keyword
MENU ▼
Read by QxMD icon Read
search

Payment reform

keyword
https://www.readbyqxmd.com/read/28723320/physician-payment-reform-progress-to-date
#1
Paul B Ginsburg, Kavita K Patel
The sustainable growth rate (SGR), a formula used by the Centers for Medicare and Medicaid Services (CMS), frequently specified large cuts in Medicare rates of payment for physician services, which led Congress to step in to defer the cuts. Now that the SGR has been repealed, the dominant policy..
July 20, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28707707/evidence-for-capitation-reform-in-a-new-rural-cooperative-medical-scheme-in-pudong-new-area-shanghai-a-longitudinal-study
#2
Yanmei Wang, Zhiqun Shu, Jianjun Gu, Xiaoming Sun, Limei Jing, Jie Bai, Xuan Huang, Jiquan Lou, Qunfang Zhang, Ming Li
Currently, China has been experiencing rapid growth of medical costs, serious waste of medical resources, increasing disease burden for residents, and a medical insurance fund deficit. Therefore, an urgent problem that needs to be solved is to choose a rational payment for the insurance system. To empirically evaluate the long-term effects of capitation reform in a New Rural Cooperative Medical Scheme in Pudong New Area, we collected and analysed data regarding financing, fund operation, medical service cost, and medical care-seeking behaviour from 2011 to 2015, a duration that includes data before and after reform...
July 14, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28700365/are-you-ready-for-payment-reform
#3
Mikio Nihira, Samantha J Pulliam
No abstract text is available yet for this article.
July 11, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28700194/california-public-hospitals-improved-quality-of-care-under-medicaid-waiver-program
#4
Nederah Pourat
California has 12 county-owned and operated hospital systems and 5 University of California hospitals designated as public hospitals. These organizations deliver the majority of inpatient care and a significant amount of outpatient care to Medicaid patients in the state. In 2010, California was the first state in the nation to implement a five-year Delivery System Reform Incentive Payment (DSRIP) program under the Section §1115 Medicaid "Bridge to Reform" waiver to improve the capacity of these hospitals to deliver high quality and more efficient care...
June 2017: Policy Brief
https://www.readbyqxmd.com/read/28696250/american-heart-association-s-call-to-action-for-payment-and-delivery-system-reform
#5
REVIEW
Vincent J Bufalino, Scott A Berkowitz, Timothy J Gardner, Ileana L Piña, Madeleine Konig
The healthcare system is undergoing a transition from paying for volume to paying for value. Clinicians, as well as public and private payers, are beginning to implement alternative delivery and payment models, such as the patient-centered medical home, accountable care organizations, and bundled payment arrangements. Implementation of these new models will necessitate delivery system transformation and will actively involve all fields of medical care, in particular medicine and surgery. This call to action, on behalf of the American Heart Association's Expert Panel on Payment and Delivery System Reform, serves to offer support and direction for further involvement by the American Heart Association...
July 10, 2017: Circulation
https://www.readbyqxmd.com/read/28693385/observations-from-california-s-delivery-system-reform-incentive-payment-program
#6
Ulfat Shaikh, Kenneth W Kizer
California's Delivery System Reform Incentive Payment (DSRIP) Program provided $3.3 billion over 5 years to support 21 public hospitals improve the quality of health care delivery and population health. The Institute for Population Health Improvement provided technical support and quality improvement mentorship to the California Department of Health Care Services in implementing the DSRIP Program. This report describes the following key observations on the implementation of the program: the need to reduce variability in data collection and management, memorialize decision-making processes, build broad quality improvement capacity, define and revisit improvement targets, anticipate evolution of clinical definitions and guidelines, provide frequent feedback to participating hospitals, engage frontline clinicians, balance short- and long-term improvement goals, acknowledge regulatory requirements and improvement efforts that may compete for resources, and build in shared learning and dissemination of interventions...
March 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28692570/payor-reform-opportunities-for-spine-surgery-part-ii-the-potential-emergence-of-population-health
#7
Jason Scalise, David Jacofsky
The pressures on spine surgery to adopt value-based reimbursement models are being seen in the increased implementation of bundled payment strategies. Given that bundled payment models typically link payments to the initiation of the surgical episode in question, despite their potential cost-saving attributes, financial incentives remain tied to the volume of services being provided. As payors and policy makers look to find savings by focusing on waste and variation of care, more comprehensive models such population health strategies are now being develop and deployed...
