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Primary care reimbursement models

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https://www.readbyqxmd.com/read/29720175/challenges-for-the-surgical-capacity-building-of-township-hospitals-among-the-central-china-a-retrospective-study
#1
Zhong Li, Jian Yang, Yue Wu, Zijin Pan, Xiaoqun He, Boyang Li, Liang Zhang
BACKGROUND: China's rapid transition in healthcare service system has posed considerable challenges for the primary care system. Little is known regarding the capacity of township hospitals (THs) to deliver surgical care in rural China with over 600 million lives. We aimed to ascertain its current performance, barriers, and summary lessons for its re-building in central China. METHODS: This study was conducted in four counties from two provinces in central China...
May 2, 2018: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29678966/an-evaluation-of-prescribing-trends-and-patterns-of-claims-within-the-preferred-drugs-initiative-in-ireland-2011-2016-an-interrupted-time-series-study
#2
Ronald McDowell, Kathleen Bennett, Frank Moriarty, Sarah Clarke, Michael Barry, Tom Fahey
OBJECTIVE: To examine the impact of the Preferred Drugs Initiative (PDI), an Irish health policy aimed at enhancing evidence-based cost-effective prescribing, on prescribing trends and the cost of prescription medicines across seven medication classes. DESIGN: Retrospective repeated cross-sectional study spanning the years 2011 - 2016. SETTING: Health Service Executive Primary Care Reimbursement Service pharmacy claims data for General Medical Services (GMS) patients, approximately 40% of the Irish population...
April 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29673268/integration-of-pediatric-behavioral-health-services-in-primary-care-improving-access-and-outcomes-with-collaborative-care
#3
John V Campo, Rose Geist, David J Kolko
OBJECTIVE: To examine collaborative care interventions to integrate pediatric mental health services into primary care as a means of addressing barriers to mental health service delivery, improving access to care, and improving health outcomes. METHOD: Selective review of published literature addressing structural and attitudinal barriers to behavioural health service delivery and the integration of behavioural health services for pediatric mental problems and disorders into primary care settings, with a special focus on Canadian and U...
January 1, 2018: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/29665016/underreporting-of-fall-injuries-of-older-adults-implications-for-wellness-visit-fall-risk-screening
#4
Geoffrey J Hoffman, Jinkyung Ha, Neil B Alexander, Kenneth M Langa, Mary Tinetti, Lillian C Min
OBJECTIVES: To compare the accuracy of and factors affecting the accuracy of self-reported fall-related injuries (SFRIs) with those of administratively obtained FRIs (AFRIs). DESIGN: Retrospective observational study SETTING: United States PARTICIPANTS: Fee-for-service Medicare beneficiaries aged 65 and older (N=47,215). MEASUREMENTS: We used 24-month self-report recall data from 2000-2012 Health and Retirement Study data to identify SFRIs and linked inpatient, outpatient, and ambulatory Medicare data to identify AFRIs...
April 17, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29627120/attending-diabetes-clinics-is-associated-with-a-lower-all-cause-mortality-a-meta-analysis-of-observational-studies-performed-in-italy
#5
E Bonora, M Monami, G Bruno, G Zoppini, E Mannucci
OBJECTIVE: The epidemiological explosion of diabetes is a challenge for Health Systems and the identification of the most appropriate models of care are warranted. The inclusion of primary care physicians in the models is unquestioned whereas the role played by secondary and tertiary care (Diabetes Clinic) is often debated. However, studies focusing on hard endpoints and comparing Diabetes Clinic attendance vs. no attendance are scant. RESEARCH DESIGN AND METHODS: A meta-analysis was performed including all observational cohort studies performed in Italy, reporting crude and/or adjusted estimates of all-cause mortality in patients with diabetes attending or not attending Diabetes Clinics...
