Digital Edition(link is external)
ISSUE March 2018
Harvard Pilgrim’s Patrick Cahill Tries To Make Sense of It All
The 40-year-old has to guide one of the health insurer’s regional markets as the ACA continues to evolve. His course? Keep strengthening ties with providers.
When Value Is in the Eye Of the Patient
Physicians and their charges have different ideas about what makes for good cancer care. Patient surveys help, but they need to be handled right.
Purchasers to Insurers: Standardize Your ACO Measures
Building on a similar effort in California, Catalyst for Payment Reform is proposing a standardized set of 50 ACO measures. Some of the country’s largest purchasers are taking it to their health plans.
A Conversation with Mai Pham, MD: Payment Innovation at Anthem: Downside Risk Will Be Rewarded
Anthem’s vice president of provider alignment solutions wants providers to know that the spigot of upside-only risk arrangements will not stay open forever.
Real-World Evidence Not Quite Believable Enough
In theory, this approach could help untangle some knotty cost and quality concerns about medications as they move from clinical trials and into clinical use. But there’s that credibility issue.
Fall Prevention Hits Stumbling Blocks
Research has pointed to ways that falls can be prevented, but logistical and financial barriers get in the way.
Assessing Provider Partnerships For Accountable Care Organizations
ACOs need to provide comprehensive care management across a spectrum of provider specialties. To do this, they need a framework for evaluating potential partners that will help risk-bearing providers establish the partnerships that will enable them to achieve their goals.
IN THIS ISSUE
Managing Editor’s Memo
Value-Based Health Care Offers Answers and Questions
Value-Based Tools
CMS Opens Window for BPCI Advanced but Target Prices Are Still Behind the Curtains
Medicare’s new bundled payments program is expected to be popular, despite unanswered questions about the target prices for the episodes, risk adjustment, and use of quality data. Here’s what we know—and don’t know.
Book Review
A Tall Order From a Cautionary Tale
Viewpoint
The CVS Effect on American Health Insurance
News & Commentary
CMS Tries 2 Approaches To Hike Primary Care Physician Pay
News & Commentary
Growing Number in High-Deductible Plans
Trending
Paul Lendner ist ein praktizierender Experte im Bereich Gesundheit, Medizin und Fitness. Er schreibt bereits seit über 5 Jahren für das Managed Care Mag. Mit seinen Artikeln, die einen einzigartigen Expertenstatus nachweisen, liefert er unseren Lesern nicht nur Mehrwert, sondern auch Hilfestellung bei ihren Problemen.