July 7, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28683379/work-related-illness-work-related-accidents-and-lack-of-social-security-in-colombia
#8
María Teresa Buitrago Echeverri, César Ernesto Abadía-Barrero, Consuelo Granja Palacios
The impacts of neoliberal or market-based social security reforms in health have been extensively studied. How such reforms transformed employment-related insurance and entitlements, however, has received significantly less attention. This study aims to understand how the employment insurance system operates in Colombia and to assess how the experience of workers seeking social security entitlements relates to the system's structure. We conducted an ethnographic study of the Colombian Occupational Risk System between May 2014 and March 2016, with two main components: 1) analysis of the system itself through in-depth interviews with 32 people working in leadership positions and a systematic review of the system's most important legislation, and 2) a study of people who experienced problems receiving entitlements and were challenging the assessment of their work-related illness or accident...
June 23, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28682666/oncology-and-palliative-care-integration-cocreating-quality-and-value-in-the-era-of-health-care-reform
#9
Tara L Kaufmann, Arif H Kamal
Recent payment reforms in health care have spurred thinking regarding how strengthened partnerships can cocreate quality and value. Oncology is an important area in which to consider further collaborations in patient care, as a result of increasing treatment complexity from an expanding armamentarium of interventions, large resource expenditures related to cancer care, and a growing disease prevalence related to an aging population. Many have highlighted the important role of palliative care in the routine care of patients with advanced cancer and high symptom burden...
July 6, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28666472/policy-entrepreneurship-in-the-reform-of-pediatric-dentistry
#10
Burton L Edelstein, William R Maas
In a recently published IJHPR article, Cohen and Horev ask whether an individual who holds rightful governmental power is able to effectively "challenge the equilibrium" in ways that might "clash with the goals" of an influential group". This question is raised within the context of a shift in governmental policy that imposed the potential for cost management by HMOs acting as financial intermediaries for pediatric dental care in an effort to provide Israeli children better access to affordable dental care...
June 30, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28664591/development-and-enrolee-satisfaction-with-basic-medical-insurance-in-china-a-systematic-review-and-stratified-cluster-sampling-survey
#11
Limei Jing, Ru Chen, Lisa Jing, Yun Qiao, Jiquan Lou, Jing Xu, Junwei Wang, Wen Chen, Xiaoming Sun
Basic Medical Insurance (BMI) has changed remarkably over time in China because of health reforms that aim to achieve universal coverage and better health care with adequate efforts by increasing subsidies, reimbursement, and benefits. In this paper, we present the development of BMI, including financing and operation, with a systematic review. Meanwhile, Pudong New Area in Shanghai was chosen as a typical BMI sample for its coverage and management; a stratified cluster sampling survey together with an ordinary logistic regression model was used for the analysis...
June 29, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28663064/dialysis-payment-model-reform-managing-conflicts-between-profits-and-patient-goals-of-care-decision-making
#12
EDITORIAL
Jeffrey S Berns, Joel D Glickman, Peter P Reese
No abstract text is available yet for this article.
June 26, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28661846/some-builders-remorse-the-rise-and-fall-of-the-oncology-medical-home
#13
Lola Butcher
Insurers pay for extra services that oncologists deliver in the hope that the investment will save them money down the road. That's the idea, anyway. In practice, payers and providers in general see the concept as another example of how vexing payment reform for cancer care is turning out to be.
May 2017: Managed Care
https://www.readbyqxmd.com/read/28647442/the-impact-of-the-transition-from-volume-to-value-on-heart-failure-care-implications-of-novel-payment-models-and-quality-improvement-initiatives
#14
REVIEW
Dushyanth Srinivasan, Nihar R Desai
In response to wide variation in quality and outcomes as well as escalating health care costs, the U.S. health care system is transitioning away from a volume based payment system to a quality- and value-based system. Medicare, the largest insurer and payer of healthcare, has accelerated the movement towards value-based care with the development and implementation of myriad alternative payment models and pay for performance programs as part of the Affordable Care Act. Given that heart failure affects a significant number of Medicare patients and these patients account for a disproportionate amount of healthcare utilization and spending, heart failure has become a focal point for these initiatives...
