May 7, 2013 - Under the Affordable Care Act, overpayments to Medicare Advantage plans are gradually being pared back. But will private plans be able to cope with the reduced payments? Using newly available government data, this brief examines average costs among Medicare Advantage plans and variation in costs among plan types.
May 6, 2013 - Combining Medicare's hospital, physician, and prescription drug coverage with commonly purchased private supplemental coverage into one health plan could produce national savings of $180 billion over a decade while improving care for beneficiaries, a new Health Affairs study finds.
In the Literature
March 18, 2013 - In this Commonwealth Fund–supported article, the authors suggest that "bundled payment" covering all services provided to a patient for treatment of a specific illness or injury would need to be risk-adjusted, so that providers do not have incentives to avoid patients, like those with chronic illness, who can be expected to have higher costs.
March 18, 2013 - The Commonwealth Fund-supported authors of this study recommend using an array of financial and nonfinancial incentives—including performance rankings—to help facilitate a broad "shared-purpose orientation" embraced by all participating clinicians.
March 13, 2013 - Based on interviews with clinical and administrative leaders, this report describes the experiences of seven accountable care organizations (ACOs).
March 1, 2013 - Colorado, Minnesota, and Vermont are working to align incentives between health care payers and providers to improve care delivery and outcomes while controlling costs. This synthesis describes the common drivers of reform across the states and lessons learned.
March 1, 2013 - Colorado is one of a handful of states piloting innovative health care payment and delivery reforms through Medicaid. Under the Accountable Care Collaborative Program, which began enrollment in May 2011, the state Medicaid agency contracts with seven regional organizations to create networks of primary care providers and ensure care coordination for Medicaid enrollees.
March 1, 2013 - Vermont Medicaid is a key player as the state pioneers multipayer health care delivery and payment reforms. Under Vermont Blueprint for Health, most Medicaid beneficiaries and state residents will be served in 2013 by medical homes with community health teams, with additional support services for Medicaid enrollees with complex conditions.
March 1, 2013 - Minnesota's Medicaid program is a leader in piloting innovative health care payment and delivery reforms. This case study is one of three in a series on innovations being undertaken by states to improve quality and efficiency in their Medicaid programs.
February 27, 2013 - In invited testimony before the United States Senate Special Committee on Aging, Commonwealth Fund president David Blumenthal made the case for comprehensive payment and delivery system changes that produce lower costs and better value not just in Medicare, but across the entire U.S. health system.
February 27, 2013 - In this Commonwealth Fund–supported article, researchers examine the challenges to developing lists of “low-value” services and ensuring that insurers and provider organizations put them to optimal use.
February 8, 2013 - In this Commonwealth Fund–supported study, researchers evaluated the effects of a Florida incentive program intended to improve care at nursing homes most at risk for providing poor-quality care.
January 23, 2013 - This case study describes how a large nonprofit home health care provider created health plans to serve this population and, in particular, how its customized care management approach has led to reductions in hospitalizations and readmissions.
January 8, 2013 - In this Commonwealth Fund–supported study, researchers set out to determine whether there was any relationship between geographic variation in Medicare Part D spending and medication-taking behavior among beneficiaries with diabetes or heart failure.
December 14, 2012 - This report on 59 hospital-based organizations that were members of a collaborative created to support the transition to accountable care finds that that organizations are pursuing different paths toward accountable care.