Thursday, August 16, 2018
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Advanced primary care boosts the savings rate and quality performance of accountable care organizations, according to research
released last week by the Patient-Centered Primary Care Collaborative and the Robert Graham Center. Researchers found a symbiotic relationship between ACOs and advanced primary care models: “Systems that already provided advanced primary care had a strong foundation on which to build an ACO, while becoming an ACO helped advanced primary care systems succeed by encouraging structural changes that align well with the PCMH model.”
(
HealthLeaders Media
;
PCPCC
)
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CMS wants ACOs to take on more risk, so it’s planning to overhaul the Medicare Shared Savings Program. It will replace Tracks 1 and 2 with a Basic track that provides a smaller window for avoiding downside financial risk,
Modern Healthcare
reports. Currently, 82 percent of the Shared Savings Program ACOs are in the upside-only track; they share in savings but not in losses. The move will be controversial: The National Association of ACOs calls the move “misguided." (
Modern Healthcare
; CMS Administrator Seema Verma outlines the proposal in a
Health Affairs Blog
post
)
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Innovation & Transformation
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General Motors and Henry Ford Health System have announced a direct-to-employer health care agreement. GM’s “ConnectedCare” plan option will be offered during open enrollment this fall. It covers everything from doctor visits to surgical procedures. Blue Cross Blue Shield of Michigan will manage claims-processing and other functions. Only 3 percent of self-insured companies nationally have some form of direct contracts with providers, according to the National Business Group on Health. It’s nevertheless gaining momentum as companies including Walmart, Intel and Boeing partner directly with providers,
Employee Benefit News
reports.
(
Employee Benefit News
;
Wall Street Journal
)
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Former HHS secretaries Kathleen Sebelius and Tommy G. Thompson penned a commentary for
The Hill
calling for regulatory reforms to support the move from volume to value.
“Over time, many regulations were adopted and designed to prevent fraud and abuse—a worthy goal. But many regulations, designed for a fee-for-service model, now create roadblocks in the move toward a value-based system and need to be modernized.” Among them: Stark and the Anti-Kickback Statute.
(
The Hill
)
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Amazon is in internal discussions to open primary care clinics in its Seattle headquarters, CNBC reports. Although the company is starting with a small pilot, it has plans to expand—perhaps even outside its employee base, according to Michael Yang, a health investor at Comcast Ventures. But he tells CNBC that questions remain about how it will be rolled out for all employees, including warehouse workers. “Dropping a package on your foot or throwing out your back after manual labor is a very different set of issues from the employee working at headquarters.”
(
CNBC
)
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The FCC is seeking input on a $100 million telehealth pilot to improve access for low-income patients. The Connected Care Pilot Program “is about identifying patient groups that are predominantly low-income patients, and how we support the deployment of telehealth directly to them where they are,” FCC Commissioner Brendan Carr told
FierceHealthcare
. “There’s no shortage of patient populations that could benefit from this; a lot of times they just need additional funding…to get it across the finish line.”
(
FierceHealthcare
;
notice
)
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Learn from employer success
:
As Atul Gawande, MD, CEO for the BHA health care consortium, begins his listening tour, he can learn a lot from employers about how to lower costs by reducing waste, especially on the demand side, Sue Lewis of ConsumerMedical writes in a commentary for
Employee Benefit Advisor.
(
Employee Benefit Advisor
)
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Some physicians were overprescribing Seroquel, an antipsychotic. They were even prescribing it for patients with dementia, for whom it can be deadly. Changing that behavior was surprisingly easy: The researchers sent each doctor a letter.
(
NPR
)
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MarketVoices...quotes worth reading
“Stark and anti-kickback laws are a remnant of the fee-for-service world and harm the very patients they are supposed to protect by deterring more comprehensive patient-centered, coordinated care.”—Former HHS secretaries Kathleen Sebelius and Tommy G. Thompson, in a joint commentary in
The Hill
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Editor
Sandy Mau
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H2R Minutes
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