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Kevin G Volpp, Amol Navathe, Emily Oshima Lee, Mark Mugishii, Andrea B Troxel, Kristen Caldarella, Amanda Hodlofski, Susannah Bernheim, Elizabeth Drye, Justin Yoshimoto, Kim Takata, Michael B Stollar, Ezekiel Emanuel
OBJECTIVES: To describe the process of developing a new physician payment system based on value and transitioning away from a fee-for-service payment system STUDY DESIGN: Descriptive. This paper describes a recent initiative involving redesign of primary care provider payment in the State of Hawaii. While there has been extensive discussion about switching payment from volume to value in recent years, much of this change has happened at the organizational level and this initiative focused on changing the incentives for individual providers...
July 9, 2018: Healthcare
Richard A Helmers, C Michel Harper
The multi-campus Academic Health Center (AHC) of the future will need to be system-based and committed to clinical integration to continue to meet institutional goals and serve the needs of its patients. The key tactics we describe to accomplish this are.
June 30, 2018: Healthcare
Sharief Hendricks, Nailah Conrad, Tania S Douglas, Tinashe Mutsvangwa
Increasing pressure to improve health outcomes of populations with limited resources has prompted an emphasis on innovation. Design thinking has been proposed as a systematic approach to innovation in health, owing to its human-centred methodology that prioritises deep empathy for the end-users' desires, needs and challenges, which results in a better understanding of the problem in order to develop more comprehensive and effective solutions. A key feature of design thinking is stakeholder participation. If design thinking is going to be used as an approach to design and implement effective, equitable and sustainable health solutions, assessing stakeholder participation should be integrated into the process...
June 27, 2018: Healthcare
Abhishek Dalal
No abstract text is available yet for this article.
June 18, 2018: Healthcare
Timothy J Judson, Matthew J Press, Allan S Detsky
No abstract text is available yet for this article.
June 8, 2018: Healthcare
David Citrin, Poshan Thapa, Isha Nirola, Sachit Pandey, Lal Bahadur Kunwar, Jasmine Tenpa, Bibhav Acharya, Hari Rayamazi, Aradhana Thapa, Sheela Maru, Anant Raut, Sanjaya Poudel, Diwash Timilsina, Santosh Kumar Dhungana, Mukesh Adhikari, Mukti Nath Khanal, Naresh Pratap Kc, Bhim Acharya, Khem Bahadur Karki, Dipendra Raman Singh, Alex Harsha Bangura, Jeremy Wacksman, Daniel Storisteanu, Scott Halliday, Ryan Schwarz, Dan Schwarz, Nandini Choudhury, Anirudh Kumar, Wan-Ju Wu, S P Kalaunee, Pushpa Chaudhari, Duncan Maru
Integrating care at the home and facility level is a critical yet neglected function of healthcare delivery systems. There are few examples in practice or in the academic literature of affordable, digitally-enabled integrated care approaches embedded within healthcare delivery systems in low- and middle-income countries. Simultaneous advances in affordable digital technologies and community healthcare workers offer an opportunity to address this challenge. We describe the development of an integrated care system involving community healthcare worker networks that utilize a home-to-facility electronic health record platform for rural municipalities in Nepal...
June 4, 2018: Healthcare
Joshua M Liao, R Tamara Konetzka, Rachel M Werner
Improving the value of post-acute care at skilled nursing facilities (SNFs) has become a Medicare policy priority. Anecdotally, hospitals have responded by formally acquiring or pursuing tighter informal connections with SNFs. We evaluated the trend in connections between US acute care hospitals and Medicare-certified SNFs between 2000 and 2013 using vertical integration and two novel network-based measures (number of SNF partners, and discharge concentration). Among 4441 hospitals and 17,215 SNFs, hospitals with weaker connections with SNFs were more often non-profit, major teaching hospitals with a larger number of discharges and beds...
May 7, 2018: Healthcare
Christopher Moriates, Vineet M Arora
No abstract text is available yet for this article.
April 27, 2018: Healthcare
Adam L Beckman, Sanchay Gupta
No abstract text is available yet for this article.
June 2018: Healthcare
Anne C Jones, Trudy Li, Meg Zomorodi, Rob Broadhurst, Amy B Weil
Interprofessional (IP) team work has been shown to decrease burnout and improve care and decrease costs. However, institutional barriers have challenged adoption in practice and education. Faculty and students are turning to IP service-learning projects to help students gain experience and provide needed services. This paper highlights a "hotspotting" program where students from different health professions work collaboratively to improve high utilizing patients' health. Benefits, challenges and preliminary results including cost savings and student efficacy are shared...
