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🔎 Par curiosité, j'ai été visiter le site internet de l'association 🚗"40 millions d'automobilistes" (sous l'égide de l'#ACO @fillon_pierre) : "débattre autour de la mobilité durable".
😱 Pas un mot sur les émissions de gaz à effet de serre des véhicules thermiques ! ⁉️Déni?
😱 Pas un mot sur les émissions de gaz à effet de serre des véhicules thermiques ! ⁉️Déni?
L'infographie ci-dessus provient du rapport grand public 2022 du @hc_climat, disponible ici : hautconseilclimat.fr/publications/
Rappel : le réchauffement à venir (et ses conséquences) vont dépendre en 1er du cumul des émissions de CO2 à venir.
Source : GIEC 2021, ipcc.ch/report/ar6/wg1…
Rappel : le réchauffement à venir (et ses conséquences) vont dépendre en 1er du cumul des émissions de CO2 à venir.
Source : GIEC 2021, ipcc.ch/report/ar6/wg1…
Sauf erreur de ma part, une voiture thermique va émettre de l'ordre de 25 (petite hybride) à 45 tonnes (gros véhicule sur son cycle de vie (200 000 km)... Ne pas le mentionner pour une "association d'automobilistes" en 2022 est pour le - étonnant.
Em 30/03/2022 a #Alemanha emitiu o primeiro alerta à população e á #indústria: reduzam o consumo de #gásnatural. O racionamento será inevitável caso o país não pague em #rublos pelo combustível importado da #Rússia.
Ainda que #Putin ofereça um prazo para aditamento dos contratos e ajustes financeiros e monetários para pagamentos de #commodities em #rublos, a Rússia não voltará atrás nessa exigência.
A #Europa precisa preparar-se urgentemente para pagar aos russos também em rublos pelo trigo, fertilizantes, madeira, alumínio, aço e titânio.
Another long, technical thread to end the day! @BlueCrossNC is on a mission to transform health care. This means sharing how we tackled problems that have stymied efforts at payment reform at scale, including how to fund the inclusion of self-insured segments within #BluePremier.
Fully insured segments are straightforward – as a plan, we can accrue the estimate reserves that we track on an ongoing basis for any given risk arrangement in which we hold the dollars. But self-insured populations are a different story. Many plans have faced this quandary.
Some have just left them out of the included populations entirely. But leaving out these populations dampens the value of the program and shortchanges the members who will benefit from accountability and alignment of providers to improve outcomes, experience, and affordability.
1/ The results are in!
Quick thread on #MSSP #ACO results in @Health_Affairs blog by @SeemaCMS
Interest In ‘Pathways To Success’ Grows: 2018 ACO Results Show Trends Supporting Program Redesign Continue | Health Affairs healthaffairs.org/do/10.1377/hbl…
Quick thread on #MSSP #ACO results in @Health_Affairs blog by @SeemaCMS
Interest In ‘Pathways To Success’ Grows: 2018 ACO Results Show Trends Supporting Program Redesign Continue | Health Affairs healthaffairs.org/do/10.1377/hbl…
2/ the total net savings to CMS continue to grow!
Now $740M net of payments to ACOs
Was $314M in 2017
Note: benchmark <> counterfactual-Lots of evidence that these savings are under-estimates, not even accounting for spillover
(@AledadeACO saved taxpayer $69M on 300k Benes)
Now $740M net of payments to ACOs
Was $314M in 2017
Note: benchmark <> counterfactual-Lots of evidence that these savings are under-estimates, not even accounting for spillover
(@AledadeACO saved taxpayer $69M on 300k Benes)
3/ and guess what??
Physician-led ACOs continue to generate a disproportionate share of savings in the program!
That hypothesis led me to launch the physician-led ACO learning network at Brookings in 2013, and @AledadeACO in 2014.
Evidence now obvious. Not so much then.
Physician-led ACOs continue to generate a disproportionate share of savings in the program!
