keyword
MENU ▼
Read by QxMD icon Read
search

Payment reform

keyword
https://www.readbyqxmd.com/read/28107703/how-universal-is-coverage-and-access-to-diagnosis-and-treatment-for-chagas-disease-in-colombia-a-health-systems-analysis
#1
Zulma M Cucunubá, Jennifer M Manne-Goehler, Diana Díaz, Pierre Nouvellet, Oscar Bernal, Andrea Marchiol, María-Gloria Basáñez, Lesong Conteh
Limited access to Chagas disease diagnosis and treatment is a major obstacle to reaching the 2020 World Health Organization milestones of delivering care to all infected and ill patients. Colombia has been identified as a health system in transition, reporting one of the highest levels of health insurance coverage in Latin America. We explore if and how this high level of coverage extends to those with Chagas disease, a traditionally marginalised population. Using a mixed methods approach, we calculate coverage for screening, diagnosis and treatment of Chagas...
January 4, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28103923/risk-adjustment-methods-for-all-payer-comparative-performance-reporting-in-vermont
#2
Karl Finison, MaryKate Mohlman, Craig Jones, Melanie Pinette, David Jorgenson, Amy Kinner, Tim Tremblay, Daniel Gottlieb
BACKGROUND: As the emphasis in health reform shifts to value-based payments, especially through multi-payer initiatives supported by the U.S. Center for Medicare & Medicaid Innovation, and with the increasing availability of statewide all-payer claims databases, the need for an all-payer, "whole-population" approach to facilitate the reporting of utilization, cost, and quality measures has grown. However, given the disparities between the different populations served by Medicare, Medicaid, and commercial payers, risk-adjustment methods for addressing these differences in a single measure have been a challenge...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28073062/effects-of-payment-reform-in-more-versus-less-competitive-markets
#3
Neeraj Sood, Abby Alpert, Kayleigh Barnes, Peter Huckfeldt, José J Escarce
Policymakers are increasingly interested in reducing healthcare costs and inefficiencies through innovative payment strategies. These strategies may have heterogeneous impacts across geographic areas, potentially reducing or exacerbating geographic variation in healthcare spending. In this paper, we exploit a major payment reform for home health care to examine whether reductions in reimbursement lead to differential changes in treatment intensity and provider costs depending on the level of competition in a market...
December 30, 2016: Journal of Health Economics
https://www.readbyqxmd.com/read/28072793/merit-based-incentive-payment-system-meaningful-changes-in-the-final-rule-brings-cautious-optimism
#4
Laxmaiah Manchikanti, Standiford Helm Ii, Aaron K Calodney, Joshua A Hirsch
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) eliminated the flawed Sustainable Growth Rate (SGR) act formula - a longstanding crucial issue of concern for health care providers and Medicare beneficiaries. MACRA also included a quality improvement program entitled, "The Merit-Based Incentive Payment System, or MIPS." The proposed rule of MIPS sought to streamline existing federal quality efforts and therefore linked 4 distinct programs into one. Three existing programs, meaningful use (MU), Physician Quality Reporting System (PQRS), value-based payment (VBP) system were merged with the addition of Clinical Improvement Activity category...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28069855/prevalence-and-spending-associated-with-patients-who-have-a-behavioral-health-disorder-and-other-conditions
#5
Ken Thorpe, Sanjula Jain, Peter Joski
: People with multiple medical conditions are a growing and increasingly costly segment of the U.S. POPULATION: Despite the co-occurrence of physical and behavioral health comorbidities, the US health care system tends to treat these conditions separately rather than holistically. To identify opportunities for population health improvement, we examined the treated prevalence of and health care spending on behavioral health disorders, by the number of coexisting physical disorders, among noninstitutionalized adults...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069851/less-intense-postacute-care-better-outcomes-for-enrollees-in-medicare-advantage-than-those-in-fee-for-service
#6
Peter J Huckfeldt, José J Escarce, Brendan Rabideau, Pinar Karaca-Mandic, Neeraj Sood
Traditional fee-for-service (FFS) Medicare's prospective payment systems for postacute care provide little incentive to coordinate care or control costs. In contrast, Medicare Advantage plans pay for postacute care out of monthly capitated payments and thus have stronger incentives to use it efficiently. We compared the use of postacute care in skilled nursing and inpatient rehabilitation facilities by enrollees in Medicare Advantage and FFS Medicare after hospital discharge for three high-volume conditions: lower extremity joint replacement, stroke, and heart failure...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28068138/payment-reform-in-the-patient-centered-medical-home-enabling-and-sustaining-integrated-behavioral-health-care
#7
Benjamin F Miller, Kaile M Ross, Melinda M Davis, Stephen P Melek, Roger Kathol, Patrick Gordon
The patient-centered medical home (PCMH) is a promising framework for the redesign of primary care and more recently specialty care. As defined by the Agency for Healthcare Research and Quality, the PCMH framework has 5 attributes: comprehensive care, patient-centered care, coordinated care, accessible services, and quality and safety. Evidence increasingly demonstrates that for the PCMH to best achieve the Triple Aim (improved outcomes, decreased cost, and enhanced patient experience), treatment for behavioral health (including mental health, substance use, and life stressors) must be integrated as a central tenet...