May 2018: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
https://www.readbyqxmd.com/read/29615013/factors-influencing-government-insurance-scheme-beneficiary-acceptance-of-the-gatekeeper-policy-a-cross-sectional-study-in-wuhan-china
#6
Wenzhen Li, Dongming Wang, Yong Gan, Yanfeng Zhou, Yawen Chen, Jing Li, Naomiem Kkandawire, Sai Hu, Yan Qiao, Zuxun Lu
BACKGROUND: Gatekeeper policy, requiring a patient to visit a primary care provider first, and the patient needs to get his or her primary care provider's referral before seeing a specialist or going to a hospital, has been implemented in China for about ten years, and it is necessary to assess the patients' acceptance of gatekeeper policy and to explore the factors influencing patients' acceptance. METHODS: A cross-sectional study with 1162 respondents was conducted between July and September 2015 at four community health centers (CHCs) in Wuhan, China...
April 4, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29551305/dialysis-dependence-predicts-complications-intensive-care-unit-care-length-of-stay-and-skilled-nursing-needs-in-elective-primary-total-knee-and-hip-arthroplasty
#7
Joseph T Patterson, Kyle Tillinghast, Derek Ward
BACKGROUND: Limited data describe risks and perioperative resource needs of total joint arthroplasty (TJA) in dialysis-dependent patients. METHODS: Retrospective multiple cohort analysis of dialysis-dependent American College of Surgeons National Surgical Quality Improvement Program patients undergoing primary elective total hip and knee arthroplasty compared to non-dialysis-dependent controls from 2005 to 2015. Relative risks (RRs) of 30-day adverse events were determined by multivariate regression adjusting for baseline differences...
February 17, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29534836/global-budget-revenue-on-a-single-institution-s-costs-and-outcomes-in-patients-undergoing-total-hip-arthroplasty
#8
Ronald E Delanois, Chukwuweike U Gwam, Jeffrey J Cherian, Jennifer I Etcheson, Nicole E George, Kathleen A Schneider, Michael A Mont
BACKGROUND: The state of Maryland was granted a waiver by the Center for Medicare and Medicaid Services to implement a Global Budget Revenue (GBR) reimbursement model. This study aims to compare (1) costs of inpatient hospital stays; (2) postacute care costs; (3) lengths of stay (LOS); and (4) discharge disposition who underwent primary total hip arthroplasty at a single Maryland-based orthopedic institution before and after the implementation of GBR. METHODS: The Maryland Center for Medicare and Medicaid Services database was queried to obtain all Medicare patients who underwent total hip arthroplasty at a single institution before and after the implementation of GBR...
February 15, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29521892/provider-reimbursement-following-the-affordable-care-act
#9
Brandon Bowling, David Newman, Craig White, Ashley Wood, Alberto Coustasse
Decreasing health care expenditures has been one of the main objectives of the Affordable Care Act. To achieve this goal, the Centers for Medicare and Medicaid Services (CMS) has been tasked with experimenting with provider reimbursement methods in an attempt to increase quality, while decreasing costs. The purpose of this research was to study the effects of the Affordable Care Act on physician reimbursement rates from CMS to determine the most cost-effective method of delivering health care services. The CMS has experimented with payment methods in an attempt to increase cost-effectiveness...
April 2018: Health Care Manager
https://www.readbyqxmd.com/read/29499816/bundle-payment-for-musculoskeletal-care-current-evidence-part-2
#10
REVIEW
Meghan A Piccinin, Zain Sayeed, Ryan Kozlowski, Vamsy Bobba, David Knesek, Todd Frush
In an effort to rein in expenditures and improve quality of care, the Centers for Medicare and Medicaid Services (CMS) has initiated bundled reimbursement programs for total joint arthroplasty (TJA) procedures. The success of CMS's bundled payment models has prompted some private insurers to collaborate with provider organizations to institute similar bundled contracts for TJA. The authors review the experiences of orthopedic groups in the implementation of bundled payments for primary and revision TJA through both public and private payers...
