Can Accountable Care Organizations Improve the Value of Health Care by Solving the Cost and Quality Quandaries?

Explores proposed models and configurations of accountable care organizations, which combine provider payment and delivery system reforms, and their potential to slow the rise of healthcare costs. Outlines key issues and program features under debate

How Will Comparative Effectiveness Research Affect the Quality of Health Care?

Outlines how the use of comparative effectiveness research on the relative merits of a healthcare intervention compared with others could improve quality of care and outcomes. Presents challenges in enhancing CE research and expanding its adoption

The Center for Medicare and Medicaid Innovation: Activity on Many Fronts

Provides an overview of the Innovation Center's organization, differences from CMS's traditional demonstration authority, payment and delivery reform initiatives, and first-year efforts to solicit and promote new ideas and collaborate with other payers

Doing Better by Doing Less: Approaches to Tackle Overuse of Services

Experts have projected that as much as a third of U.S. health care spending is unnecessary and wasteful. Of the estimated $765 billion of health care dollars wasted in 2009, a quarter --$210 billion -- was spent on the overuse of services, which includes services that are provided more frequently than necessary or services that are higher-cost, but no more beneficial than lower-cost alternatives.This paper provides a summary of the problem of overuse in the U.S. health care system. The analysis gives an overview of the provision of medically inappropriate and unnecessary services that drive up health care spending without making a positive impact on patients' health outcomes. It also describes approaches that have already been used to address overuse of health care services and outlines the broader payment reforms needed to minimize incentives to overdiagnose and overtreat.This overuse of services has implications for both health care costs and outcomes. There is substantial variation in the level of inappropriate use across different health care services. Research shows that the rates at which particular procedures, tests, and medications were performed or prescribed when clinically inappropriate ranged from a low of 1 percent to a high of 89 percent

How Will the Patient Protection and Affordable Care Act Affect Seniors?

Summarizes how healthcare reform provisions including changes to Medicare premiums and drug benefits, preventive services, Medicare Advantage plans; reduced provider payment rates; and efforts to improve quality and system performance will affect seniors

How Does the Quality of U.S. Health Care Compare Internationally?

Explores definitions of high-quality health care and evidence for comparing U.S. health care with care in other countries. Discusses measures of specific types of care; findings on over-utilization, patient safety, and uninsurance; and implications

Accountable Care Organizations in Medicare and the Private Sector: A Status Update

Provides an overview of accountable care organizations - provider networks with financial incentives to slow spending growth while maintaining or improving quality of care - and their state of adoption, as well as key considerations

The Value of Clinical Practice Guidelines as Malpractice "Safe Harbors"

Examines the extent to which evidence-based recommendations for optimizing patient care could help reduce provider defensiveness and overutilization. Outlines context for and challenges in designing and implementing clinical guidelines as policy reform

Innovative Medicaid Initiatives to Improve Service Delivery and Quality of Care: A Look at Five State Initiatives

Outlines initiatives in Alabama, Oklahoma, Oregon, Pennsylvania, and Washington to implement patient-centered medical home models designed to coordinate and improve quality of care; strategies; key lessons; and new opportunities under healthcare reform

Will the Patient-Centered Medical Home Transform the Delivery of Health Care?

Explores various definitions of the medical home model, its components, rationale, effect on primary care, issues for implementation such as costs and payment methods, evidence of effectiveness, and healthcare reform provisions promoting it