Snapshot of ACO participation suggests way forward from Pathways rule | Link between social determinants, readmissions hurts some hospitals | Survey predicts growth in value-based contracts with risks
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March 21, 2019
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First Focus
Snapshot of ACO participation suggests way forward from Pathways rule
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.
Health Affairs Blog (3/15) 
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Link between social determinants, readmissions hurts some hospitals
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.
RevCycle Intelligence (3/20) 
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Survey predicts growth in value-based contracts with risks
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.
RevCycle Intelligence (3/19) 
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Practice & Hospital Management
Ask-A-Doc program shortens consult turn-around times
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.
Health Data Management (free registration) (3/21) 
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Medical institutions work to meet need for addiction specialists
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.
National Public Radio (3/19) 
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E-Health Watch
Survey: Patients still worry about privacy of data in EHRs
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.
Becker's Health IT & CIO Report (3/18),  Healthcare Dive (3/19) 
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Other News Highlights
Spotlight on Innovation
Health system eICU reduces ICU mortality, LOS
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.
Healthcare IT News (3/18) 
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Costs & Reimbursement
State health plans look to Medicare rates to rein in costs
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.
National Public Radio (3/20) 
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MACPAC encourages Congress to phase in DSH payment cuts
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.
HealthLeaders Media (3/18) 
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Spotlight on JACC Journals
ACC News
Open Comment Period on Measures For Adults With High BP
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.
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This news roundup is provided as a timely update to ACC members and partners interested in quality health care topics in the news media. Links to articles are provided for the convenience of the health care professionals who may find them of use in discussions with patients or colleagues. Opinions expressed in ACC Quality First SmartBrief are those of the identified authors and do not necessarily reflect the opinions or policies of the American College of Cardiology. On occasion, media articles may include or imply incorrect information about the ACC and its policies, positions, or relationships. For clarification on ACC positions and policies, we refer you to ACC.org.
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