June 21, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28614471/-payment-mechanisms-and-financial-resources-management-for-consolidation-of-ecuador-s-health-system
#15
Tatiana Villacrés, Ana Cristina Mena
Objective: Analyze the proposal by the Ministry of Public Health to reform the public financing model in Ecuador with regard to pooling of funds and payment mechanisms. Method: A literature review was done of the financing model, the current legal framework, and the budgetary bases in Pubmed, SciELO, LILACS Ecuador, and regional LILACS using the key words health financing, health financing systems, capitation, pooling of funds, health system reform Ecuador, health system Ecuador, and health payment mechanisms...
June 8, 2017: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28609187/integrating-social-services-and-home-based-primary-care-for-high-risk-patients
#16
Joe Feinglass, Greg Norman, Robyn L Golden, Naoko Muramatsu, Michael Gelder, Thomas Cornwell
There is a consensus that our current hospital-intensive approach to care is deeply flawed. This review article describes the research evidence for developing a better system of care for high-cost, high-risk patients. It reviews the evidence that home-centered care and integration of health care with social services are the cornerstones of a more humane and efficient system. The article describes the strengths and weaknesses of research evaluating the effects of social services in addressing social determinants of health, and how social support is critical to successful acute care transition programs...
June 13, 2017: Population Health Management
https://www.readbyqxmd.com/read/28590954/current-valuation-of-pathology-service
#17
Jonathan L Myles, Diana M Cardona, Todd Klemp, Ayanna Wooding, W Stephen Black-Schaffer
Health care reform has accelerated as the existing health care system undergoes continuing financial stress. Medicare's new value-based payment system, commonly referred to as MACRA, provides opportunities for physicians to participate in this new system in a variety of ways. However, many of the value-based adjustments are based on existing valuations of services through traditional mechanisms. To achieve appropriate valuation of pathologist's services in the new payment models, it is imperative that we continue to achieve proper valuation of services through the traditional mechanisms...
July 2017: Advances in Anatomic Pathology
https://www.readbyqxmd.com/read/28584832/the-proportion-of-unmet-costs-considering-inpatients-billing-of-selected-hospitals-after-2014-health-system-reform-implementation-in-isfahan-province
#18
Parnaz Naghdi, Mahan Mohammadi, Mohammad Ali Jahangard, Alireza Yousefe, Noora Rafiee
INTRODUCTION: Since 2013, in Iran's health care, the contribution of direct payments for health-care services was estimated more than 50 % of all expenditures. In May 2014, Iran's health-care reform was established to improve health services quality and reduce patients' out-of-pocket payments <10% in urban and 5% in rural areas. Therefore, the purpose of this study is to investigate unmet costs (those which are not covered either by the insurance companies nor the recent reform coverage mentioned in Sections 1...
2017: Journal of Education and Health Promotion
https://www.readbyqxmd.com/read/28583973/solving-disparities-through-payment-and-delivery-system-reform-a-program-to-achieve-health-equity
#19
Rachel H DeMeester, Lucy J Xu, Robert S Nocon, Scott C Cook, Andrea M Ducas, Marshall H Chin
Payment systems generally do not directly encourage or support the reduction of health disparities. In 2013 the Finding Answers: Solving Disparities through Payment and Delivery System Reform program of the Robert Wood Johnson Foundation sought to understand how alternative payment models might intentionally incorporate a disparities-reduction component to promote health equity. A qualitative analysis of forty proposals to the program revealed that applicants generally did not link payment reform tightly to disparities reduction...
June 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28577702/the-role-of-patient-reported-outcome-measures-in-value-based-payment-reform
#20
Lee Squitieri, Kevin J Bozic, Andrea L Pusic
The U.S. health care system is currently experiencing profound change. Pressure to improve the quality of patient care and control costs have caused a rapid shift from traditional volume-driven fee-for-service reimbursement to value-based payment models. Under the 2015 Medicare Access and Children's Health Insurance Program Reauthorization Act, providers will be evaluated on the basis of quality and cost efficiency and ultimately receive adjusted reimbursement as per their performance. Although current performance metrics do not incorporate patient-reported outcome measures (PROMs), many wonder whether and how PROMs will eventually fit into value-based payment reform...
June 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
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"