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Journal of Ambulatory Care Management

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https://www.readbyqxmd.com/read/29474254/establishing-teams-how-does-it-change-practice-configuration-size-and-composition
#1
Alyna T Chien, Michael Anne Kyle, Antoinette S Peters, Kevin H Nguyen, Shalini A Tendulkar, Molly Ryan, Karen Hacker, Sara J Singer
Little is known about how practices reorganize when transitioning from traditional practice organization to team-based care. We compared practice-level (1) configuration as well as practice- and team-level (2) size and (3) composition, before and after establishing teams. We employed a pre-/poststudy using personnel lists of 1571 to 1711 staff (eg, job licenses, titles, and team assignment) and practice manager surveys. All personnel (physician and nonphysician) worked within 18 Massachusetts academic primary care practices participating in a 2-year learning collaborative aimed at establishing team-based care...
April 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/29474253/differences-in-certification-and-the-effect-on-team-climate-among-community-health-workers-in-texas
#2
Mark Siemon, Brenna Kreglo, Blake Boursaw
The purpose of this study was to compare team climate among Texas community health workers (CHWs)/promotoras who were certified by the 2 different methods: (a) completing a state-approved training program, and (b) providing evidence of work experience (grandfathering). Analysis of survey results found no significant differences in Team Climate Inventory scores between CHWs who were certified either through state-approved training or through work experience. This research provides some preliminary evidence in support of experience-based certification, but there continues to be a need for more research evaluating CHW certification requirements and the impact of state certification of CHWs on population health outcomes...
April 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/29474252/coordination-across-ambulatory-care-a-comparison-of-referrals-and-health-information-exchange-across-convenient-and-traditional-settings
#3
Ji Chang, Dave Chokshi, Joseph Ladapo
Urgent care centers have been identified as one means of shifting care from high-cost emergency departments while increasing after-hours access to care. However, the episodic nature of urgent care also has the potential to fragment care. In this study, we examine the adoption of 2 coordination activities-referrals and the electronic exchange of health information-at urgent care centers and other ambulatory providers across the United States. We find that setting is significantly associated with both health information exchange and referrals...
April 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/29474251/same-day-cancellation-in-ambulatory-surgery-a-retrospective-review-at-a-large-academic-tertiary-referral-center
#4
Bradford B Smith, Mark M Smith, Joseph A Hyder, William J Mauermann, Mary E Warner, Lauren K Licatino, David W Barbara
Although ambulatory surgery offers patients convenience and reduced costs, same-day cancellation of ambulatory surgery negatively affects patient experiences and operational efficiency. We conducted a retrospective analysis to determine the frequency and reasons for same-day cancellations in an outpatient surgery center at a large academic tertiary referral center. Of 41 389 ambulatory surgical procedures performed, same-day cancellations occurred at a rate of 0.5% and were usually unforeseeable in nature. Focusing on foreseeable cancellations offers opportunities for enhanced patient satisfaction, improved quality of care, and systems-based practice improvements to mitigate cancellations related to areas such as scheduling or patient noncompliance...
April 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/29474250/a-comment-on-moving-towards-paying-for-outcomes-in-medicaid
#5
Gail R Wilensky
No abstract text is available yet for this article.
April 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/29474249/paying-for-outcomes-in-medicaid-the-time-is-now
#6
Patrick J Roohan
Medicaid can improve quality and reduce costs by adopting a transparent quality measurement system based on outcomes that will improve quality and reduce costs.
April 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/29474248/medicaid-s-enduring-role-in-the-american-health-care-system
#7
Sara Rosenbaum
No abstract text is available yet for this article.
April 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/29474247/commentary-on-moving-toward-paying-for-outcomes-in-medicaid
#8
Joseph D Restuccia, Michael Shwartz
No abstract text is available yet for this article.
April 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/29474246/commentary-on-moving-toward-paying-for-outcomes-in-medicaid
#9
Richard H Bernstein
No abstract text is available yet for this article.
April 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/29474245/moving-toward-paying-for-outcomes-in-medicaid
#10
Billy Millwee, Kevin Quinn, Norbert Goldfield
Medicaid can improve beneficiary health and help sustain its own future by embracing payment for outcomes. Good precedents exist from states such as Florida, Maryland, Minnesota, New York, Ohio, Pennsylvania, and Texas. Medicaid outcome measures include preventable admissions, readmissions, emergency department visits, and inpatient complications; early elective deliveries; infant and child mortality; patient-reported outcomes, satisfaction, and confidence; and reduction in low-value care. Criteria to prioritize initiatives include potential savings, availability of established models, impact on health status, and Medicaid's ability to effect change...
April 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/29474244/from-the-editor
#11
(no author information available yet)
No abstract text is available yet for this article.
April 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/29176460/primary-care-and-the-hypertension-care-continuum-in-brazil
#12
James Macinko, Daniel G P Leventhal, Maria Fernanda Lima-Costa
This study provides estimates of hypertension prevalence, awareness, treatment, and control in Brazil and assesses how well different modes of primary care delivery achieve each of these outcomes. Over one-third of the Brazilian adult population had measured hypertension or prior diagnosis. Nearly 90% of these had recent contact with the health system, but only 65% were aware of their condition. Only 62% of these regularly sought care for hypertension, but of these 92% received treatment. Hypertension control was 33% overall, but increased to 57% among those who received all levels of care...
