

Aetna has won a huge state contract in Texas, pulling away 415,000 lives from Blue Cross Blue Shield and with them several billion dollars in revenue. The Teachers Retirement System of Texas selected Aetna to administer its Active Care health for some 415,000 current public school teachers and their dependents. Aetna estimates that the contract will be the largest membership sale in its history. Between the new deal and

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3/26/2014

PCMH shows benefits for highest-risk members

With a new study of Independence Blue Cross members, evidence on the effectiveness of the patient-centered medical home is swinging back towards the positive.Of 700 IBC members with multiple chronic conditions treated in patient-centered medical home practices, those with the highest-risk had “significantly reduced costs and utilization” compared to those with analogous health problems treated in regular practices, a study published in the American Journal of Managed Care found.Those

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3/26/2014

March Kaiser Health Tracking Poll Finds Gap Narrowing Between Unfavorable and Favorable Views of the Affordable Care Act Among the Public and the Uninsured

Most of the Uninsured Unaware of March 31 Deadline To Get Coverage; Half Plan to Remain Uninsured More Want Congress to Improve the Law Than Replace It As the Affordable Care Act’s first open enrollment period nears an end, the gap between favorable and unfavorable views of the law has narrowed among both the general public and the uninsured, the latest Kaiser Health Tracking Poll finds. In March, 46

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2/26/2014

Medicare Shared Savings Program Application Cycle: Deadlines to Apply for Program Year 2015

The Medicare Shared Savings Program (Shared Savings Program) facilitates coordination and cooperation among healthcare providers to improve the quality of care for Medicare fee-for-service (FFS) beneficiaries.  Eligible providers and suppliers may participate in the Shared Savings Program by creating or participating in an Accountable Care Organization (ACO.)  The Shared Savings Program rewards ACOs that lower their rate of growth in health care costs while meeting quality performance standards. You

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2/25/2014

Team-Based Care Becoming More Common

Throughout the United States, more physician practices are moving towards team-based care rather than the traditional one-on-one doctor-patient experience. Wall Street Journal provides interesting insight on this trend. Click here for full article.

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