April 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29485951/predicting-acute-exacerbations-in-chronic-obstructive-pulmonary-disease
#11
Jennifer C Samp, Min J Joo, Glen T Schumock, Gregory S Calip, A Simon Pickard, Todd A Lee
BACKGROUND: With increasing health care costs that have outpaced those of other industries, payers of health care are moving from a fee-for-service payment model to one in which reimbursement is tied to outcomes. Chronic obstructive pulmonary disease (COPD) is a disease where this payment model has been implemented by some payers, and COPD exacerbations are a quality metric that is used. Under an outcomes-based payment model, it is important for health systems to be able to identify patients at risk for poor outcomes so that they can target interventions to improve outcomes...
March 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29484218/personalized-cancer-screening-helping-primary-care-rise-to-the-challenge
#12
Kevin Selby, Gillian Bartlett-Esquilant, Jacques Cornuz
With their longitudinal patient relationships, primary care physicians and their care teams are uniquely situated to promote preventive medicine, including cancer screening. A confluence of forces is driving the demand for the personalization of cancer screening recommendations. Recommendations are increasingly based on individual patient preferences, medical history, genetic and environmental risk factors, and level of interaction with the healthcare system. Current examples include choices between colonoscopy, fecal testing, and emerging tests for colorectal cancer (CRC) screening; the use of genetic information and availability of home self-testing in cervical cancer screening; the integration of multiple risk factors and patient preferences to decide the intensity and length of breast cancer screening; and the issues of smoking cessation and competing priorities when deciding whether or not to pursue lung cancer screening...
2018: Public Health Reviews
https://www.readbyqxmd.com/read/29470731/sacral-neuromodulation-versus-personalized-conservative-treatment-in-patients-with-idiopathic-slow-transit-constipation-study-protocol-of-the-no-2-trial-a-multicenter-open-label-randomized-controlled-trial-and-cost-effectiveness-analysis
#13
S C M Heemskerk, A H Rotteveel, M A Benninga, C I M Baeten, A A M Masclee, J Melenhorst, S M J van Kuijk, C D Dirksen, S O Breukink
PURPOSE: The evidence regarding the (cost-)effectiveness of sacral neuromodulation (SNM) in patients with therapy-resistant idiopathic slow-transit constipation is of suboptimal quality. The Dutch Ministry of Health, Welfare and Sports has granted conditional reimbursement for SNM treatment. The objective is to assess the effectiveness, cost-effectiveness, and budget impact of SNM compared to personalized conservative treatment (PCT) in patients with idiopathic slow-transit constipation refractory to conservative treatment...
April 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29453504/financing-the-primary-care-behavioral-health-model
#14
Dennis S Freeman, Lesley Manson, Jeff Howard, Joel Hornberger
The PCBH model of integrated care blends behavioral health professionals into the primary care team, thereby enhancing the scope of primary care and expanding the range of services provided to the patient. Despite promising evidence in support of the model and a growing number of advocates and practitioners of PCBH integration, current reimbursement policies are not always favorable. As the nation's healthcare system transitions to value-based payment models, new financing strategies are emerging which will further support the viability of PCBH integration...
February 16, 2018: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29450469/association-between-bariatric-surgery-and-rates-of-continuation-discontinuation-or-initiation-of-antidiabetes-treatment-6-years-later
#15
Jérémie Thereaux, Thomas Lesuffleur, Sébastien Czernichow, Arnaud Basdevant, Simon Msika, David Nocca, Bertrand Millat, Anne Fagot-Campagna
Importance: Few large-scale long-term prospective cohort studies have assessed changes in antidiabetes treatment after bariatric surgery. Objective: To describe the association between bariatric surgery and rates of continuation, discontinuation, or initiation of antidiabetes treatment 6 years after bariatric surgery compared with a matched control obese group. Design, Setting, and Participants: This nationwide observational population-based cohort study extracted health care reimbursement data from the French national health insurance database from January 1, 2008, to December 31, 2015...
