keyword
MENU ▼
Read by QxMD icon Read
search

Payment reform

keyword
https://www.readbyqxmd.com/read/29618391/provider-payment-to-primary-care-physicians-in-china-background-challenges-and-a-reform-framework
#1
Xiaoying Pu, Yaming Gu, Xiaohe Wang
AIM: To provide a framework for provider payment reform for primary care physicians in China. BACKGROUND: Primary health care is central to health system reform and payment incentives have significant consequences for the equity and efficiency of it. METHODS: This paper describes the special payments system for public primary health institutions and the subsequent internal salary remuneration to primary care physicians in China. Based on an analysis of the major challenges, we suggest a reform framework including the pattern of governance, and payments to primary health institutions and employed physicians...
April 5, 2018: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/29616500/effect-of-obesity-on-postacute-outcomes-of-skilled-nursing-facility-residents-with-hip-fracture
#2
Cyrus M Kosar, Kali S Thomas, Pedro L Gozalo, Jessica A Ogarek, Vincent Mor
OBJECTIVES: To examine the effect of obesity (body mass index (BMI)≥30.0 kg/m2 ) on outcomes of older adults admitted to skilled nursing facilities (SNFs) for hip fracture postacute care (PAC). DESIGN: Retrospective cohort study. SETTING: U.S. Medicare- and Medicaid-certified SNFs from 2008 to 2015. PARTICIPANTS: Medicare fee-for-service beneficiaries discharged to a SNF after hospitalization for hip fracture (N=586,683; n=82,768 (14...
April 3, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29601630/overcoming-challenges-to-us-payment-reform-could-a-place-based-approach-help
#3
Adam D M Briggs, Hugh Alderwick, Elliott S Fisher
No abstract text is available yet for this article.
March 30, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29595464/purchasers-to-insurers-standardize-your-aco-measures
#4
Sarah Kwon
Building on a similar effort in California, Catalyst for Payment Reform is proposing a standardized set of 50 ACO measures. A timely development. In the first quarter of last year, an estimated 19.1 million lives were covered by 715 commercial ACOs, compared with 17.2 million lives a year earlier.
March 2018: Managed Care
https://www.readbyqxmd.com/read/29573463/decomposing-inequality-in-financial-protection-situation-in-iran-after-implementing-the-health-reform-plan-what-does-the-evidence-show-based-on-national-survey-of-households-budget
#5
Tayebeh Moradi, Seyran Naghdi, Heather Brown, Hesam Ghiasvand, Mohammadreza Mobinizadeh
BACKGROUND: Lack of well-designed healthcare financing mechanisms and high level of out-of-pocket payments in Iran over the last decades led to implementing Health Transformation Plan, in 2014. This study aims to decompose inequality in financial protection of Iranian households after the implementation of the Health Transformation Plan. METHODS: The data of Statistical Center of Iran (SCI) Survey on Rural and Urban Households Income-Expenditure in 2015 to 2016 were used...
March 24, 2018: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/29572707/prescription-drug-use-and-cost-trends-among-medicaid-enrolled-children-with-disruptive-behavioral-disorders
#6
Lirong Zhao, Caitlin Cross-Barnet, Vetisha L McClair
Disruptive behavior disorders (DBDs) are the most common mental health conditions in children. These conditions profoundly affect healthcare utilization and costs. Service use, costs, and diagnostic trends among pediatric Medicaid beneficiaries provide information regarding healthcare quality and potential for smarter spending. Using nationwide Medicaid administrative data, this study investigates diagnoses, prescription drug fills, and payments in 49 states and D.C. from 2006 to 2009 in Medicaid beneficiaries age 20 and under...
March 23, 2018: Journal of Behavioral Health Services & Research
https://www.readbyqxmd.com/read/29553283/improving-quality-of-care-in-oncology-through-healthcare-payment-reform
#7
Lonnie Wen, Christine Divers, Melissa Lingohr-Smith, Jay Lin, Scott Ramsey
OBJECTIVES: To provide an overview of alternative payment models (APMs) and describe how leading national organizations involved with oncology care and payment are linking quality improvement initiatives and payment reform. STUDY DESIGN: Literature review. METHODS: For this review, we summarized the literature on APMs and their goals of improving healthcare quality while jointly controlling the cost of care. We described the types of APMs that have been examined in the real-world setting, specifically in the area of oncology, and how they have affected the quality of oncology care...
March 1, 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29553080/china-s-achievements-and-challenges-in-improving-health-insurance-coverage
#8
Cuirong Zhao, Chao Wang, Chengwu Shen, Qian Wang
China has undertaken waves of healthcare reforms to keep pace with its rapid economic growth. By 2011, universal health insurance coverage was successfully achieved through the creation of a basic social medical insurance system. Growing economic power, extensive government subsidies, and strategies for program implementation are critical to that achievement. However, the breadth and depth of coverage varies considerably across insurance schemes and localities. The disjointed insurance scheme led to inequality in coverage, accessibility, and affordability of medical services, lopsided allocation of health resources, and increasing medical expenditures, and these remain crucial challenges for healthcare insurance coverage...
