FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2018372671> ?p ?o ?g. }

• W2018372671 abstract "A prescient visitor from Mars might easily conclude that the US health reform debate is actually a diversion. Most of what he hears and reads is about whether the federal government has the authority to require all individuals to obtain health care coverage so that it can reorganize insurance markets to serve all of us and not just some of us. Now, these are indeed important issues, although they are primarily philosophical and moral, respectively, but readers of Mayo Clinic Proceedings know that the most important part of our health reform debate is over delivery system reform. Simply put, effective access for tens of millions of Americans is at risk—not to mention most other public priorities and middle-class jobs in a global economy—if we fail to improve the efficiency with which high-quality care is delivered. Excessive growth of health care costs is by far the largest contributor to our fiscal stress and stagnant middle-class standard of living. After all the Sturm und Drang, this is why the Patient Protection and Affordable Care Act (PPACA) was finally passed, although it is hardly a panacea or guarantor of desirable outcomes. Powerful interests are threatened by an emphasis on efficiency, quality, and evidence-based care, and many are finding the necessary transition—from pay-for-volume fee-for-service to any new payment system that rewards value instead—to be something between a heavy lift and a long hard slog. We are nowhere near the end of the beginning of health care system transformation in our nation.No single idea for transforming health care delivery in the past few years has received half as much attention as accountable care organizations (ACOs). Advocates1 and Administration officials2 alike repeatedly emphasized the centrality of population-based coordinated care and incentive realignment with risk bearing and sharing so that health care institutions' financial interests could be linked to the efficient delivery of high-quality care. The PPACA, reflecting its authors' strong desire to jump-start our move away from volume-based payment methods, included an unprecedented new nationwide program, as opposed to a more typical narrowly focused demonstration or pilot project, that offered new payment and quality reporting rules to any set of Medicare-participating physicians and hospitals willing to accept the brave new challenges of accountable care. Participation in how-to conferences and collaboratives spread like wildfire, for it seemed like the movement to full financial and performance risk for a defined patient population was the clear direction American health care policy was moving. But then the initial Medicare Shared Savings Program ACO proposed rule (set of regulations) was released, and enthusiasm turned to disappointment, anger, and a search for viable alternatives.The Center for Medicare and Medicaid Innovation (CMMI), created by the PPACA to be the catalyst for delivery system reform, as quickly as possible developed an alternative model pilot ACO project, aptly named Pioneer ACO, even as it digested the tsunami of formal comments about how to improve the Shared Savings ACO model proposed rule. The final shared savings rule was far more palatable to most observers, although only 32 and 116 organizations have signed on to become Pioneer and Medicare Shared Savings Program ACOs, respectively, at this point. While they have important differences, both ACO concepts share 3 key features for health care organizations: (1) accept clinical and financial responsibility for a defined group of Medicare beneficiaries, essentially practice population health management, (2) measure and report a wide array of quality metrics, and (3) benefit financially vs baseline if, and only if, quality and cost saving targets are met.The major difference in the models is the much greater degree of financial risk and reward allowed to and expected of Pioneer ACOs, for they are required to accept population-based payment risk by year 3 for certain Medicare beneficiaries and to have at least 50% of their private payer contracts also be risk based by then, in the hope of spreading the payment innovation to the health care system more generally. It is also worthy of note that the Pioneer pilot is larger than the Medicare Shared Savings Program. However, the small number of ACOs in total, after all the discussion during the legislative debate and in the year before the first proposed rule came out, is a disappointing indicator of the reality that most health care organizations are still reluctant to move from fee-for-service to outcomes-based payment without more protection and support.In the commentaries published in this issue of Mayo Clinic Proceedings, 6 leading health care institutions explain why they did or did not decide to participate in 1 of the 2 ACO models now operational at the Centers for Medicare and Medicaid Services (CMS). I will certainly let the authors speak for themselves, but as an economist, I should highlight some fascinating common themes." @default.
• W2018372671 created "2016-06-24" @default.
• W2018372671 creator A5079007144 @default.
• W2018372671 date "2012-08-01" @default.
• W2018372671 modified "2023-09-24" @default.
• W2018372671 title "Accountable Care Organization Pathways: Diverse but Ultimately Parallel" @default.
• W2018372671 cites W1990084629 @default.
• W2018372671 cites W1990385374 @default.
• W2018372671 cites W2030650883 @default.
• W2018372671 cites W2040490905 @default.
• W2018372671 cites W2072647110 @default.
• W2018372671 cites W2094798760 @default.
• W2018372671 cites W2122088610 @default.
• W2018372671 cites W2167972867 @default.
