New Toolkit and Case Studies on Delivering Value Based Care to Medicare Beneficiaries

New Toolkit and Case Studies on Delivering Value Based Care to Medicare Beneficiaries

Mathematica promotes action-oriented ideas for delivering value based care through CMS’s Learning System for ACOs and its Value Based Care Learning System
Oct 12, 2021
Health care worker assisting patient
Photo By: miodrag ignjatovic

The Centers for Medicare & Medicaid Services (CMS) and Mathematica released a fifth and final toolkit and two case studies to highlight strategies that Accountable Care Organizations (ACOs) and End-Stage Renal Disease Seamless Care Organizations (ESCOs) use to improve quality of care, lower health care costs, and enhance beneficiaries’ experience. Mathematica completed this work as part of a contract with CMS.

CMS and Mathematica conducted focus groups with representatives from 13 ACOs participating in the Medicare Shared Savings Program and the Next Generation ACO Model to identify strategies for providing value-based care. With insights gained through these focus groups and other CMS-sponsored events, CMS’s ACO Learning System team developed the Operational Elements Toolkit. The toolkit presents fundamental strategies that Medicare ACOs use to begin or refine operations and considers approaches to meet the following objectives:

  • Establishing strategic partnerships to strengthen or expand an organization
  • Understanding beneficiaries’ care needs and preferences
  • Harnessing data to improve performance and support quality reporting

The Operational Elements Toolkit is part of a broader series of resources that explores how ACOs and ESCOs provide value-based care. CMS and Mathematica added to these resources with two new case studies that highlight the following strategies:

  • Partnering with emergency departments to improve care coordination services (Reliance Healthcare)
  • Creating an Innovation Fund that distributes grants to local organizations to improve quality, cost, and care experience (OneCare Vermont)

For more information about this toolkit and other resources highlighting ACO and ESCO initiatives—including previous toolkits on care transformation, provider engagement, beneficiary engagement, and care coordination, and almost two dozen case studies—please visit CMS’s website.