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https://www.readbyqxmd.com/read/29026491/does-economic-instability-affect-healthcare-provision-evidence-based-on-the-urban-family-physician-program-in-iran
#1
Enayatollah Homaie Rad, Sajad Delavari, Afsoon Aeenparast, Abolhassan Afkar, Faranak Farzadi, Farzaneh Maftoon
BACKGROUND: The main aim of this study was to evaluate the achievements of some important goals of Iran's urban family physician plan. This plan was implemented when the country experienced economic instability. We examine whether an economic crisis affects the efficacy of a healthcare program. METHODS: We used the household income and expenditures survey data for 2011 (before program implementation) and 2012 (after program implementation). Changes in out-of-pocket payments and healthcare utilization were investigated using the propensity score matching estimator...
September 2017: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/29021830/emerging-issues-in-public-health-a-perspective-on-ghana-s-healthcare-expenditure-policies-and-outcomes
#2
REVIEW
Eric Adua, Kwasi Frimpong, Xia Li, Wei Wang
Ghana's healthcare expenditure has increased over the past two decades. Increased healthcare expenditures are required to enhance the acquisition of better hospital resources that may improve healthcare. This study presents an overview of healthcare expenditures and health outcomes (i.e. infant mortality, under-5 mortality and life expectancy) from 1995 to 2014 in Ghana. Infant and under-5 mortalities have declined by 50 and 25%, respectively, as of 2014, while life expectancy has increased from 60.7 to 64...
September 2017: EPMA Journal
https://www.readbyqxmd.com/read/29021109/design-and-impact-of-bundled-payment-for-detox-and-follow-up-care
#3
Amity E Quinn, Dominic Hodgkin, Jennifer N Perloff, Maureen T Stewart, Mary Brolin, Nancy Lane, Constance M Horgan
INTRODUCTION: Recent payment reforms promote movement from fee-for-service to alternative payment models that shift financial risk from payers to providers, incentivizing providers to manage patients' utilization. Bundled payment, an episode-based fixed payment that includes the prices of a group of services that would typically treat an episode of care, is expanding in the United States. Bundled payment has been recommended as a way to pay for comprehensive SUD treatment and has the potential to improve treatment engagement after detox, which could reduce detox readmissions, improve health outcomes, and reduce medical care costs...
November 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28983134/pension-spiking-free-riding-and-the-effects-of-pension-reform-on-teachers-earnings
#4
Maria D Fitzpatrick
In many states, local school districts are responsible for setting the earnings that determines the size of pensions, but are not required to make contributions to cover the resulting state pension fund liabilities. In this paper, I document evidence that this intergovernmental incentive inherent in public sector defined benefit pension systems distorts the amount and timing of income for public school teachers. I use the introduction of a policy that required experience-rating on earnings increases above a certain limit in a differences-in-differences framework to identify whether districts are willing to pay the full costs of their earnings promises...
April 2017: Journal of Public Economics
https://www.readbyqxmd.com/read/28976480/the-effectiveness-of-transitions-of-care-interventions-in-reducing-hospital-readmissions-and-mortality-a-systematic-review
#5
Angela K Kamermayer, A Renee Leasure, Lisa Anderson
BACKGROUND: The Affordable Care Act of 2010 set forth payment models that provided $10 billion to incent the health care system in developing innovative programs that target reform, including transitional care to reduce preventable readmissions. While transitional care programs exist, US hospitals remain challenged, with 1 in 5 readmissions within 30 days. OBJECTIVE: This systematic review examined the effectiveness of select evidence-based transitions-of-care interventions on reducing 30-day readmission rates, reducing emergency room visits, and reducing mortality rates...
November 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28972519/the-journey-to-become-a-health-literate-organization-a-snapshot-of-health-system-improvement
#6
Cindy Brach
A health literate health care organization is one that makes it easy for people to navigate, understand, and use information and services to take care of their health. This chapter explores the journey that a growing number of organizations are taking to become health literate. Health literacy improvement has increasingly been viewed as a systems issue, one that moves beyond siloed efforts by recognizing that action is required on multiple levels. To help operationalize the shift to a systems perspective, members of the U...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28963145/the-reform-of-methods-of-payment-for-orthopaedic-services
#7
EDITORIAL
D J Jacofsky, F S Haddad
No abstract text is available yet for this article.
October 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28962656/equity-in-health-financing-of-guangxi-after-china-s-universal-health-coverage-evidence-based-on-health-expenditure-comparison-in-rural-guangxi-zhuang-autonomous-region-from-2009-to-2013
#8
Xianjing Qin, Hongye Luo, Jun Feng, Yanning Li, Bo Wei, Qiming Feng
BACKGROUND: Healthcare financing should be equitable. Fairness in financial contribution and protection against financial risk is based on the notion that every household should pay a fair share. Health policy makers have long been concerned with protecting people from the possibility that ill health will lead to catastrophic financial payments and subsequent impoverishment. A number of studies on health care financing equity have been conducted in some provinces of China, but in Guangxi, we found such observation is not enough...
