Health insurers often pay health plans to manage the care of their members. Good care can help prevent emergencies, such as avoidable trips to a hospital emergency department (ED). Medically complex patients, such as those with behavioral health problems or substance use disorders, tend to have a lot of ED visits. Social determinants of health… Read More »
Over the past eight years, the US health care system has seen the widespread implementation of Accountable Care Organizations (ACOs) as a way to move from volume to value. What are ACOs? ACOs are groups of providers that are collectively accountable for the cost and quality of care for a defined patient population. Examples include… Read More »
Value-based care is all the rage in health care system transformation. Promising in concept, value-based care initiatives aim to reward value over volume, shifting our understanding and practice of delivery and payment reform. These efforts received governmental support in 2015 via the Medicare Access and CHIP Reauthorization Act (MACRA), which launched a myriad of quality… Read More »
Accountable Care Organizations (ACOs) are groups of health care providers, including doctors, hospitals, and other service providers, who provide coordinated care, reducing the need for patients to manage coordination of their own care. These organizations receive incentives from Medicare when they deliver care to patients efficiently. Providers make more money if they keep their patients healthy. Medicare… Read More »