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https://www.readbyqxmd.com/read/29443647/system-level-health-care-integration-and-the-costs-of-cancer-care-across-the-disease-continuum
#1
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...
February 13, 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29439895/adding-value-to-total-joint-arthroplasty-care-in-an-academic-environment-the-utah-experience
#2
Christopher E Pelt, Mike B Anderson, Jill A Erickson, Jeremy M Gililland, Christopher L Peters
BACKGROUND: Adding value in a university-based academic health care system provides unique challenges when compared to other health care delivery models. Herein, we describe our experience in adding value to joint arthroplasty care at the University of Utah, where the concept of value-based health care reform has become an embraced and driving force. METHODS: To improve the value, new resources were needed for care redesign, physician leadership, and engagement in alternative payment models...
February 10, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29433491/barriers-to-delivering-mental-health-services-in-georgia-with-an-economic-and-financial-focus-informing-policy-and-acting-on-evidence
#3
Lela Sulaberidze, Stuart Green, Ivdity Chikovani, Maia Uchaneishvili, George Gotsadze
BACKGROUND: Whilst there is recognition that the global burden of disease associated with mental health disorders is significant, the economic resources available, especially in Low and Middle Income Countries, are particularly scarce. Identifying the economic (system) and financial (individual) barriers to delivering mental health services and assessing the opportunities for reform can support the development of strategies for change. METHODS: A mixed methods study was developed, which engaged with a range of stakeholders from mental health services, including key informants, service managers, healthcare professional and patients and their care-takers...
February 13, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29427179/evaluating-the-quality-of-patient-decision-making-regarding-post-acute-care
#4
Robert E Burke, Jacqueline Jones, Emily Lawrence, Amy Ladebue, Roman Ayele, Chelsea Leonard, Brandi Lippmann, Daniel D Matlock, Rebecca Allyn, Ethan Cumbler
BACKGROUND: Despite a national focus on post-acute care brought about by recent payment reforms, relatively little is known about how hospitalized older adults and their caregivers decide whether to go to a skilled nursing facility (SNF) after hospitalization. OBJECTIVE: We sought to understand to what extent hospitalized older adults and their caregivers are empowered to make a high-quality decision about utilizing an SNF for post-acute care and what contextual or process elements led to satisfaction with the outcome of their decision once in SNF...
February 9, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29426165/cap-payments-and-agricultural-ghg-emissions-in-italy-a-farm-level-assessment
#5
Silvia Coderoni, Roberto Esposti
The Common Agricultural Policy (CAP) is an important external driver of European agricultural production. Nowadays and in its envisioned future structure post-2020, the CAP has among its major objectives tackling climate change, for what concerns both adaptation and mitigation strategies. However, little is known about the link between past CAP reforms and agricultural greenhouse gases (GHG) emissions. This paper investigates the possible role played by the Fischler Reform (FR) on the agricultural GHG emissions at the farm level...
January 29, 2018: Science of the Total Environment
https://www.readbyqxmd.com/read/29419821/the-use-of-individual-provider-performance-reports-by-us-hospitals
#6
Joshua A Rolnick, Kira L Ryskina
Medicare reimbursement for hospitals is increasingly tied to performance. The use of individual provider performance reports offers the potential to improve clinical outcomes through social comparison, and isolated cases of clinical dashboard uses at specific institutions have been previously reported. However, little is known about overall trends in how hospitals use the electronic health record to track and provide feedback on provider performance. We used data from 2013 to 2015 from the American Hospital Association (AHA) Annual Survey Information Technology Supplement, which asked hospitals if they have used electronic data to create performance profiles...
February 7, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29414261/the-affordable-care-act-what-s-next
#7
Mark McClellan, Mark Japinga
The postelection efforts to repeal, replace, or modify the Affordable Care Act (ACA) suggest that the debate over healthcare coverage will remain contentious, particularly because of the high and rising cost of health care. Feasible, potentially bipartisan approaches to improving access to coverage should emphasize reforming health care to achieve higher quality at a lower cost. In the individual market, where many enrollees face limited options and rising premiums, a combination of high-risk pools, reinsurance, and risk adjustment could improve coverage options while encouraging innovations in care for the highest-risk patients...
January 29, 2018: Annual Review of Medicine
https://www.readbyqxmd.com/read/29401027/integrating-social-needs-into-health-care-a-twenty-year-case-study-of-adaptation-and-diffusion
#8
Rebecca D Onie, Risa Lavizzo-Mourey, Thomas H Lee, James S Marks, Rocco J Perla
The US health care system has recently begun to account for patients' unmet social needs in care delivery and payment reform. This article presents a twenty-year qualitative case study of five stages of diffusion-testing and learning, standardization, replication, shifting from doing to enabling, and catalyzing broad adoption-of a practical approach for integrating social needs into clinical care. This case study of Health Leads and its funders confirms the importance of focusing on a clear aim, investing in model testing and standardization to enable subsequent responsiveness to the market, and the willingness of innovators and their investors to cede control of a model to allow local adaption and accelerate broad adoption...