September 29, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28958276/successful-incorporation-of-performance-based-payments-for-trauma-center-readiness-costs-into-the-georgia-trauma-system
#9
Dennis W Ashley, Jeffrey M Nicholas, Christopher J Dente, Tracy J Johns, Laura E Garlow, Gina Solomon, Dena Abston, Colville H Ferdinand
As quality and outcomes have moved to the fore front of medicine in this era of healthcare reform, a state trauma system Performance Based Payments (PBP) program has been incorporated into trauma center readiness funding. The purpose of this study was to evaluate the impact of a PBP on trauma center revenue. From 2010 to 2016, a percentage of readiness costs funding to trauma centers was placed in a PBP and withheld until the PBP criteria were completed. To introduce the concept, only three performance criteria and 10 per cent of readiness costs funding were tied to PBP in 2010...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28952981/reporting-from-the-front-lines-implementing-oregon-s-alternative-payment-methodology-in-federally-qualified-health-centers
#10
Erika K Cottrell, Jennifer D Hall, Glenn Kautz, Heather Angier, Sonja Likumahuwa-Ackman, Laura Sisulak, Sara Keller, David C Cameron, Jennifer E DeVoe, Deborah J Cohen
Alternative payment models have been proposed as a way to facilitate patient-centered medical home model implementation, yet little is known about how payment reform translates into changes in care delivery. We conducted site visits, observed operations, and conducted interviews within 3 Federally Qualified Health Center organizations that were part of Oregon's Alternative Payment Methodology demonstration project. Data were analyzed using an immersion-crystallization approach. We identified several care delivery changes during the early stages of implementation, as well as challenges associated with this new model of payment...
September 25, 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/28946711/health-care-payments-in-vietnam-patients-quagmire-of-caring-for-health-versus-economic-destitution
#11
Andre Pekerti, Quan-Hoang Vuong, Tung Manh Ho, Thu-Trang Vuong
In the last three decades many developing and middle-income nations' health care systems have been financed via out-of-pocket payments by individuals. User fees charges, however, may not be the best approach or thenmost equitable approach to finance and/or reform health services in developing nations. This study investigates the status of Vietnam's current health system as a result of implementing user fees policies. A recent mandate by the government to increase the universal cover to 100% attempts to tackle inadequate insurance cover, one of the four major factors contributing to the high and increasing probability of destitution for Vietnamese patients (the other three being: non-residency, long stay in hospital, and high cost of treatment)...
September 25, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28930760/medical-education-and-health-care-delivery-a-call-to-better-align-goals-and-purposes
#12
David P Sklar, Paul A Hemmer, Steven J Durning
The transformation of the U.S. health care system is under way, driven by the needs of an aging population, rising health care spending, and the availability of health information. However, the speed and effectiveness of the transformation of health care delivery will depend, in large part, upon engagement of the health professions community and changes in clinicians' practice behaviors. Current efforts to influence practice behaviors emphasize changes in the health payment system with incentives to move from fee-for-service to alternative payment models...
September 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28916895/the-cost-of-conversion-in-robotic-and-laparoscopic-colorectal-surgery
#13
Robert K Cleary, Andrew J Mullard, Jane Ferraro, Scott E Regenbogen
BACKGROUND: Conversion from minimally invasive to open colorectal surgery remains common and costly. Robotic colorectal surgery is associated with lower rates of conversion than laparoscopy, but institutions and payers remain concerned about equipment and implementation costs. Recognizing that reimbursement reform and bundled payments expand perspectives on cost to include the entire surgical episode, we evaluated the role of minimally invasive conversion in total payments. METHODS: This is an observational study from a linked data registry including clinical data from the Michigan Surgical Quality Collaborative and payment data from the Michigan Value Collaborative between July 2012 and April 2015...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28911328/devolution-and-its-effects-on-health-workforce-and-commodities-management-early-implementation-experiences-in-kilifi-county-kenya
#14
Benjamin Tsofa, Catherine Goodman, Lucy Gilson, Sassy Molyneux
BACKGROUND: Decentralisation is argued to promote community participation, accountability, technical efficiency, and equity in the management of resources, and has been a recurring theme in health system reforms for several decades. In 2010, Kenya passed a new constitution that introduced 47 semi-autonomous county governments, with substantial transfer of responsibility for health service delivery from the central government to these counties. Focusing on two key elements of the health system, Human Resources for Health (HRH) and Essential Medicines and Medical Supplies (EMMS) management, we analysed the early implementation experiences of this major governance reform at county level...
