Across all payers, more than 1,000 accountable care organizations cover about 33 million US lives, and those numbers have consistently increased since the model's inception, even after the Pathways to Success rule was finalized. Data show that at the end of 2018, hospital-led ACOs and large ACOs of all types had low dropout rates despite a move toward downside risk, and dropout rates were highest among small physician-led ACOs, suggesting a need for program modifications to accommodate and encourage their participation.
A study in Health Services Research found a strong link between social determinants of health and high rates of readmission to safety-net hospitals, which often serve the most vulnerable patients. The study suggests that if the CMS were to adjust for social health factors such as disability and housing instability in hospital readmission rates, safety-net hospitals would see lower penalties under Medicare's Hospital Readmissions Reduction Program, resulting in $17 million in savings for these hospitals.
A survey of 185 health care leaders found about 90% said most value-based health care contracts will have upside and downside risks within the next five years, according to a report from the HealthCare Executive Group and Change Healthcare. The survey showed 6.3% of respondents said most value-based contracts will never include upside and downside risks.
Data from Geisinger's Ask-A-Doc program, which included 22,000 physician consultations, showed it reduced the turn-around time between primary and specialty physicians to 6.5 hours compared with traditional referrals that could take from weeks to months. The program also reduced costs, mainly due to fewer emergency department and physician office visits.
Alarming levels of addiction and overdose have shined a spotlight on an inadequate workforce of physicians trained in addiction medicine, and medical institutions are responding with new and expanded programs for training doctors for the specialty. "The medical community has begun to wake up to consider not only their role in triggering this opioid epidemic but also the ways they need to step up to solve the problem," says Dr. Anna Lembke, Stanford University School of Medicine's medical director of addiction medicine.
A report from the Kaiser Family Foundation found that while the number of respondents who said their physicians use EHRs rose from 46% in 2009 to 88% in 2019, 54% are still "very concerned" or "somewhat concerned" that their personal health information may be accessed by an unauthorized person. Meanwhile, 45% of respondents also cited concerns about errors in their medical records that could negatively affect their care, with 21% reporting that they or a family member have noticed an error in their EHRs, including incorrect medical history, personal information, prescription or medication information, laboratory or test results and billing issues.
Data from Valley Health's first year using a tele-ICU showed it reduced ICU length of stay 34% and ICU mortality by 35% to 44%. Officials said it helped save 125 lives, reduced sepsis mortality and improved best practice compliance.
State employee health plans are starting to tie hospital reimbursement to Medicare rates as a way of reining in spending, and if the idea works, private-sector employers may follow suit. However, hospitals say Medicare underpays them, and some industry groups have said that if public employers link payments to Medicare rates, private-sector businesses could end up paying more.
The Medicaid and CHIP Payment and Access Commission issued a report last week urging Congress to gradually phase in disproportionate share hospital payment cuts and first target states with unspent DSH money. The commission also called for a new method of calculating DSH funding so the total received by each state more accurately reflects its low-income population.
The ACC/AHA Task Force on Performance Measures invites clinicians, administrators, patients and other interested individuals to review a draft version of the 2019 ACC/AHA Clinical Performance and Quality Measures For Adults With High Blood Pressure. This document aims to update the 2011 ACC/AHA Hypertension Measure Set and present new measures to evaluate the care of patients in accordance with the 2017 High Blood Pressure Guideline and some relevant recommendations from the new Primary Prevention Guideline. The draft document and survey are available online. Comments must be submitted by Tuesday, April 16.
If there's anything you've wanted to do for yourself, just get out and go for it.
Arlene Pieper, first woman to finish a US marathon (Pikes Peak Marathon, 1959)
March is Women's History Month
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