Publications

Prices for laboratory and other clinical services vary widely. Employers and insurers increasingly are adopting “reference pricing” policies to create incentives for patients to select lower-priced facilities. In this HCFO-funded study, the researchers measured the association between implementation of reference pricing and patient choice of laboratory, test prices, patient out-of-pocket spending, and insurer spending.

Tiered physician networks are a managed care network design used by payers to contain health care costs and improve value in the health care system. Prior studies found that tiered provider networks channel patients to preferred providers in certain contexts. This paper evalautes whether the effects of tiered physician networks vary for different types of patients.

This executive summary provides an overview of the discussion from a May 2016 meeting where RWJF grantees presented some of the key findings from their research on the use and impact of price data in health care to a panel of experts actively engaged in developing and using health care price information.

This issue brief summarizes the discussion from a May 2016 meeting where RWJF grantees presented some of the key findings from their research on the use and impact of price data in health care to a panel of experts actively engaged in developing and using health care price information.

Accountable Care Organizations (ACO) emerged as a novel payment model to create a coordinated health system whereby providers contract together to take collective responsibility for managing the cost and quality of care for a population of patients. Preventive care is critical to ACO success. Evaluating ACOs’ strategic choices in terms of their organizational structure and early performance provides an avenue to a better understanding of the factors behind preventive care quality. In a HCFO-funded study, Valerie Lewis, Ph.D., of Dartmouth College and colleagues conducted a cross-sectional study examining Medicare Shared Savings Program and Pioneer ACO Program participants and the association between preventive care quality performance and ACO characteristics to inform strategies for preventive care quality management.

During the past decade, preventive care in medicine has become a national priority. Accountable Care Organizations (ACO) emerged as a novel payment model to create a coordinated health system whereby providers contract together to take collective responsibility for managing the cost and quality of care for a population of patients. Preventive care is critical to ACOs’ success. In a HCFO-funded study, Valerie Lewis, Ph.D., of Dartmouth College and colleagues conducted a cross-sectional study examining Medicare Shared Savings Program (MSSP) and Pioneer ACO Program participants and the association between preventive care quality performance and ACO characteristics. Their goal was to inform strategies for preventive care quality management.

This letter is a response to a critique of the researchers' publication, "Retail Clinic Visits For Low-Acuity Conditions Increase Utilization And Spending", published in the March 2016 Health Affairs.

Laboratory testing to identify contraindications and adverse drug reactions is important for safety of patients initiating angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs). Rates and predictors of appropriate testing among Medicare fee-for-service beneficiaries are unknown. In this HCFO-funded study, the researchers examined baseline laboratory testing rates to identify predictors of suboptimal testing and to assess the prevalence of abnormal creatinine and potassium among beneficiaries initiating ACE inhibitors or ARBs.

Commercial virtual visits are an increasingly popular model of health care for the management of common acute illnesses. In commercial virtual visits, patients access a website to be connected synchronously — via videoconference, telephone, or webchat — to a physician with whom they have no prior relationship. To date, whether the care delivered through those websites is similar or quality varies among the sites has not been assessed. Drawing on HCFO-funded work, R. Adams Dudley, University of California, San Francisco, and colleagues assessed the variation in the quality of urgent health care among virtual visit companies.

Calls for transparency in health care prices are increasing, in an effort to encourage and enable patients to make value-based decisions. Yet there is very little evidence of whether and how patients use health care price transparency tools. In a HCFO-funded study, Anna Sinaiko, Harvard T.H. Chan School of Public Health, and colleagues evaluated the experiences of an insured population of nonelderly adults with Aetna’s Member Payment Estimator, a web-based tool that provides real-time, personalized, episode-level price estimates.