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Category Archives: Payment Reform

2016 State Price Transparency Report Card is Released

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July 25, 2016 Review of Laws Shows Progress with Much Room for Improvement Most states could be doing more to give consumers the price information they need for making educated health care choices, according to an annual report card released by two independent health policy organizations. The report not only identifies the states failing at health […]

Paying For Value: Perspective From The Front Lines

By: Denis Cortese, John Toussaint, David Krueger, and Robert Smoldt as posted at the Health Affairs Blog. May 24, 2016 The concept of value-based health care is rapidly gaining traction in the U.S., yet implementation remains a significant challenge. For example, the current Medicare “shared savings” payment approach penalizes high-value providers, while rewarding historical inefficiency. Read the full article […]

Diagnostic Errors, Measuring Performance Among Top Healthcare Quality Issues for 2016

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by Sabriya Rice, January 1, 2016 in Modern Healthcare A focus on individual physician performance, reducing diagnostic errors, standardizing performance measures and rethinking patient satisfaction will be among the top agenda items for healthcare quality and safety leaders in 2016. Dr. John Toussaint, CEO of the ThedaCare Center for Healthcare Value, said there will be a […]

The Evolution of Accountable Care Organizations and the Role of Pharmacists

By Rachel Regan and John Toussaint, MD, as posted at Pharmacy Times Accountable care organizations (ACOs) are groups of doctors, hospitals, and other health care providers, such as pharmacists, who come together voluntarily to give coordinated high-quality care to their Medicare patients. The goal of coordinated care is to ensure that patients, especially the chronically […]

Creating The Next Generation: The Payment Model We Need From Medicare

Four years of nation-wide testing by The Centers for Medicare and Medicaid Services (CMS) has now proven that the current shared savings payment models do not work effectively for low-cost Accountable Care Organizations (ACOs). High-cost ACOs have more room to improve and therefore more opportunity for savings. In this Health Affairs blog, David Krueger, M.D., […]

ACO Model Should Encourage Efficient Care Delivery

This article by John Toussaint, David Krueger, Stephen M. Shortell, Arnold Milstein, and David M. Cutler, is available at http://authors.elsevier.com/a/1RhPA7tCW1aw~q Abstract The independent Office of the Actuary for CMS certified that the Pioneer ACO model has met the stringent criteria for expansion to a larger population. Significant savings have accrued and quality targets have been met, so the […]

Making a Case for Healthcare Innovation

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A Selected Case Study in Healthcare Innovation and Transformation Looking Beyond Fee for Service by Rachel Regan Program Description: Until now, experiments using alternative payment methods to meet similar objectives have shown mixed results. Wisconsin’s Statewide Value Committee (SVC), a multi-stakeholder group working to accelerate the improvement of the healthcare system, began new discussions to […]

Investigative Report: How Much Hospitals Charge

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GREEN BAY – As a cost-conscious consumer, you wouldn’t pay $3 a gallon for gas if across town you could buy it for $2.50. But whether you realize it or not that’s what you’re doing with health care. FOX11 Investigates found hospitalization cost figures, provided by Green Bay’s four hospitals, show a wide range of […]

Medicare Announces its Intention of Moving the “Over 65” Population Toward a Value Payment Model

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HHS has set a goal of tying 30 percent of traditional, or fee-for-service, Medicare payments to quality or value through alternative payment models, such as Accountable Care Organizations (ACOs) or bundled payment arrangements by the end of 2016, and tying 50 percent of payments to these models by the end of 2018.  HHS also set […]