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Category Archives: Payment Reform

Health Care Cost Institute Adds Price and Utilization Research to Healthy Marketplace Index

Posted on by CATALYSIS

New HCCI research examines health care spending and its components—prices and utilization—in 61 metro areas for three common medical services: knee injections, ACL repair, and full knee replacement surgery. The Healthy Marketplace Index measures the economic performance of health care markets across the country. Read here: http://www.healthcostinstitute.org/healthy-marketplace-index/

The Affordable Care Act Has Saved Hospitals More Than $12 Billion in Healthcare Spend – Don’t Repeal It

John Toussaint, MD, Contributor at The Huffington Post CEO of Catalysis, CEO emeritus of ThedaCare President Donald Trump addressed a joint session of the United States Congress on February 28. There, among many other campaign topics, he spoke of the need to repeal and replace the Affordable Care Act also known as Obamacare. On March 6, […]

How Atrius Health Is Making the Shift from Volume to Value

From Harvard Business Review by Ted Toussaint, Karen DaSilva, John S. Toussaint December 13, 2016 Republican control of the White House and Congress won’t change the U.S. health care’s movement away from the traditional fee-for-service system to one that is based on value, paying providers on the basis of the quality of outcomes achieved for the money […]

Improve the Affordable Care Act, Don’t Repeal It

Dr. Toussaint, in this Harvard Business Review article, outlines the important features of the Affordable Care Act and what should be kept. He discusses the root cause of the cost problem in American healthcare and options to deal with it. Finally, there is a call to action to redesign care around the patient, change the […]

ThedaCare Center for Healthcare Value Supports Value‐Based Payment Initiatives

The move from fee-for-service reimbursement in healthcare to value-based reimbursement is no longer “if” – it’s “when” and “how.” The Centers for Medicare and Medicaid Services is leading the way with the support of many other organizations, including the Center, through an initiative called the Health Care Payment Learning and Action Network (HCP-LAN). Download article […]

2016 State Price Transparency Report Card is Released

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

Posted on by CATALYSIS

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., […]