September 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28895824/value-based-care-will-flop-without-clinical-integration
#15
Chad Johnson
Value-based payment is gaining traction and proving to be a major factor in health care reform. But the success of those value-based models will depend on true clinical integration of providers-not just lip service to coordination.
August 2017: Managed Care
https://www.readbyqxmd.com/read/28885288/early-effects-of-medicare-s-bundled-payment-for-care-improvement-bpci-program-for-lumbar-fusion
#16
Brook I Martin, Jon D Lurie, Farrokh R Farrokhi, Kevin J McGuire, Sohail K Mirza
STUDY DESIGN: Retrospective analysis of Medicare claims linked to hospital participation in the Center for Medicare and Medicaid Innovation's episode-based Bundled Payment for Care Improvement (BPCI) program for lumbar fusion. OBJECTIVES: To describe the early effects of BPCI participation for lumbar fusion on 90-day reimbursement, procedure volume, reoperation, and readmission. SUMMARY OF BACKGROUND DATA: Initiated on January 1st, 2013, BPCI's voluntary bundle payment program provides a predetermined payment for services related to a Diagnosis Related Group-defined "triggering event" over a defined time period...
September 6, 2017: Spine
https://www.readbyqxmd.com/read/28874198/who-pays-for-healthcare-in-bangladesh-an-analysis-of-progressivity-in-health-systems-financing
#17
Azaher Ali Molla, Chunhuei Chi
BACKGROUND: The relationship between payments towards healthcare and ability to pay is a measure of financial fairness. Analysis of progressivity is important from an equity perspective as well as for macroeconomic and political analysis of healthcare systems. Bangladesh health systems financing is characterized by high out-of-pocket payments (63.3%), which is increasing. Hence, we aimed to see who pays what part of this high out-of-pocket expenditure. To our knowledge, this was the first progressivity analysis of health systems financing in Bangladesh...
September 6, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28874176/evaluative-reports-on-medical-malpractice-policies-in-obstetrics-a-rapid-scoping-review
#18
Roberta Cardoso, Wasifa Zarin, Vera Nincic, Sarah Louise Barber, Ahmet Metin Gulmezoglu, Charlotte Wilson, Katherine Wilson, Heather McDonald, Meghan Kenny, Rachel Warren, Sharon E Straus, Andrea C Tricco
BACKGROUND: The clinical specialty of obstetrics is under particular scrutiny with increasing litigation costs and unnecessary tests and procedures done in attempts to prevent litigation. We aimed to identify reports evaluating or comparing the effectiveness of medical liability reforms and quality improvement strategies in improving litigation-related outcomes in obstetrics. METHODS: We conducted a rapid scoping review with a 6-week timeline. MEDLINE, EMBASE, LexisNexis Academic, the Legal Scholarship Network, Justis, LegalTrac, QuickLaw, and HeinOnline were searched for publications in English from 2004 until June 2015...
September 6, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28868904/the-dynamics-of-catastrophic-and-impoverishing-health-spending-in-indonesia-how-well-does-the-indonesian-health-care-financing-system-perform
#19
Budi Aji, Shafiu Mohammed, Md Aminul Haque, Manuela De Allegri
Our study examines the incidence and intensity of catastrophic and impoverishing health spending in Indonesia. A panel data set was used from 4 waves of the Indonesian Family Life Surveys 1993, 1997, 2000, and 2007. Catastrophic health expenditure was measured by calculating the ratio of out-of-pocket payments to household income. Then, we calculated poverty indicators as a measure of impoverishing spending in the health care financing system. Head count, overshoot, and mean positive overshoot for each given threshold in 2000 were lower than other surveyed periods; otherwise, fraction headcount in 2007 of households were the higher...
September 2017: Asia-Pacific Journal of Public Health
https://www.readbyqxmd.com/read/28864710/principles-of-child-health-care-financing
#20
Mark L Hudak, Mark E Helm, Patience H White
After passage of the Patient Protection and Affordable Care Act, more children and young adults have become insured and have benefited from health care coverage than at any time since the creation of the Medicaid program in 1965. From 2009 to 2015, the uninsurance rate for children younger than 19 years fell from 9.7% to 5.3%, whereas the uninsurance rate for young adults 19 to 25 years of age declined from 31.7% to 14.5%. Nonetheless, much work remains to be done. The American Academy of Pediatrics (AAP) believes that the United States can and should ensure that all children, adolescents, and young adults from birth through the age of 26 years who reside within its borders have affordable access to high-quality and comprehensive health care, regardless of their or their families' incomes...
September 2017: Pediatrics
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