Skip to main content Accessibility help
×
  1. Home
  2. Search

Refine search

Refine search

Access:
Content type:
Publication date:
Apply   From and To filters
Subject: Show more
Journals Show more
Publishers: Show more
Societies Show more
Series: Show more
Collections: Show more

Actions for selected content:

Select all | Deselect all
  • View selected items
  • Export citations
  • Download PDF (zip)
  • Save to Kindle
  • Save to Dropbox
  • Save to Google Drive

Save Search

You can save your searches here and later view and run them again in "My saved searches".

Please provide a title, maximum of 40 characters.
Cancel
×

2 results

  • Chapter 30 - Financial Considerations for ICU Follow-Up Clinics

  • from Section 4 - General Principles of Critical Illness Survivorship and Follow-Up Care
  • Edited by Brad W. Butcher, University of Pittsburgh School of Medicine, Pennsylvania
  • Book:
    Post-Intensive Care Syndrome
    Published online:
    22 January 2026
    Print publication:
    22 January 2026, pp 385-398

  • Summary

    Understanding the financial implications of intensive care unit (ICU) survivor care is critical to the success of ICU follow-up clinics. The model of value-based healthcare first suggested by Porter and Teisburg in their 2006 book, Redefining Health Care: Creating Value-Based Competition on Results, presents a perspective from which to argue for the importance of ICU follow-up clinics. A robust understanding of the financial implications of ICU follow-up clinics must go beyond billing and collections generated by these clinics and should focus on total value provided by these clinics to patients. A general equation to assess value is value = quality / cost. Cost should include not only cost to providers or payors but also to patients and their families. We present a series of practical financial considerations when developing a follow-up clinic that focus on the value attained relative to the costs of running the clinic. We also suggest areas that would benefit from further research, such as optimal staffing, alignment of time frame for resolution of post intensive care syndrome with time points at which the value of follow-up clinics is assessed, and application of behavioral economics to ICU survivor follow-up care process design.

  • VALUE AND PERFORMANCE OF ACCOUNTABLE CARE ORGANIZATIONS: A COST-MINIMIZATION ANALYSIS

  • Sonal Parasrampuria, Allison H. Oakes, Shannon S. Wu, Megha A. Parikh, William V. Padula
  • Journal:
    International Journal of Technology Assessment in Health Care / Volume 34 / Issue 4 / 2018
    Published online by Cambridge University Press:
    11 July 2018, pp. 388-392
    • Article
      • You have access
    • PDF
    • HTML
    • Export citation
  • Objectives:

    Determine the relationship between quality of an accountable care organization (ACO) and its long-term reduction in healthcare costs.

    Methods:

    We conducted a cost minimization analysis. Using Centers for Medicare and Medicaid cost and quality data, we calculated weighted composite quality scores for each ACO and organization-level cost savings. We used Markov modeling to compute the probability that an ACO transitioned between different quality levels in successive years. Considering a health-systems perspective with costs discounted at 3 percent, we conducted 10,000 Monte Carlo simulations to project long-term cost savings by quality level over a 10-year period. We compared the change in per-member expenditures of Pioneer (early-adopters) ACOs versus Medicare Shared Savings Program (MSSP) ACOs to assess the impact of coordination of care, the main mechanism for cost savings.

    Results:

    Overall, Pioneer ACOs saved USD 641.24 per beneficiary and MSSP ACOs saved USD 535.59 per beneficiary. By quality level: (a) high quality organizations saved the most money (Pioneer: USD 459; MSSP: USD 816); (b) medium quality saved some money (Pioneer: USD 222; MSSP: USD 105); and (c) low quality suffered financial losses (Pioneer: USD -40; MSSP: USD -386).

    Conclusions:

    Within the existing fee-for-service healthcare model, ACOs are a mechanism for decreasing costs by improving quality of care. Higher quality organizations incorporate greater levels of coordination of care, which is associated with greater cost savings. Pioneer ACOs have the highest level of integration of services; hence, they save the most money.