January 2017: American Psychologist
https://www.readbyqxmd.com/read/28065452/value-based-approaches-for-emergency-care-in-a-new-era
#8
Laura Medford-Davis, David Marcozzi, Shantanu Agrawal, Brendan G Carr, Emily Carrier
Although emergency departments (EDs) play an integral role in the delivery of acute unscheduled care, they have not been fully integrated into broader health care reform efforts. Communication and coordination with the ambulatory environment remain limited, leaving ED care disconnected from patients' longitudinal care. In a value-based environment focused on improving quality, decreasing costs, enhancing population health, and improving the patient experience, this oversight represents a missed opportunity for emergency care...
January 5, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28061965/report-of-the-acr-s-economics-committee-on-value-based-payment-models
#9
Giles W Boland, Lucille Glenn, Shlomit Goldberg-Stein, Saurabh Jha, Mark Mangano, Samir Patel, Kurt A Schoppe, David Seidenwurm, John Lohnes, Ezequiel Silva, Richard Abramson, Daniel J Durand, Laura Pattie, Pamela Kassing, Richard E Heller
A major outcome of the current health care reform process is the move away from unrestricted fee-for-service payment models toward those that are based on the delivery of better patient value and outcomes. The authors' purpose, therefore, is to critically evaluate and define those components of the overall imaging enterprise that deliver meaningful value to both patients and referrers and to determine how these components might be measured and quantified. These metrics might then be used to lobby providers and payers for sustainable payment solutions for radiologists and radiology services...
January 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28057203/expanding-public-health-in-china-an-empirical-analysis-of-healthcare-inputs-and-outputs
#10
F Deng, J H Lv, H L Wang, J M Gao, Z L Zhou
OBJECTIVES: The Chinese Government claims that China's health policy is primarily focused on prevention. However, this does not appear to be the case. Researchers with an interest in China's health policy may be aware that the Chinese Government launched a health reform in 2009 to improve the health status of the entire population by 2020.(1) This health reform has been in place for 7 years, and only 4 years now remain to achieve the overall objectives by 2020. This study analyzed the main inputs and outputs of China's health reform in order to identify the main problems and highlight the major challenges...
January 2017: Public Health
https://www.readbyqxmd.com/read/28011159/the-impact-of-state-tort-reforms-on-imaging-utilization
#11
Suhui Li, Avi Dors, Darwyyn Deyo, Danny R Hughes
PURPOSE: Defensive medicine, broadly defined as medical practices that protect physicians from malpractice lawsuits without providing benefits to patients, can lead to wasteful use of health care resources and higher cost. Although physicians cite malpractice liability as an important factor driving their decisions to order imaging tests, little research has been done to examine the systematic impact of liability pressure on overall imaging. The authors examined the extent to which radiography use is influenced by malpractice liability pressure among office-based physicians...
December 20, 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28004380/impact-of-health-system-affiliation-on-hospital-resource-use-intensity-and-quality-of-care
#12
Rachel Mosher Henke, Zeynal Karaca, Brian Moore, Eli Cutler, Hangsheng Liu, William D Marder, Herbert S Wong
OBJECTIVE: To assess the impact of hospital affiliation, centralization, and managed care plan ownership on inpatient cost and quality. DATA SOURCES: Inpatient discharges from 3,957 community hospitals in 44 states and American Hospital Association Annual Survey data from 2010 to 2012. STUDY DESIGN: We conducted a retrospective longitudinal regression analysis using hierarchical modeling of discharges clustered within hospitals. DATA COLLECTION: Detailed discharge data including costs, length of stay, and patient characteristics from the Healthcare Cost and Utilization Project State Inpatient Databases were merged with hospital survey data from the American Hospital Association...
December 22, 2016: Health Services Research
https://www.readbyqxmd.com/read/27993960/patterns-of-informal-patient-payments-in-bulgaria-hungary-and-ukraine-a-comparison-across-countries-years-and-type-of-services
#13
Tetiana Stepurko, Milena Pavlova, Irena Gryga, Péter Gaál, Wim Groot
Informal payments for health care are a well-known phenomenon in many health care systems around the world. While informal payments could be an important source of health care financing, they have an adverse impact on efficiency and access to care, and are a major impediment to ongoing health care reforms. This paper aims to study the scale and patterns of informal patient payments for out-patient and in-patient services in three former-socialist countries: Bulgaria, Hungary and Ukraine. The data are collected in 2010 and 2011 based on national representative samples and are analysed in pooled models to explain variations in payments...
