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https://www.readbyqxmd.com/read/27932264/physician-attitudes-toward-participating-in-a-financial-incentive-program-for-ldl-reduction-are-associated-with-patient-outcomes
#1
Tianyu Liu, David A Asch, Kevin G Volpp, Jingsan Zhu, Wenli Wang, Andrea B Troxel, Aderinola Adejare, Darra D Finnerty, Karen Hoffer, Judy A Shea
No abstract text is available yet for this article.
December 5, 2016: Healthcare
https://www.readbyqxmd.com/read/27932263/long-term-disease-and-economic-outcomes-of-prior-authorization-criteria-for-hepatitis-c-treatment-in-pennsylvania-medicaid
#2
Mina Kabiri, Jagpreet Chhatwal, Julie M Donohue, Mark S Roberts, A Everette James, Michael A Dunn, Walid F Gellad
BACKGROUND: Several highly effective but costly therapies for hepatitis C virus (HCV) are available. As a consequence of their high price, 36 state Medicaid programs limited treatment coverage to patients with more advanced HCV stages. States have only limited information available to predict the long-term impact of these decisions. METHODS: We adapted a validated hepatitis C microsimulation model to the Pennsylvania Medicaid population to estimate the existing HCV prevalence in Pennsylvania Medicaid and estimate the impact of various HCV drug coverage policies on disease outcomes and costs...
December 5, 2016: Healthcare
https://www.readbyqxmd.com/read/27932262/the-coach-program-a-joint-approach-to-patient-education-and-support
#3
Yael Shaked, Patricia Dickson, Kathy Workman
Hospital lengths of stay for orthopaedic procedures are declining internationally. Discharge home from hospital following total joint replacement surgery can be stressful due to pain and physical restrictions. Thus, many patients report experiencing increased anxiety and feeling a sudden withdrawal of support from their medical team. The Coach Program maximizes human resources and family-centred care by formally integrating an individual whom the patient identifies as their primary support into their health care team...
December 5, 2016: Healthcare
https://www.readbyqxmd.com/read/27932261/does-adding-clinical-data-to-administrative-data-improve-agreement-among-hospital-quality-measures
#4
Amresh D Hanchate, Kelly L Stolzmann, Amy K Rosen, Aaron S Fink, Michael Shwartz, Arlene S Ash, Hassen Abdulkerim, Mary Jo V Pugh, Priti Shokeen, Ann Borzecki
BACKGROUND: Hospital performance measures based on patient mortality and readmission have indicated modest rates of agreement. We examined if combining clinical data on laboratory tests and vital signs with administrative data leads to improved agreement with each other, and with other measures of hospital performance in the nation's largest integrated health care system. METHODS: We used patient-level administrative and clinical data, and hospital-level data on quality indicators, for 2007-2010 from the Veterans Health Administration (VA)...
December 5, 2016: Healthcare
https://www.readbyqxmd.com/read/27914968/segmenting-high-cost-medicare-patients-into-potentially-actionable-cohorts
#5
Karen E Joynt, Jose F Figueroa, Nancy Beaulieu, Robert C Wild, E John Orav, Ashish K Jha
BACKGROUND: Providers are assuming growing responsibility for healthcare spending, and prior studies have shown that spending is concentrated in a small proportion of patients. Using simple methods to segment these patients into clinically meaningful subgroups may be a useful and accessible strategy for targeting interventions to control costs. METHODS: Using Medicare fee-for-service claims from 2011 (baseline year, used to determine comorbidities and subgroups) and 2012 (spending year), we used basic demographics and comorbidities to group beneficiaries into 6 cohorts, defined by expert opinion and consultation: under-65 disabled/ESRD, frail elderly, major complex chronic, minor complex chronic, simple chronic, and relatively healthy...
November 30, 2016: Healthcare
https://www.readbyqxmd.com/read/27840099/taking-action-on-overuse-creating-the-culture-for-change
#6
Michael L Parchman, Nora B Henrikson, Paula R Blasi, Diana S Buist, Robert Penfold, Brian Austin, Emily H Ganos
BACKGROUND: Unnecessary care contributes to high costs and places patients at risk of harm. While most providers support reducing low-value care, changing established practice patterns is difficult and requires active engagement in sustained behavioral, organizational, and cultural change. Here we describe an action-planning framework to engage providers in reducing overused services. METHODS: The framework is informed by a comprehensive review of social science theory and literature, published reports of successful and unsuccessful efforts to reduce low-value care, and interviews with innovators of value-based care initiatives in twenty-three health care organizations across the United States...
