Only nine Medicare Advantage plans in the country earned 5 stars overall, and Group Health Cooperative’s plan is one of them.
Numbers are the currency of the land—the best way we have to demonstrate accountability and transparency regarding how we take care of people. But over the years our concept of quality has evolved beyond just scores and numbers. Continue reading ‘Performance Matters’
After much anticipation and an outpouring of feedback on the proposed rule released last March, the Department of Health and Human Services (HHS) released its final rule on the Accountable Care Medicare Shared Savings Program late last week. This program was created by one of a few key delivery system reform provisions in the health care reform law, to better align financial incentives in Fee-For-Service Medicare to strive for cost savings while protecting and improving quality of care. Provider groups had many concerns with the proposed rule, largely stemming from the lack of flexibility in initial funding that is required to develop a new ACO model and keep it running. The general analysis was that the potential upside offered through the program would not be sufficient to support the development of ACOs in the Medicare Fee-For-Service market – and the potential downside risk too great. Continue reading ‘HHS Releases Final ACO Rules’
In a national survey of primary care physicians that the Archives of Internal Medicine published last month, nearly half agreed: Their own patients are getting too much care.
The study drew widespread attention as Americans struggle with health care’s drag on our economy. At Group Health’s Annual Membership Meeting, Commonwealth Fund President Karen Davis, PhD, said the United States is paying twice as much per capita for health care as other industrialized countries. Yet 15 nations outrank us in quality of care. Clearly, we could do better with less. But how do we decide which care to eliminate? Continue reading ‘If less is more, which health care should be cut?’
The Institute of Medicine (IOM) released its recommendations for the essential health benefits (EHB) package this morning. Continue reading ‘IOM releases report on the essential health benefits package’
The Institute of Medicine (IOM) announced that its report on recommended essential health benefits will be released October 7. The Affordable Care Act (ACA) requires the Department of Health and Human Services (HHS) to delineate the essential health benefits that must be offered by all carrier participants in the state health insurance exchanges. All health plans must cover these health benefits to be certified and offered in the proposed state health insurance exchanges. In addition, Medicaid state plans must cover these services by 2014. Continue reading ‘IOM report on essential health benefits expected this week’
King County made the recent stunning announcement that it will save $60 million in health care costs in the next two years over earlier projections. The single biggest reason for the savings? Healthier employees.
With seven years of health care cost data to support the report, King County Executive Dow Constantine delivered a treasure trove of information that provides insight into best practices for managing healthcare costs across an organization. The data shows encouraging trends for King County and points at what may be possible nationally to make health care reform work. Continue reading ‘King County has the data that shows the way’
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