January 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/29176459/patient-primary-care-provider-and-specialist-perspectives-on-specialty-care-coordination-in-an-integrated-health-care-system
#13
Varsha G Vimalananda, Kelly Dvorin, B Graeme Fincke, Nicole Tardiff, Barbara G Bokhour
Successful coordination of specialty care requires understanding the perspectives of patients, primary care providers, and specialists-that is, the specialty care "triad." This study used qualitative methods to compare these perspectives in an integrated health care system, using diabetes specialty care as an exemplar. Primary care providers and endocrinologists relied on interclinician relationships to coordinate care. Clinicians rarely included patients or other staff in their conceptualization of specialty care coordination...
January 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/29176458/from-the-editor
#14
(no author information available yet)
No abstract text is available yet for this article.
January 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/28990993/rural-patients-and-primary-care-clinic-staffs-perceptions-of-ehr-implementation-an-ethnographic-exploration
#15
Sarah Kooienga
This focused ethnographic research study explores patients' and clinic staffs' experience of electronic health record (EHR) implementation in a small, independent, rural primary care practice. On the basis of participant observation of clinic staff, staff focus group, and patient interviews, results demonstrate that both patients and clinic staff have distrust and disconnect from technology. Yet, patients and clinic staff embrace patient-centered approaches and value team-based care. Understanding patients' and staffs' experience can facilitate the EHR implementation in the rural primary care setting and facilitate online access, patient portals, and other technologically based patient-centered approaches...
October 4, 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/28990992/comparing-patient-centered-medical-home-implementation-in-urban-and-rural-vha-clinics-results-from-the-patient-aligned-care-team-initiative
#16
Victoria Johnson, Edwin Wong, Michelle Lampman, Idamay Curtis, John Fortney, Peter Kaboli, Stephan Fihn, Karin Nelson
Rural Veterans Health Administration (VHA) primary care clinics are smaller, have fewer staff, and serve more rural patients compared with urban VHA primary care clinics. This may lead to different challenges to implementation of the Patient-Centered Medical Home (PCMH) model, the Patient Aligned Care Team, in the VHAs' large integrated health system. In this cross-sectional observational study of 905 VHA primary clinics in the United States and Puerto Rico, we found overall PCMH implementation was greater in rural compared to urban primary care clinics...
October 4, 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/28990991/brazilian-payment-for-performance-pmaq-seen-from-a-global-health-and-public-policy-perspective-what-does-it-mean-for-research-and-policy
#17
Fabiana C Saddi, Stephen Peckham
This supplement of the Journal of Ambulatory Care Management on the Brazilian National Program for Improving Access and Quality of Primary Care (PMAQ) reveals a relevant gap in the Brazilian literature on pay for performance/PMAQ, and is therefore an opportunity to bring contributions from global health and public policy to the debate. We discuss the relevant gap in the light of developments in evaluation and policy analysis. We afterward present the state of knowledge regarding global health and public policy in pay for performance, giving attention to diverse themes, methods, types of analyses, theoretical contributions, and limitations...
October 4, 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/28990990/how-6-organizations-developed-tools-and-processes-for-social-determinants-of-health-screening-in-primary-care-an-overview
#18
Kate LaForge, Rachel Gold, Erika Cottrell, Arwen E Bunce, Michelle Proser, Celine Hollombe, Katie Dambrun, Deborah J Cohen, Khaya D Clark
Little is known about how health care organizations are developing tools for identifying/addressing patients' social determinants of health (SDH). We describe the processes recently used by 6 organizations to develop SDH screening tools for ambulatory care and the barriers they faced during those efforts. Common processes included reviewing literature and consulting primary care staff. The organizations prioritized avoiding redundant data collection, integrating SDH screening into existing workflows, and addressing diverse clinic needs...
October 4, 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/28857887/reporting-from-the-front-lines-implementing-oregon-s-alternative-payment-methodology-in-federally-qualified-health-centers
#19
Erika K Cottrell, Jennifer D Hall, Glenn Kautz, Heather Angier, Sonja Likumahuwa-Ackman, Laura Sisulak, Sara Keller, David C Cameron, Jennifer E DeVoe, Deborah J Cohen
Alternative payment models have been proposed as a way to facilitate patient-centered medical home model implementation, yet little is known about how payment reform translates into changes in care delivery. We conducted site visits, observed operations, and conducted interviews within 3 Federally Qualified Health Center organizations that were part of Oregon's Alternative Payment Methodology demonstration project. Data were analyzed using an immersion-crystallization approach. We identified several care delivery changes during the early stages of implementation, as well as challenges associated with this new model of payment...
October 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/28857886/perspectives-on-how-to-engage-consumers-in-health-system-transformation
#20
Kris Wiitala, Ann Hwang
While health care organizations and public programs have recently demonstrated an increased interest in engaging patients and consumers as part of the implementation of new programs and policies, there is little published to date to guide these organizations in how to best engage consumers. We turn to an unconventional source-health care consumer advocates-who have developed experience in the type of consumer outreach, engagement, and activation that could help inform health care organizations and policy makers in further defining and studying engagement...
October 2017: Journal of Ambulatory Care Management
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