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Journal of Ambulatory Care Management

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https://www.readbyqxmd.com/read/29771742/multiple-chronic-conditions-and-disparities-in-30-day-hospital-readmissions-among-nonelderly-adults
#1
Jayasree Basu, Amresh Hanchate, Siran Koroukian
This study examines the patterns of 30-day hospital readmissions by race/ethnicity and multiple chronic conditions (MCC) burden among nonelderly adult patients. We used hospital discharge data of patients in the 18- to 64-year age group in 5 US states, California, Florida, Missouri, New York, and Tennessee, for 2009 from the Healthcare Cost and Utilization Project State Inpatient Database (HCUP-SID) of the Agency for Healthcare Research and Quality, linked to contextual and provider data from the Health Resources and Services Administration...
May 15, 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/29771741/impacts-of-the-affordable-care-act-on-community-health-centers-characteristics-of-new-patients-and-early-changes-in-delivery-of-care
#2
Brigit Hatch, Ning Smith, Mary Ann McBurnie, Thu Quach, Kenneth H Mayer, Mary J Dunne, Erika Cottrell
The aim of this study was to assess the impact of the Affordable Care Act (ACA) on community health centers (CHCs). Using electronic health records from the Community Health Applied Research Network, we assessed new patient characteristics, office visit volume, and payer distribution among CHC patients before and after ACA implementation, 2011-2014 (n = 442 455). New patients post-ACA were younger, more likely to be female and have chronic health conditions, and utilized more primary care (P < .05 for each)...
May 15, 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/29771740/closing-the-referral-loop-improving-ambulatory-referral-management-electronic-health-record-connectivity-and-care-coordination-processes
#3
Stephen L Davidow, Jignesh Sheth, Constance S Sixta, Linda Thomas-Hemak
More than 105 million referrals of Medicare beneficiaries to specialists occur annually. Different settings and electronic health records have made care coordination complex. PCPI (formerly American Medical Association-convened Physicians Consortium for Performance Improvement) and The Wright Center for Graduate Medical Education sponsored the Closing the Referral Loop pilot project. Twelve dyads of primary care and specialist physicians sought to improve ambulatory referrals by mapping the referral process, and using care compacts, metrics, and electronic health records...
May 15, 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/29771739/commentary-on-moving-towards-paying-for-outcomes-in-medicaid
#4
Gail R Wilensky
No abstract text is available yet for this article.
May 15, 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/29474254/establishing-teams-how-does-it-change-practice-configuration-size-and-composition
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
(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/29298178/actively-integrating-suicide-risk-assessment-into-primary-care-settings
#16
Heather A Finnegan, Candice N Selwyn, Jennifer Langhinrichsen-Rohling
Adequate evaluation and response to suicide risk require (i) awareness of need, (ii) comfort gathering key information, and (iii) ongoing training. A survey administered at 2 urban primary care settings in the process of implementing integrated care measured awareness, comfort, and training related to suicide risk assessment among 31 primary care providers (PCPs). Greater PCP comfort asking patients about psychological trauma was associated with more frequent engagement in safety planning with suicidal patients...
April 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/29298177/offsetting-patient-centered-medical-homes-investment-costs-through-per-member-per-month-or-medicare-merit-based-incentive-payment-system-incentive-payments
#17
Briget da Graca, Gerald O Ogola, Cliff Fullerton, Russell McCorkle, Neil S Fleming
Primary care practices become patient-centered medical homes (PCMHs) to improve care. However, investment costs and opportunities to offset those costs are critical to the decision. We examined potential offsets through commercial payer per-member-per-month (PMPM) payments and the Medicare Merit-based Incentive Payment System (MIPS) for a network that spent $4 818 260 over 4 years obtaining and renewing PCMH recognition for 57 practices. With PMPM payments of $3.37 to $8.98, "breakeven" requires that 2...
April 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/29176460/primary-care-and-the-hypertension-care-continuum-in-brazil
#18
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
#19
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
#20
(no author information available yet)
No abstract text is available yet for this article.
January 2018: Journal of Ambulatory Care Management
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