The American journal of managed care
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To understand physician organization (PO) responses to financial incentives for quality and total cost of care among POs that were exposed to a statewide multipayer value-based payment (VBP) program, and to identify challenges that POs face in advancing the goals of VBP. ⋯ Transformation could be advanced by strengthening financial incentives for value; engaging specialists in care redesign and delivering value; enhancing partnerships among POs, hospitals, and payers to align quality and cost actions; strengthening information exchange across providers; and applying other strategies to influence physician behavior.
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To validate a method that estimates disease burden as disability-adjusted life-years (DALYs) from insurance claims and death records for the purpose of identifying the conditions that place the greatest burden of disease on an insured population. ⋯ Health plans can use DALYs calculated from their own health insurance claims and death records as a valid and inexpensive method to identify the conditions that place the greatest burden of poor function and ill health on their insured populations.
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Abstract