December 19, 2016: Health Policy and Planning
https://www.readbyqxmd.com/read/27993434/competition-policy-for-health-care-provision-in-france
#14
Philippe Choné
There are more than two thousand hospitals in France, about equally divided between government-owned and privately-owned hospitals. Activity-based payment, which has been generalized in 2008 for acute care hospitals, has raised competition issues as DRG tariffs differ according to ownership status. Furthermore, the payment rule has been criticized for preventing the realization of potential hospital synergies, and as a result a recent reform has mandated close cooperation between public hospitals. The physician market is dual, with most GPs being subject to fee regulation and many self-employed, private-practice, specialist doctors being allowed to set their prices freely...
November 24, 2016: Health Policy
https://www.readbyqxmd.com/read/27982667/accountable-care-organization-hospitals-differ-in-health-it-capabilities
#15
Daniel M Walker, Arthur M Mora, Ann Scheck McAlearney
OBJECTIVES: The aim of this study was to evaluate health information technology (IT) adoption in hospitals participating in accountable care organizations (ACOs) and compare this adoption to non-ACO hospitals. STUDY DESIGN: A cross-sectional sample of US nonfederal, acute care hospitals with data from 3 matched sources: the 2013 American Hospital Association (AHA) Annual Survey, the 2013 AHA Survey of Care Systems and Payments (CSP), and the 2014 AHA Information Technology Supplement...
December 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27934539/healthcare-reform-in-the-middle-east-and-the-usa
#16
Mustafa Z Younis
Mustafa Z Younis speaks to Laura Dormer, Commissioning Editor: Dr Mustafa Z Younis is an internationally recognized scholar and was a member of the Executive Committee of the International Society for Research of Healthcare Financial Management. Dr Younis has authored and published over 200 articles, abstracts and presentations in refereed journals and meetings, and has presented at national and international conferences. Dr Younis has administrative experience as Senior Adviser for the President at Zirve University, Turkey and as Chair of the Department of Health Policy and Management at Florida International University (FL, USA) where he led the accreditation efforts for the Healthcare Management Program...
January 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/27916434/competition-policy-for-health-care-provision-in-norway
#17
Kurt R Brekke, Odd Rune Straume
Competition policy has played a very limited role for health care provision in Norway. The main reason is that Norway has a National Health Service (NHS) with extensive public provision and a wide set of sector-specific regulations that limit the scope for competition. However, the last two decades, several reforms have deregulated health care provision and opened up for provider competition along some dimensions. For specialised care, the government has introduced patient choice and (partly) activity (DRG) based funding, but also corporatised public hospitals and allowed for more private provision...
November 23, 2016: Health Policy
https://www.readbyqxmd.com/read/27905941/financing-strategies-to-improve-essential-public-health-equalization-and-its-effects-in-china
#18
Li Yang, Li Sun, Liankui Wen, Huyang Zhang, Chenyang Li, Kara Hanson, Hai Fang
BACKGROUND: In 2009, China launched a health reform to promote the equalization of national essential public health services package (NEPHSP). The present study aimed to describe the financing strategies and mechanisms to improve access to public health for all, identify the strengths and weaknesses of the different approaches, and showed evidence on equity improvement among different regions. METHODS: We reviewed the relevant literatures and identified 208 articles after screening and quality assessment and conducted six key informants' interviews...
December 1, 2016: International Journal for Equity in Health
https://www.readbyqxmd.com/read/27893519/effects-of-hospital-systems-on-medical-home-transformation-in-primary-care-residency-training-practices
#19
Kyle Knierim, Tristen Hall, Douglas Fernald, Thomas J Staff, Emilie Buscaj, Jessica Cornett Allen, Mary Onysko, W Perry Dickinson
Most primary care residency training practices have close financial and administrative relationships with teaching hospitals and health systems. Many residency practices have begun integrating the core principles of the patient-centered medical home (PCMH) into clinical workflows and educational experiences. Little is known about how the relationships with hospitals and health systems affect these transformation efforts. Data from the Colorado Residency PCMH Project were analyzed. Results show that teaching hospitals and health systems have significant opportunities to influence residency practices' transformation, particularly in the areas of supporting team-based care, value-based payment reforms, and health information technology...
November 23, 2016: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27887667/from-instinct-to-evidence-the-role-of-data-in-country-decision-making-in-chile
#20
Ximena Paz Aguilera, Consuelo Espinosa-Marty, Carla Castillo-Laborde, Claudia Gonzalez
BACKGROUND: The Chilean health system has undergone profound reforms since 1990, while going through many political upheavals, and faced demographic, health, and economic transformations. The full information requirements to develop an evidence-informed process implied the best possible use of available data, as well as efforts for improving the information systems. OBJECTIVE: To examine, from a historical perspective, the use of data during the health reforms undertaken in Chile since 1990, and to identify the factors that have determined its utilization and improvement...
2016: Global Health Action
keyword
keyword
117118
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"