Value-based contracts come with many quality measures | Mass. Medicaid ACO improves maternal health care quality | Molina, Magnolia Health awarded Miss. Medicaid contracts
September 4, 2024
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Physicians were required to track an average of 57 quality measures, for multiple insurers, that tied outcomes to payments under value-based contracts from 2020 to 2022, according to an analysis of 890 primary care doctors' VBCs that was published in JAMA Health Forum. Medicare contracts, especially, loaded quality measures on physicians at an average of 13.42, compared with 10.07 for commercial insurers and 5.37 for Medicaid contracts.
Full Story: Medscape (8/29) 
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A study published in the journal Health Affairs showed implementation of the Medicaid ACO in Massachusetts was associated with a significant increase in postpartum depression screening, postpartum visits and all-cause office visits during prenatal and postpartum periods during the first three years of the program. The findings suggest that implementation of the ACO program in 38 states without them could enhance maternal health care quality and engagement.
Full Story: Health Affairs (9/3) 
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Mississippi Medicaid awarded Centene's Magnolia Health, Molina Healthcare and nonprofit TrueCare four-year, $3.8 billion contracts to manage the state's managed care program, MississippiCAN. Beneficiaries can start enrolling in new plans in May 2025.
Full Story: Mississippi Today (8/28) 
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CVS Health's Aetna has signed a new multiyear contract agreement with Washington-based health system Providence. The agreement will allow Aetna's 35,000 commercial members in Washington to receive care from providers at Kadlec, Swedish Health Services and Pacific Medical Centers.
Full Story: Becker's Payer Issues (9/3),  The Seattle Times (tiered subscription model) (9/3) 
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Insight into Health Care Quality
A study published in the journal Obstetrics & Gynecology found that postpartum remote monitoring of hypertension was linked with fewer hospital readmissions, increased adherence to national guidelines and greater use of antihypertensive medications, with 97.6% of participants recording blood pressure within 10 days of delivery. Attendance at postpartum visits also improved.
Full Story: Medscape (8/29) 
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The Technology Component
Long-term continuous heart monitors in wearable form helped to identify 52% more instances of atrial fibrillation than usual procedures did, but no related drop in stroke-associated hospitalizations was noted, researchers reported in the Journal of the American College of Cardiology and at the European Society of Cardiology conference. Investigators said the findings do not conclusively demonstrate whether screening for AFib can lower stroke rates.
Full Story: Medical Dialogues (9/2) 
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There are no standards for clinical validation of AI devices for health care, and 43% of 521 AI-powered devices authorized by the FDA between 2016 and 2022 lack publicly available data showing they were tested using real patient information, according to a study published in the journal Nature Medicine. The study leaders developed standard terminology for prospective, retrospective and clinical validation to guide testing, and they suggested that clinicians could clinically validate AI devices, perhaps as part of a fellowship.
Full Story: Medscape (8/30) 
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Research by informaticians, primary care providers, neurologists and other stakeholders led to the development of an EHR tool for the diagnosis and management of headaches in primary care. Use of the tool led to cost savings, fewer neurology referrals, and reduced MRI orders, according to a study published in the journal Neurology Clinical Practice.
Full Story: Neurology Live (9/2) 
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Advancing consumer-focused care
How can we do an even better job putting consumers first? At AHIP's Consumer Experience & Digital Health Forum, we'll dig into the tech advances and CX strategies transforming health care. Don't miss this keynote. Register now for Sept. 24 through 26 in Nashville.
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Population Health and Patients
Women who receive recommendations for additional imaging, biopsy or short-interval follow-up after a mammogram that turns out to be a false-positive are less likely to return for subsequent screening within nine to 30 months than those who receive a true-negative result, according to a study published in the journal Annals of Internal Medicine. "Offering same-day interpretation and diagnostic work-up of screening mammography may decrease the anxiety and inconvenience associated with having to return for a second visit," the study authors suggested.
Full Story: MedPage Today (free registration) (9/2) 
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Individuals ages 40 and older who undergo annual mammograms are less likely to be diagnosed with late-stage breast cancer compared to those who screen every two years or less, researchers reported in the Journal of Clinical Oncology. Lead researcher Margarita Zuley emphasized that the benefits of early detection outweigh the potential harms of false positives.
Full Story: HealthDay News (8/28) 
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Researchers studied more than 7,100 patients with sepsis and found that nearly 24% were readmitted to the hospital within 30 days of discharge, often due to recurrent infections. The findings published in the American Journal of Critical Care underscore the need for better discharge planning and follow-up to reduce the risk of readmission.
Full Story: HealthDay News (9/2) 
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Health Insurance and Accountable Care Provider Company News
Solutions Provider News
AHIP News
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Unlike mass market sites, the AHIP Career Center was created for health care professionals. With data tools that get you from post to placement faster, it's the better way to target health care's best and brightest. Discover all the ways it can work hard for you. Post a job today.
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