February 2018: Health Affairs
https://www.readbyqxmd.com/read/29374822/analysis-of-multi-drug-resistant-tuberculosis-mdr-tb-financial-protection-policy-mdr-tb-health-insurance-schemes-in-chhattisgarh-state-india
#9
Debashish Kundu, Nandini Sharma, Sarabjit Chadha, Samia Laokri, George Awungafac, Lai Jiang, Miqdad Asaria
INTRODUCTION: There are significant financial barriers to access treatment for multi drug resistant tuberculosis (MDR-TB) in India. To address these challenges, Chhattisgarh state in India has established a MDR-TB financial protection policy by creating MDR-TB benefit packages as part of the universal health insurance scheme that the state has rolled out in their effort towards attaining Universal Health Coverage for all its residents. In these schemes the state purchases health insurance against set packages of services from third party health insurance agencies on behalf of all its residents...
January 27, 2018: Health Economics Review
https://www.readbyqxmd.com/read/29373587/qualitative-analysis-of-the-dynamics-of-policy-design-and-implementation-in-hospital-funding-reform
#10
Karen S Palmer, Adalsteinn D Brown, Jenna M Evans, Husayn Marani, Kirstie K Russell, Danielle Martin, Noah M Ivers
BACKGROUND: As in many health care systems, some Canadian jurisdictions have begun shifting away from global hospital budgets. Payment for episodes of care has begun to be implemented. Starting in 2012, the Province of Ontario implemented hospital funding reforms comprising three elements: Global Budgets; Health Based Allocation Method (HBAM); and Quality-Based Procedures (QBP). This evaluation focuses on implementation of QBPs, a procedure/diagnosis-specific funding approach involving a pre-set price per episode of care coupled with best practice clinical pathways...
2018: PloS One
https://www.readbyqxmd.com/read/29360300/healthcare-reform-payment-reform
#11
(no author information available yet)
No abstract text is available yet for this article.
December 26, 2017: Issue Brief of the Health Policy Tracking Service
https://www.readbyqxmd.com/read/29338994/both-patients-and-maternity-care-providers-can-benefit-from-payment-reform-four-steps-to-prepare
#12
Malini A Nijagal, Neel T Shah, Jeff Levin-Scherz
Many Medicaid programs and private health plans are implementing new models of maternity care reimbursement, and clinicians face mounting pressure to demonstrate high quality care at lower cost. Clinicians will be better prepared to meet these challenges with a fuller understanding of new payment models and the opportunities they present. We describe the structure of maternity care "episode payments" and recommend four ways that clinicians can prepare for success as value-based payment models are implemented: identify opportunities to improve outcomes and experience, measure quality, reduce waste and work in teams across settings...
January 12, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29284470/improving-equity-in-health-care-financing-in-china-during-the-progression-towards-universal-health-coverage
#13
Mingsheng Chen, Andrew J Palmer, Lei Si
BACKGROUND: China is reforming the way it finances health care as it moves towards Universal Health Coverage (UHC) after the failure of market-oriented mechanisms for health care. Improving financing equity is a major policy goal of health care system during the progression towards universal coverage. METHODS: We used progressivity analysis and dominance test to evaluate the financing channels of general taxation, pubic health insurance, and out-of-pocket (OOP) payments...
December 29, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29274916/healthcare-reforms-in-cyprus-2013-2017-does-the-crisis-mark-the-end-of-the-healthcare-sector-as-we-know-it
#14
Panagiotis Petrou, Sotiris Vandoros
As part of a bailout agreement with the International Monetary Fund, the European Commission and the European Central Bank (known as the Troika), Cyprus had to achieve a fiscal surplus through budget constraints and efficiency enhancement. As a result, a number of policy changes were implemented, including a reform of the healthcare sector, and major healthcare reforms are planned for the upcoming years, mainly via the introduction of a National Health System. This paper presents the healthcare sector, provides an overview of recent reforms, assesses the recently implemented policies and proposes further interventions...
