October 27, 2021
Accountable Care SmartBrief
Accountable Care Spotlight
The National Association of Accountable Care Organizations (NAACOS) released a white paper offering recommendations to the CMS on how to use accountable care organizations (ACOs) to close equity gaps. Specifically, NAACOS recommends the CMS develop new quality measures that address health equity at population level and create new incentives for ACOs to boost quality scores for certain populations if the government wants to use ACOs to close health equity gaps, according to an advocacy group. The CMS should collaborate with ACOs on creating best quality measures for equity assessment, and developing a standardized screening tool that can be used by health care organizations, the group noted.
Full Story: FierceHealthcare (10/25) 
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An Avalere Health analysis found more Medicare Advantage (MA) plans will offer supplemental benefits that address social determinants of health (SDOH) such as meals, transportation and in-home support in the 2022 plan year. A review of benefits packages found that meal service is the most popular benefit, offered by 68% of MA plans; followed by transportation, offered by 39% of plans; and nutrition support, offered by 30% of plans.
Full Story: FierceHealthcare (10/20) 
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Socioeconomic factors are increasingly recognized as determinants of health, but health care professionals say siloed data, a lack of standard terminology and EHR workflow shortcomings make SDOH difficult to track and address. Efforts are underway to standardize SDOH data, screen for and track SDOH, expand patient access to social workers and community resources, and update payment models to reimburse health care professionals for SDOH initiatives.
Full Story: FierceHealthcare (10/25) 
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CVS Health and Aetna are launching a new connected health plan for midsize employers with 101 to 300 workers in North Carolina that will give members access to more than 350 CVS Pharmacy sites and CVS MinuteClinics for acute care and chronic conditions, personalized counseling and a care concierge. The Aetna Connected Plan with CVS Health "delivers a new health care model that is more connected, convenient and affordable for employers and members ... allowing members to get the care they need, where and when they need it," said Jim Bostian, Aetna's president of the Midsouth market.
Full Story: Becker's Payer Issues (10/22) 
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Insight into Health Care Quality
Health care organizations can implement three kinds of interventions to reduce administrative spending, according to a McKinsey & Co. report. Measures include internal "within" interventions such as automation of back-office work; external "between" interventions, such as development of insurer-clinician communication tools that offer consistent messaging to patients; and "seismic" interventions involving broad and structural changes across the health care system such as new technology systems and payment models.
Full Story: HealthLeaders Media (10/21) 
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The Technology Component
Cigna Health Plan's Evernorth unit will expand virtual care access to all enrollees in the company's employer-sponsored plans starting next year. The company will leverage its MDLive telehealth platform to offer digital-first primary care, urgent care and clinical services for behavioral, dermatology and other needs, and some people will have access to virtual-first health plans with $0 copays for primary care, care navigation and chronic disease management support.
Full Story: HealthLeaders Media (10/26) 
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A study published in the American Journal of Roentgenology found that a deep learning algorithm yielded an 98.5% accuracy, 99% specificity and 98% sensitivity in detecting reticular opacity on chest X-rays of patients with interstitial lung disease (ILD). "Given the sensitivity of [the deep learning algorithm] for reticular opacity in mild to moderate disease, the technique could be applied for screening patients with suspected ILD, an area for which chest radiography has historically not performed well," researchers wrote.
Full Story: AuntMinnie (free registration) (10/25) 
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HHS Chief Artificial Intelligence Officer Oki Mek wants to make sure HHS staff understand what artificial intellligence (AI) and machine learning are and how they work before moving ahead with a strategy to promote AI adoption and ensure that algorithms are fair, legal and ethical. The HHS is running use cases, working with other federal agencies to the extent possible under HIPAA and identifying where data resides, Mek says.
Full Story: Federal News Network/WFED-AM (Washington, D.C.) (10/21) 
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Population Health and Patients
Researchers analyzed more than 5 million members of the US Veterans Health Administration and found that 2.9% of 21,930 women who underwent breast cancer screening received low-value testing, while 7.5% of over 4.6 million men, or 350,705, who underwent prostate cancer screening received a low-value test. The findings, published in JAMA Network Open, showed that patients with greater comorbidity or frailty and those who went to leading clinics for continuity of care were unlikely to receive low-value testing, while patient ethnicity and race, illness burden and sociodemographic factors contribute to increased odds of having low-value tests.
Full Story: AuntMinnie (free registration) (10/22) 
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Researchers estimate that 14,024 infants were treated in the emergency room for injuries associated with baby-wearing products between 2011 and 2020, with traumatic brain injuries as the most common. The preliminary findings presented at the annual meeting of the American Academy of Pediatrics also showed that over 60% of the injuries occurred in babies ages 5 months or younger, and nearly 84% of those injured in that age group sustained a head injury.
Full Story: HealthDay News (10/21) 
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Health Insurance and Accountable Care Provider Company News
Solutions Provider News
What are you waiting for? Right now, AHIP's Consumer Experience & Digital Health Forum Online (Dec. 7 through 9) is FREE for AHIP member health insurance providers. $0 registration ends 10.29. This great deal means more of your colleagues can participate. Not a member? Get the early registration rate. See all the reasons to lock in your plans today.
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Reach health insurance provider decision makers at AHIP's National Conference on Health Policy and Government Health Programs in March, and AHIP 2022 in June. With sponsorships available for budgets of all sizes, let's talk today. Contact BusinessDevelopment@ahip.org.
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