2018: Drug Discoveries & Therapeutics
https://www.readbyqxmd.com/read/29549661/does-%C3%A2-1-per-prescription-make-a-difference-impact-of-a-capped-low-intensity-pharmaceutical-co-payment
#9
Pilar García-Gómez, Toni Mora, Jaume Puig-Junoy
BACKGROUND: Increasing patient contributions and reducing the population exempt from pharmaceutical co-payment and co-insurance rates were one of the most common measures in the reforms adopted in Europe during 2010-2015. OBJECTIVE: We estimated the association between the introduction of a capped co-payment of €1 per prescription and drug consumption of the publicly insured population of Catalonia (Spain). METHODS: We used administrative data on monthly pharmaceutical consumption (defined daily doses [DDDs]) from January 2012 to December 2014, for a representative sample of 85,000 people...
March 16, 2018: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/29544708/society-of-gynecologic-oncology-future-of-physician-payment-reform-task-force-report-the-endometrial-cancer-alternative-payment-model-ecap
#10
Emily M Ko, Laura J Havrilesky, Ronald D Alvarez, Oliver Zivanovic, Leslie R Boyd, Elizabeth L Jewell, Patrick F Timmins, Randall S Gibb, Anuja Jhingran, David E Cohn, Sean C Dowdy, Matthew A Powell, Eva Chalas, Yongmei Huang, Jill Rathbun, Jason D Wright
Health care in the United States is in the midst of a significant transformation from a "fee for service" to a "fee for value" based model. The Medicare Access and CHIP Reauthorization Act of 2015 has only accelerated this transition. Anticipating these reforms, the Society of Gynecologic Oncology developed the Future of Physician Payment Reform Task Force (PPRTF) in 2015 to develop strategies to ensure fair value based reimbursement policies for gynecologic cancer care. The PPRTF elected as a first task to develop an Alternative Payment Model for thesurgical management of low risk endometrial cancer...
March 12, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29537697/hepatology-in-a-changing-health-care-landscape-a-call-for-health-services-research
#11
Lisa B VanWagner, Fasiha Kanwal
With the passage of the Affordable Care Act (ACA) followed by the physician payment reform, there is an urgent need to better understand the complex relationships between structure (including incentives), processes, and outcomes of health care and, based on this understanding, identify interventions that can ensure delivery of high value care to patients with liver disease. As hepatologists, how do we systematically address these issues and ensure that we provide high-value care to our patients? These factors combine in the burgeoning field of health services research...
March 14, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29530670/policy-change-is-not-enough-engaging-provider-champions-on-immediate-postpartum-contraception
#12
Ekwutosi M Okoroh, Debra J Kane, Rebekah E Gee, Lyn Kieltyka, Brittni N Frederiksen, Katharyn M Baca, Kristin M Rankin, David A Goodman, Charlan D Kroelinger, Wanda D Barfield
Rates of short interval pregnancies resulting in unintended pregnancies remain high in the United States and contribute to adverse reproductive health outcomes. Long-acting reversible contraception (LARC) methods have annual failure rates of less than 1% compared with 9% for oral contraceptive pills, and are an effective strategy to reduce unintended pregnancies. To increase access to LARCs in the immediate postpartum period, several State Medicaid programs, including those in Iowa (IA) and Louisiana (LA), recently established reimbursement policies to remove the barriers to reimbursement of immediate postpartum LARC insertion...
March 9, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29523121/caesarean-section-rate-and-cost-control-effectiveness-of-case-payment-reform-in-the-new-cooperative-medical-scheme-for-delivery-evidence-from-xi-county-china
#13
Shuang Liu, Jing Wang, Liang Zhang, Xiang Zhang
BACKGROUND: In China, increases in both the caesarean section (CS) rates and delivery costs have raised questions regarding the reform of the medical insurance payment system. Case payment is useful for regulating the behaviour of health providers and for controlling the CS rates and excessive increases in medical expenses. New Cooperative Medical Scheme (NCMS) agencies in Xi County in Henan Province piloted a case payment reform (CPR) in delivery for inpatients. We aimed to observe the changes in the CS rates, compare the changes in delivery-related variables, and identify variables related to delivery costs before and after the CPR in Xi County...