November 11, 2017: Health Policy
https://www.readbyqxmd.com/read/29261249/real-world-economic-value-of-a-21-gene-assay-in-early-stage-breast-cancer
#15
Stanley E Waintraub, Donna McNamara, Deena Mary Atieh Graham, Andrew L Pecora, John Min, Tommy Wu, Hyun Gi Noh, Jacqueline Connors, Ruth Pe Benito, Kelly Choi, Eric Schultz, Stuart L Goldberg
OBJECTIVES: Value-based payment reforms shift cost-containment responsibilities to the physician. Although gene expression profiling (GEP) utilizing a 21-gene panel among patients with early-stage, axillary lymph node-negative, hormone receptor-positive, HER2/neu oncogene-negative breast cancer is able to identify a cohort that may achieve excellent outcomes without adjuvant chemotherapy, high up-front costs (list price, $4175) could dissuade usage. STUDY DESIGN: Retrospective review of consecutive patients with breast cancer treated at a single cancer center...
December 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29259949/the-evaluation-of-urban-community-health-centers-in-relation-to-family-physician-and-primary-health-care-in-southern-iran
#16
Mohammad Reza Heydari, Ahmad Kalateh Sadati, Kamran Bagheri Lankarani, Mohamma Hadi Imanieh, Homataj Baghi, Mohammad Javad Lolia
Background: Shiraz University of Medical Sciences, Iran has developed a new version of health urban posts called Urban Community Health Center (UCHC) with primary aim of improving primary health care (PHC) in urban areas. The aim of present study was to evaluate this newly developed model of UCHC in Ghaleno, a suburban region of Shiraz, Iran in 2014. Methods: Besides descriptive analysis of foregoing model and considering its goal, plan, and dimensions, a qualitative study was carried out using in-depth interview with four managers of this model in Ghaleo region as well as the family physicians (FPs) of the model...
December 2017: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/29242239/defining-quality-in-cardiovascular-imaging-a-scientific-statement-from-the-american-heart-association
#17
REVIEW
Leslee J Shaw, Ron Blankstein, Jill E Jacobs, Jonathon A Leipsic, Raymond Y Kwong, Viviany R Taqueti, Rob S B Beanlands, Jennifer H Mieres, Scott D Flamm, Thomas C Gerber, John Spertus, Marcelo F Di Carli
The aims of the current statement are to refine the definition of quality in cardiovascular imaging and to propose novel methodological approaches to inform the demonstration of quality in imaging in future clinical trials and registries. We propose defining quality in cardiovascular imaging using an analytical framework put forth by the Institute of Medicine whereby quality was defined as testing being safe, effective, patient-centered, timely, equitable, and efficient. The implications of each of these components of quality health care are as essential for cardiovascular imaging as they are for other areas within health care...
December 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29241620/trends-in-and-projections-of-indicators-of-universal-health-coverage-in-bangladesh-1995-2030-a-bayesian-analysis-of-population-based-household-data
#18
Md Shafiur Rahman, Md Mizanur Rahman, Stuart Gilmour, Khin Thet Swe, Sarah Krull Abe, Kenji Shibuya
BACKGROUND: Many countries are implementing health system reforms to achieve universal health coverage (UHC) by 2030. To understand the progress towards UHC in Bangladesh, we estimated trends in indicators of the health service and of financial risk protection. We also estimated the probability of Bangladesh's achieving of UHC targets of 80% essential health-service coverage and 100% financial risk protection by 2030. METHODS: We estimated the coverage of UHC indicators-13 prevention indicators and four treatment indicators-from 19 nationally representative population-based household surveys done in Bangladesh from Jan 1, 1991, to Dec 31, 2014...
January 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29239903/proposed-performance-based-metrics-for-the-future-funding-of-graduate-medical-education-starting-the-conversation
#19
Kelly J Caverzagie, Susan W Lane, Niraj Sharma, John Donnelly, Jeffrey R Jaeger, Heather Laird-Fick, John P Moriarty, Darilyn V Moyer, Sara L Wallach, Richard M Wardrop, Alwin F Steinmann
Graduate medical education (GME) in the United States is financed by contributions from both federal and state entities that total over $15 billion annually. Within institutions, these funds are distributed with limited transparency to achieve ill-defined outcomes. To address this, the Institute of Medicine convened a committee on the governance and financing of GME to recommend finance reform that would promote a physician training system that meets society's current and future needs. The resulting report provided several recommendations regarding the oversight and mechanisms of GME funding, including implementation of performance-based GME payments, but did not provide specific details about the content and development of metrics for these payments...
December 12, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29239587/redefining-medical-care
#20
Lauren R Roth
President Donald J. Trump has said he will repeal the Affordable Care Act (ACA) and replace it with health savings accounts (HSAs). Conservatives have long preferred individual accounts to meet social welfare needs instead of more traditional entitlement programs. The types of "medical care" that can be reimbursed through an HSA are listed in section 213(d) of the Internal Revenue Code (Code) and include expenses "for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body...
2017: Cornell Journal of Law and Public Policy
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