February 14, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29445515/telementoring-with-project-echo-a-pilot-study-in-europe
#16
Clíona Ní Cheallaigh, Aisling O'Leary, Shay Keating, Aileen Singleton, Sheila Heffernan, Eamon Keenan, Lisa Robson, Jess Sears, John Moloney, Sanjeev Arora, Colm Bergin, Suzanne Norris
The Extension of Community Healthcare Outcomes (ECHO) project is a novel educational intervention designed in New Mexico to transfer subspecialty knowledge about hepatitis C virus (HCV) to primary care providers, thereby increasing patient access to HCV care. The ECHO model has been shown to deliver educational benefits and to result in good treatment outcomes for HCV-infected individuals in the USA; however, this approach has not been assessed in a European setting. We sought to evaluate the feasibility, acceptability and implementation of the ECHO model in Ireland using a pilot study...
July 2017: BMJ Innovations
https://www.readbyqxmd.com/read/29420405/rate-of-pelvic-organ-prolapse-surgery-among-privately-insured-women-in-the-united-states-2010-2013
#17
Anne G Sammarco, Carolyn W Swenson, Neil S Kamdar, Emily K Kobernik, John O L DeLancey, Brahmajee Nallamothu, Daniel M Morgan
OBJECTIVE: To analyze utilization of, and payments for, pelvic organ prolapse procedures after the 2011 U.S. Food and Drug Administration (FDA) communication regarding transvaginal mesh. METHODS: This is a retrospective cohort study examining private claims from three insurance providers for inpatient and outpatient prolapse procedures from 2010 to 2013 in the Health Care Cost Institute. Primary outcomes were the change in utilization of prolapse procedures, with and without mesh, before and after the July 2011 FDA communication...
March 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29402306/sustainable-reduction-of-antibiotic-induced-antimicrobial-resistance-arena-in-german-ambulatory-care-study-protocol-of-a-cluster-randomised-trial
#18
Martina Kamradt, Petra Kaufmann-Kolle, Edith Andres, Tonia Brand, Anja Klingenberg, Katharina Glassen, Regina Poß-Doering, Lorenz Uhlmann, Katharina Hees, Dorothea Weber, Andreas Gutscher, Veit Wambach, Joachim Szecsenyi, Michel Wensing
BACKGROUND: Despite many initiatives to enhance the rational use of antibiotics, there remains substantial room for improvement. The overall aim of this study is to optimise the appropriate use of antibiotics in German ambulatory care in patients with acute non-complicated infections (respiratory tract infections, such as bronchitis, sinusitis, tonsillitis and otitis media), community-acquired pneumonia and non-complicated cystitis, in order to counter the advancing antimicrobial resistance development...
February 5, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29378584/development-of-a-5as-based-technology-assisted-weight-management-intervention-for-veterans-in-primary-care
#19
Katrina F Mateo, Natalie B Berner, Natalie L Ricci, Pich Seekaew, Sandeep Sikerwar, Craig Tenner, Joanna Dognin, Scott E Sherman, Adina Kalet, Melanie Jay
BACKGROUND: Obesity is a worldwide epidemic, and its prevalence is higher among Veterans in the United States. Based on our prior research, primary care teams at a Veterans Affairs (VA) hospital do not feel well-equipped to deliver effective weight management counseling and often lack sufficient time. Further, effective and intensive lifestyle-based weight management programs (e.g. VA MOVE! program) are underutilized despite implementation of systematic screening and referral at all VA sites...
January 29, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29371100/the-zika-contraception-access-network-a-feasibility-programme-to-increase-access-to-contraception-in-puerto-rico-during-the-2016-17-zika-virus-outbreak
#20
Eva Lathrop, Lisa Romero, Stacey Hurst, Nabal Bracero, Lauren B Zapata, Meghan T Frey, Maria I Rivera, Erin N Berry-Bibee, Margaret A Honein, Judith Monroe, Denise J Jamieson
BACKGROUND: Prevention of unintended pregnancy is a primary strategy to reduce adverse pregnancy and birth outcomes related to Zika virus infection. The Zika Contraception Access Network (Z-CAN) aimed to build a network of health-care providers offering client-centred contraceptive counselling and the full range of reversible contraception at no cost to women in Puerto Rico who chose to prevent pregnancy during the 2016-17 Zika virus outbreak. Here, we describe the Z-CAN programme design, implementation activities, and baseline characteristics of the first 21 124 participants...
February 2018: Lancet. Public Health
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