That hypothesis led me to launch the physician-led ACO learning network at Brookings in 2013, and @AledadeACO in 2014.
Evidence now obvious. Not so much then.
For the #ACO wonks out there, we applied lessons from other existing or previous #ACO models to inform our approach for #BluePremier. Let’s go into a deep dive into the methodology here. [THREAD] /1
We’ll use risk adjusted, trended, historical baseline to determine shared savings/losses for the attributed population. In two-sided risk, we’ll apply a discount to ensure the plan and its ASO customers have savings even as we pass back higher amounts of savings. #HealthData /2
This fits our first lesson: meet providers where they are—try to move too fast and lose opportunity. Given this is our first broad scale total cost of care model with many of these organizations, need to start gradually. /3
We see a lots of announcements about value-based care and #ACO contracts in our industry. Important to call out what’s new here with #BluePremier and what’s meaningful. @ASlavitt, @Atul_Gawande, @Farzad_MD, @chasedave, @SGottliebFDA /1
These 5 systems (@ConeHealth @DukeHealth @UNC_Health_Care @WakeMed @WakeHealth) are making a multiyear commitment to this program – and a commitment to two-sided risk. /2
They will be accountable for total #costofcare and quality for fully insured and self-insured lives (think large group employers). /3
1/ 2017 #MSSP #ACO Results!
ACOs have scaled rapidly across the country!
In aggregate, the 472 ACOs were accountable for nearly 9 million Medicare beneficiaries and $95 Billion- that's a quarter of all fee for service, and almost half of the entire Medicare Advantage market.
ACOs have scaled rapidly across the country!
In aggregate, the 472 ACOs were accountable for nearly 9 million Medicare beneficiaries and $95 Billion- that's a quarter of all fee for service, and almost half of the entire Medicare Advantage market.
2/ If you add up all the actual costs versus benchmarks, these 472 ACOs were collectively $1.1B under their benchmarks (more on whether that's the right counterfactual later).
Medicare shared $780 million in payments with the ACOs, netting the taxpayer $313M
Medicare shared $780 million in payments with the ACOs, netting the taxpayer $313M
But wait!
There's lots of evidence that the benchmark under-estimates the savings produced. @JMichaelMcW et al have shown convincingly that a true "difference in difference" approach would show substantially higher net impact.
The green eyeshades folks at CMS OACT said add 60%
There's lots of evidence that the benchmark under-estimates the savings produced. @JMichaelMcW et al have shown convincingly that a true "difference in difference" approach would show substantially higher net impact.
The green eyeshades folks at CMS OACT said add 60%
So right off the bat we are talking about a July 1, 2019 start where existing ACOs would extend their current contracts six months and new entrants wouldn't start till July 1. This is disruptive hopefully they left the door open to a Jan 1 start.
Very substantial changes as we thought there would be with the new administration and a long time in coming for the rule. The reg text changes themselves run 78 pages
We're bummed @AcademyHealth #ARM18 is over, so we wanted to share our #policypics from our booth! We asked you what you were excited to talk about at #ARM18 and here are some of your pics! #maternalhealth #opioids #Medicaid #VUHealthPolicyPhD
Here are the 2016 #MSSP #ACO results you’ve been waiting for. Results are very different for physician-only
#Physician_Led_ACOs_Kick_Butt
#Physician_Led_ACOs_Kick_Butt
Sometimes the rainbows and unicorns are right in front of you
@amitabhchandra2 @Michael_Chernew @C_Garthwaite @JMichaelMcW
@amitabhchandra2 @Michael_Chernew @C_Garthwaite @JMichaelMcW
So, as a lot of you a probably aware, the new Assassins Creed is going to be set in Egypt. Specifically, during the reign of Cleopatra VII.
As you may or may not know, this is the period I studied as my honours topic.
I've been seeing a lot of ads for the new game. It looks like they're advertising using Middle Kingdom hieroglyphs (which I also studied)
