The number of accountable care organizations participating in Medicare advanced payment models has grown steadily to 561 this year, according to the CMS, and representatives of participating ACOs expressed confidence in the model. As health care providers take on more financial risk, they are likely to do more to keep their patient populations healthy, says Avalere Senior Vice President Josh Seidman.
Accountable care organizations in Track 1 of the Medicare Shared Savings Program could have received an additional $966 million in 2016 if they had instead participated in Track 1+, which includes some downside financial risk, according to an analysis by Avalere. Track 1+ incentive payments would resulted in net gain for most of the participating ACOs, the analysis found.
Maryland's 4-year-old hospital capitated-payment pilot project has controlled costs but does not appear to have reduced readmissions, inpatient stays for observation, emergency department utilization or outpatient care in the program's first two years, according to a study in the Journal of the American Medical Association. Non-hospital costs will be included in the next phase, and health care providers will be offered new incentives, but the study authors warned it could take up to 10 years for significant, lasting changes to become apparent.
AHIP, the Blue Cross Blue Shield Association and four other health care provider organizations are working to streamline prior authorizations to improve access to timely and affordable care while reducing administrative burdens. The groups agreed to reduce the number of providers subject to prior authorization rules, improve communication, and regularly review services and medications that require prior authorization.
A study in The BMJ found that total duration of opioid use following surgery was the strongest predictor of misuse. The analysis of surgical claims data for more than 37 million commercially insured patients found that the risk of misuse increased with every refill and additional week of postoperative opioid prescription.
Analyzing EHR data can show the prevalence of low-value medical testing and identify the causes of unnecessary tests, according to a study in the American Journal of Managed Care based on 13 measures identified by the Choosing Wisely campaign. Researchers said EHR data combined with manual chart review and administrative claims can help find low-value testing overuse and identify risk factors.
Burnout among physicians may have been augmented by increased EHR use amid the shift to value-based care and their overwillingness to take on administrative burdens related to operating a practice, Dr. Donald Mack, family physician at the Ohio State University Wexner Medical Center, wrote in a commentary published in the Journal of the American Board of Family Medicine. Implementing direct primary care, which physicians said resulted in increased autonomy, control and time with patients, may be one solution for overcoming physician burnout, Mack wrote.
Recent studies have sent mixed signals when it comes to the effect of exercise on cognitive health. While the American Academy of Neurology said neurologists should recommend exercise for people with mild cognitive impairment, a panel of experts for the National Academies of Science, Engineering and Medicine said scientific evidence is not sufficient to support claims that exercise can prevent MCI or dementia.
Type 2 diabetes patients living in communities with the most exercise opportunities and in areas with the best food availability had an up to 0.19% and a 0.10% greater improvement in their A1C levels, respectively, compared with those in places with the fewest physical activity resources and in communities that do not offer healthy food options, according to a study in Diabetes Care. Researchers evaluated 15,308 patients with poorly controlled diabetes at baseline with an average age of 58 and found that socioeconomic deprivation and chronic stress also negatively affect blood glucose control among diabetes patients.
Almost 1 in 4 children and adolescents had elevated blood pressure readings during initial screening, but secondary screening indicated just over 2% of the youths had sustained hypertension over time, according to a study in the Journal of Clinical Hypertension. "Because an elevated first blood pressure in youth is common, correct identification of truly elevated blood pressure may be a first step to improve the recognition of hypertension in pediatric care," said researcher Corinna Koebnick.
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