June 2018: Healthcare
Michael J Yedidia
BACKGROUND: Patients who heavily utilize hospitals and emergency departments frequently have complex needs requiring services spanning medical, behavioral, and social service sectors. This study identifies essential competencies for caring for high-needs patients and highlights their importance to primary care delivery. METHODS: Transcripts of in-depth interviews with 30 clinical and administrative staff at 23 complex care programs across the United States were analyzed using standard qualitative techniques...
June 2018: Healthcare
Anita Chary, David Flood, Kirsten Austad, Marcela Colom, Jessica Hawkins, Katia Cnop, Boris Martinez, Waleska Lopez, Peter Rohloff
No abstract text is available yet for this article.
June 2018: Healthcare
Caterina Hill, Khin-Kyemon Aung, Toyin Ajayi, Mika Cheng, Lauren Easton, Karen Derby, Jerome Genser, Bradley Keith, Peggy Johnson
No abstract text is available yet for this article.
June 2018: Healthcare
Karen M Goldstein, Dawne Vogt, Alison Hamilton, Susan M Frayne, Jennifer Gierisch, Jill Blakeney, Anne Sadler, Bevanne M Bean-Mayberry, Diane Carney, Brooke DiLeone, Annie B Fox, Ruth Klap, Ellen Yee, Yasmin Romodan, Holly Strehlow, Julia Yosef, Elizabeth M Yano
PURPOSE: This study evaluated the Implementation of Essential Health Care Program (EHCP) in the Department of Education - Schools Division of Tarlac Province during the School Year 2014-2015 in partnership with the Provincial Government of Tarlac (PGT). METHODS: The Context Input Process Product (CIPP) evaluation model was used in the study. The questionnaire, documentary analysis, interview and observation were used in the data gathering. Documents that were available such as records and DepED memoranda and orders were used as sources of data...
June 2018: Healthcare
Charlie M Wray, Vineet M Arora, Donald Hedeker, David O Meltzer
BACKGROUND: Inpatient service handoffs are a vulnerable transition during a patients' hospitalization. We hypothesized that performing the service handoff at the patients' bedside may be one mechanism to more efficiently transfer patient information between physicians, while further integrating the patient into their hospital care. METHODS: We performed a 6-month prospective study of performing a bedside handoff (BHO) at the service transition on a non-teaching hospitalist service...
June 2018: Healthcare
Andrew J Knighton, Lucy A Savitz, Jose Benuzillo, James A VanDerslice
BACKGROUND: Local social determinants may act as effect modifiers for the impact of neighborhood material deprivation on patient-level healthcare outcomes. The objective of this study was to understand the mediating effect of local social determinants on neighborhood material deprivation and delivery outcomes in heart failure (HF) patients. MATERIAL AND METHODS: A retrospective cohort study was conducted using 4737 HF patients receiving inpatient care (n=6065 encounters) from an integrated healthcare delivery system from 2010 to 2014...
June 2018: Healthcare
Donna Keyser, Jane Kogan, Marion McGowan, Pamela Peele, Diane Holder, William Shrank
National-level demonstration projects and real-world studies continue to inform health care transformation efforts and catalyze implementation of value-based service delivery and payment models, though evidence generation and diffusion of learnings often occurs at a relatively slow pace. Rapid-cycle learning models, however, can help individual organizations to more quickly adapt health care innovations to meet the challenges and demands of a rapidly changing health care landscape. Integrated delivery and financing systems (IDFSs) offer a unique platform for rapid-cycle learning and innovation...
March 30, 2018: Healthcare
Smitha Ganeshan, Galina Gheihman, Marissa Palmor, Stephanie Choi, Diana Wohler, Lisa S Rotenstein
No abstract text is available yet for this article.
March 28, 2018: Healthcare
Ravi B Parikh, Justin E Bekelman, Amanda Hodlofksi, Amol S Navathe
No abstract text is available yet for this article.
March 2018: Healthcare
Miranda B Lam, Laura G Burke, E John Orav, Ashish K Jha
BACKGROUND: A small proportion of patients account for the majority of health care spending. Of this group, little is known about what proportion have a cancer diagnosis and how their spending pattern compares to those without cancer. METHODS: Using national Medicare data of enrollees 65 or older, we identified patients in the top decile of spending in 2014 and designated them as high-cost. We used ICD-9 codes to identify patients with a cancer diagnosis and examined cancer prevalence among both high-cost and non-high-cost patients...
March 2018: Healthcare
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