November 10, 2016: Healthcare
https://www.readbyqxmd.com/read/27727028/meaningful-use-of-the-electronic-patient-portal-virginia-mason-s-journey-to-create-the-perfect-online-patient-experience
#7
Norifumi Kamo, A James Bender, Kavitha Kalmady, C Craig Blackmore
We present a case study of Virginia Mason Medical Center's successful implementation of the online patient portal. The organization exceeded its Meaningful Use 2 View/Download/Transmit targets and national benchmarks, with over 70% of unique patient encounters being provided timely online access to their health information, over 50% viewing, downloading, and transmitting health information electronically, and potential cost savings to the institution. Key lessons learned in our implementation process were.
October 7, 2016: Healthcare
https://www.readbyqxmd.com/read/27720694/the-power-of-capturing-and-using-information-at-the-point-of-care
#8
William H Gruber, Adam C Powell, John B Torous
Historically, the process of scientific discovery and the process of clinical delivery have been poorly integrated. As a result of the Decade of Health Information Technology (2004-2014), many of the former barriers to capturing, processing, and retrieving medical information at the point of care have been surmounted. This change has the potential to both transform how new medical discoveries are made and how evidence-based medicine is put into practice. To illustrate the impact of this ongoing change, several examples are provided of institutions which have innovatively used information at the point of care...
October 6, 2016: Healthcare
https://www.readbyqxmd.com/read/27720139/patient-portals-and-health-apps-pitfalls-promises-and-what-one-might-learn-from-the-other
#9
Jessica L Baldwin, Hardeep Singh, Dean F Sittig, Traber Davis Giardina
Widespread use of health information technology (IT) could potentially increase patients' access to their health information and facilitate future goals of advancing patient-centered care. Despite having increased access to their health data, patients do not always understand this information or its implications, and digital health data can be difficult to navigate when displayed in a small-format, complex interface. In this paper, we discuss two forms of patient-facing health IT tools-patient portals and applications (apps)-and highlight how, despite several limitations of each, combining high-yield features of mobile health (mHealth) apps with portals could increase patient engagement and self-management and be more effective than either of them alone...
October 3, 2016: Healthcare
https://www.readbyqxmd.com/read/27693204/case-study-johns-hopkins-community-health-partnership-a-model-for-transformation
#10
Scott A Berkowitz, Patricia Brown, Daniel J Brotman, Amy Deutschendorf, Linda Dunbar, Anita Everett, Debra Hickman, Eric Howell, Leon Purnell, Carol Sylvester, Ray Zollinger, Michele Bellantoni, Samuel C Durso, Constantine Lyketsos, Paul Rothman
To address the challenging health care needs of the population served by an urban academic medical center, we developed the Johns Hopkins Community Health Partnership (J-CHiP), a novel care coordination program that provides services in homes, community clinics, acute care hospitals, emergency departments, and skilled nursing facilities. This case study describes a comprehensive program that includes: a community-based intervention using multidisciplinary care teams that work closely with the patient's primary care provider; an acute care intervention bundle with collaborative team-based care; and a skilled nursing facility intervention emphasizing standardized transitions and targeted use of care pathways...
September 29, 2016: Healthcare
https://www.readbyqxmd.com/read/27693259/from-healthcare-to-health-a-proposed-pathway-to-population-health
#11
Ursula Koch, Somava Stout, Bruce E Landon, Russell S Phillips
Innovations in payment are encouraging clinical-community partnerships that address health determinants. However, little is known about how healthcare systems transform and partner to improve population health. We synthesized views of population health experts from nine organizations and illustrated the resulting model using examples from four health systems. The transformation requires a foundation of primary care, connectors and integrators that span the boundaries, sharing of goals among participants, aligned funding and incentives, and a supporting infrastructure, all leading to a virtuous cycle of collaboration...
September 28, 2016: Healthcare
https://www.readbyqxmd.com/read/27687917/determinants-of-success-in-shared-savings-programs-an-analysis-of-aco-and-market-characteristics
#12
Mariétou H Ouayogodé, Carrie H Colla, Valerie A Lewis
BACKGROUND: Medicare's Accountable Care Organization (ACO) programs introduced shared savings to traditional Medicare, which allow providers who reduce health care costs for their patients to retain a percentage of the savings they generate. OBJECTIVE: To examine ACO and market factors associated with superior financial performance in Medicare ACO programs. METHODS: We obtained financial performance data from the Centers for Medicare and Medicaid Services (CMS); we derived market-level characteristics from Medicare claims; and we collected ACO characteristics from the National Survey of ACOs for 215 ACOs...
September 27, 2016: Healthcare
https://www.readbyqxmd.com/read/27687916/macraeconomics-physician-incentives-and-behavioral-economics-in-the-medicare-access-and-chip-reauthorization-act
#13
Zirui Song
No abstract text is available yet for this article.
