Physician distrust of payers presents a significant impediment to creating value-based reimbursement programs, according to a new survey from global business advisory firm FTI Consulting. In fact, 41 percent of physicians who do not participate in a value-based relationship point to distrust of payers as the major reason, according to a new survey.
Both payers and providers can reap financial returns from ACO efforts, former Centers for Medicare & Medicaid Services Administrator and current Director of the Health Care Innovation and Value Initiative at the Brookings Institution Mark McClellan, M.D., Ph.D., told AAFP News.
Data analytics are a necessary ingredient for insurers creating accountable care organizations because they're key to helping providers improve the quality of care they deliver to ACO participants.
Developing an accountable care organization that motivates doctors to participate and deliver high-quality, low-cost care can be a lot like building a baseball diamond in a corn field. If you build it, will they really come to visit?
The Blue Cross Blue Shield Association's plans are spending more than $65 million a year in value-based payment programs that have a high return on investment. In 2012 alone, the plans saved $500 million.
While most value-based contracts include shared savings, payers are ready to transform these methods to include more risk for primary care providers, according to AIS Health.
Having already launched 40 accountable care organizations, Aetna views a trusting relationship between the participating payer and provider as a key component to these arrangements.
While many doctors still operate on a fee-for-service basis, insurers are moving toward value-based reimbursement that focuses more on quality, transparency and accountability, reports Forbes.
Pharmaceuticals, the prime treatment for many common conditions that lead to poor outcomes later on, play an important role in comprehensive approaches to providing quality healthcare. Their proper prescribing and use keep patients from needing unnecessary hospital admissions or emergency room visits, so they must be a consideration for accountable care organizations, Aetna's National Medical Director for Pharmacy Policy and Strategy Edmund Pezalla, M.D., told FierceHealthPayer.
Insurers' initiatives, including increasing the use of consumer-directed health plans, better educating consumers and shifting away from fee-for-service payments, will help prevent healthcare costs from jumping by double-digit percentages, according to a new study from the PwC Health Research Institute.