Snapshot of ACO participation suggests way forward from Pathways rule | Md.'s request to amend Medicaid program gets CMS approval | Regence strikes agreement for value-based cancer care
March 20, 2019
Accountable Care SmartBrief
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Accountable Care Spotlight
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 encourage their participation.
Health Affairs Blog (3/15) 
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Md.'s request to amend Medicaid program gets CMS approval
The CMS has approved Maryland's request to amend its Medicaid program through 2021. The waiver will allow greater funding for certain family planning services and allow the state to test a substance misuse treatment program, an adult dental pilot program and a diabetes prevention program for adults who have prediabetes or are at risk of type 2 diabetes.
Becker's Hospital Review (3/19) 
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Regence strikes agreement for value-based cancer care
Regence and Northwest Medical Specialties have struck an agreement meant to promote value-based care in oncology. Metrics will be tied to patient satisfaction, experience and outcomes for members treated by NWMS for brain, leukemia, lung, breast, colon and other cancers.
State of Reform (3/12) 
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Insight into Health Care Quality
Study: HF readmission penalties hit safety-net hospitals harder
A study presented at the American College of Cardiology Scientific Session showed safety-net hospitals were more likely to be penalized for 30-day heart failure readmissions and had average penalties of 0.7% compared with 0.51% for hospitals in high-income areas. Researcher Sameed Ahmed Khatana said under the 21st Century Cures Act, CMS in fiscal 2019 starts to account for socioeconomic factors in its Hospital Readmissions Reduction Program, which will lead to fewer penalties for safety-net hospitals but more penalties for other hospitals.
Healio (free registration)/Cardiology Today (3/17) 
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Behavioral therapies better than meds for bladder issues in women
A review of clinical data from 84 studies showed that behavioral therapies, such as "bladder training" and avoiding bladder irritants, are more effective than medications for treating urinary incontinence in women. However, the study in Annals of Internal Medicine found that medications for overactive bladder were more helpful than no treatment at all.
HealthDay News (3/19) 
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The Technology Component
Investigation: 10 years in, EHRs fail to live up to their promise
The digitization of health records in the US was supposed to improve the quality and value of health care by providing real-time access to the information needed to optimize decisions and improve outcomes, but 10 years after legislation fast-tracked the move to EHRs, even the architects of the effort agree the US' $36 billion investment has not delivered as expected. Although nearly all hospitals have EHRs, the systems are difficult to use, interoperability is poor, and an investigation by Kaiser Health News and Fortune has uncovered reports of patient deaths, injuries and close calls tied to software glitches, user error and other problems.
Fortune/Kaiser Health News (3/18) 
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Experts offer best practices for using data analytics
Bradley Hunter at KLAS Research said one best practice for implementing data analytics into provider organizations is collaboration among stakeholders on which outcomes are important to the organization's success. Mark Morsch of Optum said advanced analytics investments should have a defined objective and be aligned with an organization's overall technology strategy.
Healthcare IT News (3/14) 
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Population Health and Patients
Cardiology groups issue new guidance on aspirin use for heart disease
The American Heart Association and the American College of Cardiology have released a revised recommendation that says most people never previously diagnosed with heart disease should not take aspirin to prevent heart attacks and other heart disease, releasing a set of "primary prevention" guidelines during a recent ACC conference. The recommendation was based on findings from studies that showed an increased risk of bleeding in aspirin users, particularly gastrointestinal bleeding, although the drug is still recommended for prevention of heart attacks in those previously diagnosed with cardiovascular illnesses.
The Wall Street Journal (tiered subscription model) (3/17) 
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Research shows drop in heart attack mortality in older US adults
Mortality within 30 days of a heart attack among older US adults dropped to 12% between 1995 and 2014, down by more than one-third since 1995, while hospitalizations for heart attacks also declined 38%, according to findings published in JAMA Network Open. Researchers analyzed more than 4 million Medicare patients, and lead researcher Dr. Harlan Krumholz cautioned that the increasing prevalence of obesity and diabetes could undermine these improvements.
HealthDay News (3/15) 
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Health Insurance and Accountable Care Provider Company News
Solutions Provider News
AHIP News
Billie Jean King to keynote at Institute & Expo
It's hard to think of a more inspiring and powerful close to this year's Institute & Expo than Billie Jean King. She's broken barriers for years, focusing on innovative solutions to tough challenges. In her presentation "Breaking Barriers and Opening Doors: A Conversation with Billie Jean King," she'll draw on her life's work and focus on equality, access, and empowering future generations.
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Sponsorships that make a lasting impact
AHIP's sponsorship solutions create a powerful marketing environment for your brand. With event sponsorships, branded webinars, targeted media placements, and access to C-level decision-makers, AHIP's Business Affairs Team can create a sponsorship package that fits your calendar, your budget, and your marketing goals. Contact BusinessDevelopment@ahip.org.
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There are some cases in which one pill can kill a child. Literally one pill can kill a child.
Sadiqa Kendi,
medical director for Safe Kids District of Columbia, urging parents to be vigilant in protecting against accidental ingestion of any medications or supplements

March 17 to 23 is National Poison Prevention Week

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