September 27, 2016: Healthcare
https://www.readbyqxmd.com/read/27687915/scalable-principles-of-community-based-high-value-care-for-seriously-ill-individuals-diamonds-in-the-rough
#14
Ravi B Parikh, Brynn Bowman, Constance Dahlin, Jeanne S Twohig, Diane E Meier
Early, integrated palliative care has been shown to improve quality of life and reduce utilization in both inpatient and outpatient settings. As health systems shift to risk-based payment structures, palliative care will play an increasing role in improving value of care outside of the hospital. Based on successful models of community-based palliative care, we identify six principles - interdisciplinary team-based care; 24/7 access and responsiveness; concurrent palliative care with disease-directed treatment; targeting services to high-risk patients; integrated medical and social supports; and caregiver support - that are widely implemented because of their impact on improving value for seriously ill individuals...
September 27, 2016: Healthcare
https://www.readbyqxmd.com/read/27663554/a-test-of-the-first-course-emergency-medicine-that-is-globally-available-for-credit-and-for-free
#15
Erica Frank, Kate Tairyan, Michelle Everton, Jennifer Chu, Craig Goolsby, Alisa Hayes, Ann Hulton
BACKGROUND: The WHO has called for the use of computer-aided education to train millions of additional health providers. We herein address this appeal with the first globally available, free, accredited, computer-aided, and peer and mentor-guided course. METHODS: The intervention studied was NextGenU.org's first course, "Emergency Medicine (EM) for Senior Medical Students", required for the graduating Classes of 2013 at the University of Missouri (UM) and the U...
September 20, 2016: Healthcare
https://www.readbyqxmd.com/read/27618668/independent-practice-associations-advantages-and-disadvantages-of-an-alternative-form-of-physician-practice-organization
#16
Lawrence P Casalino, Norman Chenven
BACKGROUND: Value-based purchasing (VBP) favors provider organizations large enough to accept financial risk and develop care management infrastructure. Independent Practice Associations (IPAs) are a potential alternative for physicians to becoming employed by a hospital or large medical group. But little is known about IPAs. METHODS: We selected four IPAs that vary in location, structure, and strategy, and conducted interviews with their president and medical director, as well as with a hospital executive and health plan executive familiar with that IPA...
September 8, 2016: Healthcare
https://www.readbyqxmd.com/read/27599395/the-physician-insurer-dynamic-must-shift-to-successfully-implement-value-based-payments
#17
Roy A Beveridge, Laura E Happe, Mike Funk
Decades of practice under a system that set the financial interests of physicians and insurers at odds, has resulted in physician distrust of insurers being cited a key obstacle to value-based arrangements. Insurers must work to shift the insurer-provider relationship from one that's transactional to a partnership built on trust. Even when physicians and insurers agree philosophically on quality over quantity, there are practical challenges. Insurers can provide the data, systems and analytical insights that help inform the physician's care strategy...
September 2, 2016: Healthcare
https://www.readbyqxmd.com/read/27594306/how-much-do-clinicians-support-patient-self-management-the-development-of-a-measure-to-assess-clinician-self-management-support
#18
Jessica Greene, Rebecca M Sacks, Judith H Hibbard, Valerie Overton
BACKGROUND: Primary care provider (PCP) support of patient self-management may be important mechanism to improving patient health outcomes. In this paper we develop a PCP-reported measure of clinician strategies for supporting patient self-management, and we psychometrically test and validate the measure. METHODS: We developed survey items based upon effective self-management support strategies identified in a prior mixed methods study. We fielded a survey in the fall of 2014 with 139 Fairview Health Services PCPs, and conducted exploratory factor analysis and Cronbach's Alpha to test for scale reliability...
September 2, 2016: Healthcare
https://www.readbyqxmd.com/read/27637831/choosing-wisely%C3%A2-a-case-study-of-constructive-engagement-in-health-policy
#19
Daniel Wolfson, Anthony Suchman
Choosing Wisely began at a time when a polarized national debate on healthcare reform stymied effective conversation on effective and efficient resource use. The ABIM Foundation sought to change attitudes and culture and promote the idea that removing waste is an integral component of providing high quality care by using an approach of constructive engagement to persuade specialty societies to identify five wasteful tests or treatments within their field.
September 2016: Healthcare
https://www.readbyqxmd.com/read/27637830/improving-the-diagnostic-stage-of-the-suspected-colorectal-cancer-pathway-a-quality-improvement-project
#20
James B Haddow, Maria Walshe, Dinesh Aggarwal, Ankur Thapar, John Hardman, Jonathan Wilson, Ayo Oshowo, Chetan Bhan, Hasan Mukhtar
We aimed to improve the lead-time and the patient experience of the diagnostic stage of the suspected colorectal cancer pathway. This project worked within the constraints of limited resources and an austere environment. The core team included a project manager trained in quality improvement methodologies. Senior and Fleming's planned change model was used as the overall framework. Baseline data supported the case for change and highlighted targets for improvement. A stakeholder workshop employed social movement theory, lean thinking, experience-based design and patient stories to engage influential leaders and secure support and commitment...
September 2016: Healthcare
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