Center for Medicare & Medicaid Innovation head Brad Smith said newer value-based care payment models based on a global budget have shown success, while others, such as those with bundled payments, have led to a lot of transformation but failed to show expected quality or savings improvements. Smith said some of the successful models had a "clear thesis" about quality and cost improvements.
The Core Quality Measure Collaborative -- which includes the CMS, the National Quality Forum and America's Health Insurance Plans -- has developed four new quality measure sets designed to promote value-based care, and health insurance providers can use them to guide data collection on health care quality. The measures cover pediatrics; gastroenterology; gynecology and obstetrics; and hepatitis C and HIV.
A study in JAMA Network Open showed a bundled payment model for knee and joint replacements led to improved care for Black patients. The study included 700,000 patients who had joint replacement surgeries covered by Medicare between 2013 and 2017, and they found Black patients experienced a 3% reduction in readmission risk and lower use of institutional post-acute care after the implementation of Comprehensive Care for Joint Replacement model in April 2016.
A bipartisan group of 29 lawmakers sent a letter to House leaders urging them to include a provision in the next pandemic relief package that would lower the qualifying thresholds for getting bonus payments under the advanced alternative payment models. According to the lawmakers, the pandemic will make it difficult for accountable care organizations and other APM participants to meet the current 50% threshold, which will increase to 75% under the Medicare Access and CHIP Reauthorization Act of 2015.
Horizon Blue Cross Blue Shield of New Jersey said its shared accountability program with Atlantic Health System reduced costs by 5% and unnecessary hospitalizations by 9% in the program's first year, partly due to improved data sharing and patient support. Under the program, Horizon BCBS links reimbursement to clinical outcome and cost targets instead of patient volumes.
Twenty-two of 27 studies reviewed showed that health care spending declined after deployment of EHR-based clinical decision support tools, researchers reported in BMC Health Services Research. Unnecessary laboratory testing and duplicate order entry rates declined, but maintenance costs and malfunctions could negate the savings, and order entry systems with default lists and orders could increase spending, researchers noted.
A pilot study published in the New England Journal of Medicine found drone delivery of an automated external defibrillator to a person with an out-of-hospital cardiac arrest was feasible and often faster than having a bystander go searching for an AED. "The drone landed safely, every time, within 10 feet of the person, and it usually beat a person trying to find an AED," said researcher Wayne Rosamond of the University of North Carolina at Chapel Hill.
Researchers found that providing free CT coronary artery calcium screening for cardiovascular risk assessment prompted a 546% average monthly gain in test utilization, with increases found in the age of patients receiving the test, as well as test use among Black patients and women. The findings, published in the Journal of the American College of Cardiology, also correlated the intervention with statin eligibility reclassification, preventive treatment changes and risk factor improvements.
The cumulative effect of low-density lipoprotein exposures over time may increase the risk of cardiovascular events, researchers reported in the Journal of the American College of Cardiology. "Importantly, this risk is modulated by the time course of area accumulation," researchers wrote.
Register now for ACC Quality Summit Virtual, scheduled for Oct. 8 - 9, to experience phenomenal speakers, including Quinn Capers, IV, MD, FACC, who will deliver the Ralph G. Brindis Keynote Lecture. Capers, an interventional cardiologist and professor of internal medicine and vice dean for faculty affairs at the Ohio State University College of Medicine, will discuss ACC's commitment to improving diversity and inclusion in the cardiovascular workforce and in ACC's leadership and membership. Attendees will learn best practices and discover tools and techniques to improve quality through engaging educational sessions, networking and posters. Registration is free and open to all. Register now.
A new article in Cardiology magazine explores how ACC members around the world are addressing some of the most pressing issues confronting cardiology, from matters of work-life balance and diversity and inclusion to advocacy and innovation. While there may not be quick and easy solutions, the ACC firmly believes there is a path forward - and it starts with all cardiovascular professionals bringing their experiences, perspectives and skills to the table and forging a global community founded on collaboration, diversity, innovation and mutual support. Read more.
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