Patrick H. Conway

The “3T’s” Road Map to Transform US Health Care: The “How” of High-Quality Care

THE ONGOING SIGNIFICANT INVESTMENT IN BASIC SCIence and clinical discovery in the United States continues to produce impressive results. However, the United States struggles to deliver high-quality care and improved health outcomes due to the systematic failure of discoveries to reach patients in a timely fashion. Despite expenditures that reached

Value-Based Purchasing — National Programs to Move from Volume to Value

2 trillion or more than

Association of Pioneer Accountable Care Organizations vs Traditional Medicare Fee for Service With Spending, Utilization, and Patient Experience

6000 per capita in 2005, the United States will continue to fail to fully leverage new clinical discoveries into improved health outcomes unless there is an accelerated transformation of the health care system. The research enterprise cannot achieve this alone. We propose a model to transform the US health care system (FIGURE), intended to accelerate the pace at which innovations are implemented in clinical settings by addressing the “how” of health care delivery.

A New Taxonomy for Stakeholder Engagement in Patient-Centered Outcomes Research

A potentially transformational tool that the Centers for Medicare and Medicaid Services is deploying to achieve better health, better care, and lower costs is value-based purchasing (VBP). Two VBP programs are under way, and a third will begin next year.

Accountable Health Communities — Addressing Social Needs through Medicare and Medicaid

IMPORTANCE The Pioneer Accountable Care Organization (ACO) Model aims to drive health care organizations to reduce expenditures while improving quality for fee-for-service (FFS) Medicare beneficiaries. OBJECTIVE To determine whether FFS beneficiaries aligned with Pioneer ACOs had smaller increases in spending and utilization than other FFS beneficiaries while retaining similar levels of care satisfaction in the first 2 years of the Pioneer ACO Model. DESIGN, SETTING, AND PARTICIPANTS Participants were FFS Medicare beneficiaries aligned with 32 ACOs (n = 675,712 in 2012; n = 806,258 in 2013) and a comparison group of alignment-eligible beneficiaries in the same markets (n = 13,203,694 in 2012; n = 12,134,154 in 2013). Analyses comprised difference-in-differences multivariable regression with Oaxaca-Blinder reweighting to model expenditure and utilization outcomes over a 2-year performance period (2012-2013) and 2-year baseline period (2010-2011) as well as adjusted analyses of Consumer Assessment of Healthcare Providers & Systems (CAHPS) survey responses among random samples of beneficiaries in Pioneer ACOs (n = 13,097), FFS (n = 116,255), or Medicare Advantage (n = 203,736) for 2012 care. EXPOSURES Beneficiary alignment with a Pioneer ACO in 2012 or 2013. MAIN OUTCOMES AND MEASURES Medicare spending, utilization, and CAHPS domain scores. RESULTS Total spending for beneficiaries aligned with Pioneer ACOs in 2012 or 2013 increased from baseline to a lesser degree relative to comparison populations. Differential changes in spending were approximately -

Pediatric Hospitalists: A Systematic Review of the Literature

35.62 (95% CI, -

Five Next Steps for a New National Program for Comparative-Effectiveness Research

40.12 to -

Improving Situation Awareness to Reduce Unrecognized Clinical Deterioration and Serious Safety Events

31.12) per-beneficiary-per-month (PBPM) in 2012 and -

Medicare's New Bundled Payments: Design, Strategy, and Evolution.

11.18 (95% CI, -

CMS—Engaging Multiple Payers in Payment Reform

15.84 to -