• W2018372671 cites W2172275997 @default.
• W2018372671 doi "https://doi.org/10.1016/j.mayocp.2012.05.010" @default.
• W2018372671 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/3498217" @default.
• W2018372671 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/22862858" @default.
• W2018372671 hasPublicationYear "2012" @default.
• W2018372671 type Work @default.
• W2018372671 sameAs 2018372671 @default.
• W2018372671 citedByCount "7" @default.
• W2018372671 countsByYear W20183726712012 @default.
• W2018372671 countsByYear W20183726712014 @default.
• W2018372671 countsByYear W20183726712015 @default.
• W2018372671 crossrefType "journal-article" @default.
• W2018372671 hasAuthorship W2018372671A5079007144 @default.
• W2018372671 hasBestOaLocation W20183726711 @default.
• W2018372671 hasConcept C138885662 @default.
• W2018372671 hasConcept C142724271 @default.
• W2018372671 hasConcept C160735492 @default.
• W2018372671 hasConcept C162324750 @default.
• W2018372671 hasConcept C17744445 @default.
• W2018372671 hasConcept C204787440 @default.
• W2018372671 hasConcept C26993612 @default.
• W2018372671 hasConcept C2776534028 @default.
• W2018372671 hasConcept C2776643233 @default.
• W2018372671 hasConcept C2778137410 @default.
• W2018372671 hasConcept C2778584109 @default.
• W2018372671 hasConcept C39549134 @default.
• W2018372671 hasConcept C41895202 @default.
• W2018372671 hasConcept C47344431 @default.
• W2018372671 hasConcept C50522688 @default.
• W2018372671 hasConcept C71924100 @default.
• W2018372671 hasConceptScore W2018372671C138885662 @default.
• W2018372671 hasConceptScore W2018372671C142724271 @default.
• W2018372671 hasConceptScore W2018372671C160735492 @default.
• W2018372671 hasConceptScore W2018372671C162324750 @default.
• W2018372671 hasConceptScore W2018372671C17744445 @default.
• W2018372671 hasConceptScore W2018372671C204787440 @default.
• W2018372671 hasConceptScore W2018372671C26993612 @default.
• W2018372671 hasConceptScore W2018372671C2776534028 @default.
• W2018372671 hasConceptScore W2018372671C2776643233 @default.
• W2018372671 hasConceptScore W2018372671C2778137410 @default.
• W2018372671 hasConceptScore W2018372671C2778584109 @default.
• W2018372671 hasConceptScore W2018372671C39549134 @default.
• W2018372671 hasConceptScore W2018372671C41895202 @default.
• W2018372671 hasConceptScore W2018372671C47344431 @default.
• W2018372671 hasConceptScore W2018372671C50522688 @default.
• W2018372671 hasConceptScore W2018372671C71924100 @default.
• W2018372671 hasLocation W20183726711 @default.
• W2018372671 hasLocation W20183726712 @default.
• W2018372671 hasLocation W20183726713 @default.
• W2018372671 hasLocation W20183726714 @default.
• W2018372671 hasOpenAccess W2018372671 @default.
• W2018372671 hasPrimaryLocation W20183726711 @default.
• W2018372671 hasRelatedWork W1564276779 @default.
• W2018372671 hasRelatedWork W1607698822 @default.
• W2018372671 hasRelatedWork W1925741719 @default.
• W2018372671 hasRelatedWork W1970727874 @default.
• W2018372671 hasRelatedWork W1978239799 @default.
• W2018372671 hasRelatedWork W2003209702 @default.
• W2018372671 hasRelatedWork W2006927588 @default.
• W2018372671 hasRelatedWork W2016218323 @default.
• W2018372671 hasRelatedWork W2031276929 @default.
• W2018372671 hasRelatedWork W2034689513 @default.
• W2018372671 hasRelatedWork W2037138146 @default.
• W2018372671 hasRelatedWork W2080414554 @default.
• W2018372671 hasRelatedWork W2094798760 @default.
• W2018372671 hasRelatedWork W2110198385 @default.
• W2018372671 hasRelatedWork W2122088610 @default.
• W2018372671 hasRelatedWork W2338766713 @default.
• W2018372671 hasRelatedWork W3122320607 @default.
• W2018372671 hasRelatedWork W3124044200 @default.
• W2018372671 hasRelatedWork W2188530194 @default.
• W2018372671 hasRelatedWork W2277967618 @default.
• W2018372671 isParatext "false" @default.
• W2018372671 isRetracted "false" @default.
• W2018372671 magId "2018372671" @default.
• W2018372671 workType "article" @default.