March 9, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29514639/aligning-policy-objectives-and-payment-design-in-palliative-care
#14
Stephen Duckett
BACKGROUND: Payment models for palliative care vary across nations, with few adopting contemporary payments designs that apply to other parts of the health system. AIM: To propose optimal payment arrangements for palliative care. APPROACH: Review of relevant literature on funding mechanisms in health care generally and palliative care in particular. RESULTS: Payment models for palliative care should move toward activity-based funding using an agreed classification, be uncapped funding with performance monitoring, and make explicit use of performance metrics and reporting...
March 7, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29513863/referral-system-in-rural-iran-improvement-proposals
#15
Mansour Naseriasl, Ali Janati, Abolgasem Amini, Davoud Adham
Because of insufficient communication between primary health care providers and specialists, which leads to inefficiencies and ineffectiveness in rural population health outcomes, to implement a well-functioning referral system is one of the most important tasks for some countries. Using purposive and snowballing sampling methods, we included health experts, policy-makers, family physicians, clinical specialists, and experts from health insurance organizations in this study according to pre-determined criteria...
March 5, 2018: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/29513712/impact-of-universal-medical-insurance-system-on-the-accessibility-of-medical-service-supply-and-affordability-of-patients-in-china
#16
Xiaolei Xiong, Zhiguo Zhang, Jing Ren, Jie Zhang, Xiaoyun Pan, Liang Zhang, Shiwei Gong, Si Jin
BACKGROUND: China's universal medical insurance system (UMIS) is designed to promote social fairness through improving access to medical services and reducing out-of-pocket (OOP) costs for all Chinese. However, it is still not known whether UMIS has a significant impact on the accessibility of medical service supply and the affordability, as well as the seeking-care choice, of patients in China. METHODS: Segmented time-series regression analysis, as a powerful statistical method of interrupted time series design, was used to estimate the changes in the quantity and quality of medical service supply before and after the implementation of UMIS...
2018: PloS One
https://www.readbyqxmd.com/read/29508113/legislative-and-policy-developments-and-imperatives-for-advancing-the-primary-care-behavioral-health-pcbh-model
#17
Dennis S Freeman, Cathy Hudgins, Joel Hornberger
The Primary Care Behavioral Health (PCBH) practice model continues to gain converts among primary care and behavioral health professionals as the evidence supporting its effectiveness continues to accumulate. Despite a growing number of practices and organizations using the model effectively, widespread implementation has been hampered by outmoded policies and regulatory barriers. As policymakers and legislators begin to recognize the contributions that PCBH model services make to the care of complex patients and the expansion of access to those in need of behavioral health interventions, some encouraging policy initiatives are emerging and the policy environment is becoming more favorable to implementation of the PCBH model...
March 5, 2018: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29458428/a-review-of-promoting-access-to-medicines-in-china-problems-and-recommendations
#18
Jing Sun, Cecile Jia Hu, Mark Stuntz, Hans Hogerzeil, Yuanli Liu
BACKGROUND: Despite recent reforms, distorting funding mechanisms and over-prescribing still maintain severe financial barriers to medicines access in China. Complicated and interrelated problems in the pharmaceutical sector require a common framework to be resolved as fragmented solutions do not work. We present a preliminary assessment of the impact of the national healthcare reforms on access to medicines, and propose policy recommendations for promoting universal access to medicines in China...
February 20, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29452560/health-care-efficiencies-consolidation-and-alternative-models-vs-health-care-and-antitrust-regulation-irreconcilable-differences
#19
Michael W King
Despite the U.S. substantially outspending peer high income nations with almost 18% of GDP dedicated to health care, on any number of statistical measurements from life expectancy to birth rates to chronic disease, 1 the U.S. achieves inferior health outcomes. In short, Americans receive a very disappointing return on investment on their health care dollars, causing economic and social strain. 2 Accordingly, the debates rage on: what is the top driver of health care spending? Among the culprits: poor communication and coordination among disparate providers, paperwork required by payors and regulations, well-intentioned physicians overprescribing treatments, drugs and devices, outright fraud and abuse, and medical malpractice litigation...
November 2017: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29443647/system-level-health-care-integration-and-the-costs-of-cancer-care-across-the-disease-continuum
#20
Deborah R Kaye, Hye Sung Min, Edward C Norton, Zaojun Ye, Jonathan Li, James M Dupree, Chad Ellimoottil, David C Miller, Lindsey A Herrel
PURPOSE: Policy reforms in the Affordable Care Act encourage health care integration to improve quality and lower costs. We examined the association between system-level integration and longitudinal costs of cancer care. METHODS: We used linked SEER-Medicare data to identify patients age 66 to 99 years diagnosed with prostate, bladder, esophageal, pancreatic, lung, liver, kidney, colorectal, breast, or ovarian cancer from 2007 to 2012. We attributed each patient to one or more phases of care (ie, initial, continuing, and end of life) according to time from diagnosis until death or end of study interval...
March 2018: Journal of Oncology Practice
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"