Case Study: Medicare Preventive Services and Influenza
Every year the CDC issues guidelines for influenza vaccines in its efforts to decrease the spread and severity of influenza.(6) Despite the warnings and guidelines, aIn an effort to lower costs and experiment with different incentives and systems, CMS created several programs to promote coordination within the healthcare system and improve the quality of care for chronically-ill patients.(1) As part of Medicare’s transition from volume-driven care to value-based care, the Accountable Care Organization (ACO) model provides incentives for healthcare providers to promote quality over quantity.(2) This effort is supported by the American Medical Association, because the organization understands that ACO success encompasses much more than cost-savings.(3) With a focus on systems to improve patient care, ACOs are well-situated in a consumer-oriented market.
Over the past decade, CMS has argued that providers will increase quality of care when they share in savings from better-coordinated preventative, diagnostic, and therapeutic services. As a result, ACOs are responsible for providing their patients with healthcare management services. In order to realize the benefits of cost-savings through evidence-based healthcare management strategies (e.g. vaccines, flu-shots, cancer screenings, Annual Wellness Visits, etc.), they must furnish their patients with management services. Consequently, partnerships with a third party, such as Connect Care Plus, are an effective way to provide these services.