keyword
MENU ▼
Read by QxMD icon Read
search

Payment reform

keyword
https://www.readbyqxmd.com/read/28614471/-payment-mechanisms-and-financial-resources-management-for-consolidation-of-ecuador-s-health-system
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28576954/payment-reform-meets-pharmacy-practice-and-education-transformation
#7
Troy Trygstad
The pharmacy profession has for the greater part of four decades been associated with dispensing activities and product reimbursement. This has hindered the ability of pharmacists to evolve their roles in their respective sites of care. Payment reform efforts that create an outcomes marketplace offer an opportunity for professional transformation.
May 2017: North Carolina Medical Journal
https://www.readbyqxmd.com/read/28576295/alternative-payment-models-lead-to-strategic-care-coordination-workforce-investments
#8
Clese E Erikson, Patricia Pittman, Alicia LaFrance, Susan A Chapman
BACKGROUND: Care coordination is generally viewed as a key to success for health systems seeking to adapt to a range of new value-based payment policies. PURPOSE: This study explores care coordination staffing in four health systems participating in new payment models, including Medicaid payment reform and Accountable Care Organizations. METHODS: Comparative case study design is used to describe models of care coordination. Analysis of 43 semi-structured interviews with leadership, clinicians, and care coordination staff at four health systems engaged in value-based contracts...
April 13, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28562453/continuing-professional-development-for-faculty-an-elephant-in-the-house-of-academic-medicine-or-the-key-to-future-success
#9
David A Davis, William F Rayburn, Gary A Smith
The scope of change required by academic medical centers (AMCs) to maintain their viability and achieve their tripartite mission in the future is large; such reform is affected by numerous global, national, and local forces. Most AMCs focus their transformational efforts on organizational infrastructure (e.g., undertaking payment reform, developing new organizational structures, investing in information technology) and educational programs (with subsequent changes in undergraduate and graduate medical education curricula)...
May 30, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28562306/statement-of-the-problem-health-reform-value-based-purchasing-alternative-payment-strategies-and-children-and-youth-with-special-health-care-needs
#10
Sara S Bachman, Meg Comeau, Thomas F Long
There is increasing interest in maximizing health care purchasing value by emphasizing strategies that promote cost-effectiveness while achieving optimal health outcomes. These value-based purchasing (VBP) strategies have largely focused on adult health, and little is known about the impact of VBP program development and implementation on children, especially children and youth with special health care needs (CYSHCN). With the increasing emphasis on VBP, policymakers must critically analyze the potential impact of VBP for CYSCHN, because this group of children, by definition, uses more health care services than other children and inevitably incurs higher per person costs...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28562140/the-effects-of-global-budget-on-cost-control-and-readmission-in-rural-china-a-difference-in-difference-analysis
#11
Ruibo He, Yudong Miao, Ting Ye, Yan Zhang, Wenxi Tang, Zhong Li, Liang Zhang
BACKGROUND: Global budget (GB) is considered one of the most important payment methods available. Since a new round of healthcare system reforms in 2009, the Chinese government has been paying attention to this prospective payment. However, it is unclear whether GB has influenced cost control and how it works in rural China. METHODS: YC county was chosen as the intervention group, with 33,175 inpatients before and 36,883 inpatients after the reform (2012 and 2014, respectively)...
June 19, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28560726/payment-reform-and-health-disparities-changes-in-dialysis-modality-under-the-new-medicare-dialysis-payment-system
#12
Marc Turenne, Regina Baker, Jeffrey Pearson, Chad Cogan, Purna Mukhopadhyay, Elizabeth Cope
OBJECTIVE: To evaluate the effect of the Medicare dialysis payment reform on potential disparities in the selection of peritoneal dialysis (PD) for the treatment of end-stage renal disease (ESRD). DATA SOURCES: Centers for Medicare & Medicaid Services (CMS) ESRD Medical Evidence Form, Medicare claims, and other CMS data for 2008-2013. STUDY DESIGN: We examined the association of patient age, race/ethnicity, urban/rural location, pre-ESRD care, comorbidities, insurance, and other factors with the selection of PD as initial dialysis modality across prereform (2008-2009), interim (2010), and postreform (2011-2013) time periods...
May 30, 2017: Health Services Research
https://www.readbyqxmd.com/read/28559677/human-rights-and-the-political-economy-of-universal-health-care-designing-equitable-financing
#13
Anja Rudiger
Health system financing is a critical factor in securing universal health care and achieving equity in access and payment. The human rights framework offers valuable guidance for designing a financing strategy that meets these goals. This article presents a rights-based approach to health care financing developed by the human right to health care movement in the United States. Grounded in a human rights analysis of private, market-based health insurance, advocates make the case for public financing through progressive taxation...
December 2016: Health and Human Rights
https://www.readbyqxmd.com/read/28552272/understanding-stakeholders-perspectives-and-experiences-of-general-practice-accreditation
#14
Deborah Debono, David Greenfield, Luke Testa, Virginia Mumford, Anne Hogden, Marjorie Pawsey, Johanna Westbrook, Jeffrey Braithwaite
OBJECTIVE: To examine general practice accreditation stakeholders' perspectives and experiences to identify program strengths and areas for improvements. DESIGN, SETTING AND PARTICIPANTS: Individual (n=2) and group (n=9) interviews were conducted between September 2011-March 2012 with 52 stakeholders involved in accreditation in Australian general practices. Interviews were recorded, transcribed and thematically analysed. Member checking activities in April 2016 assessed the credibility and currency of the findings in light of current reforms...
May 19, 2017: Health Policy
https://www.readbyqxmd.com/read/28537961/the-affordable-care-act-and-cancer-care-delivery
#15
Gabriel A Brooks, J Russell Hoverman, Carrie H Colla
The Affordable Care Act (ACA) has reformed US health care delivery through insurance coverage expansion, experiments in payment design, and funding for patient-centered clinical and health care delivery research. The impact on cancer care specifically has been far reaching, with new ACA-related programs that encourage coordinated, patient-centered, cost-effective care. Insurance expansions through private exchanges and Medicaid, along with preexisting condition clauses, have helped more than 20 million Americans gain health care coverage...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28534279/overcoming-resistance-against-managed-care-insights-from-a-bargaining-model
#16
Andree Ehlert, Thomas Wein, Peter Zweifel
Recent healthcare reforms have sought to increase efficiency by introducing managed care (MC) while respecting consumer preferences by admitting choice between MC and conventional care. This article proposes an institutional change designed to let German consumers choose between the two settings through directing payments from the Federal Health Fund to social health insurers (SHIs) or to specialized MC organizations (MCOs). To gauge the chance of success of this reform, a game involving a SHI, a MCO, and a representative insured (RI) is analyzed...
December 2017: Health Economics Review
https://www.readbyqxmd.com/read/28532306/from-instinct-to-evidence-the-role-of-data-in-country-decision-making-in-chile
#17
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 political upheaval and facing demographic, health, and economic transformations. The full information requirements to develop an evidence-informed process implied the best possible use of the available data, as well as efforts to improve information systems. OBJECTIVE: To examine, from a historical perspective, the use of evidence during the health sector reforms undertaken in Chile from 1990 to date, and to identify the factors that have both determined improvements in the data and facilitated their use...
January 2017: Global Health Action
https://www.readbyqxmd.com/read/28531288/an-evaluation-of-systemic-reforms-of-public-hospitals-the-sanming-model-in-china
#18
Hongqiao Fu, Ling Li, Mingqiang Li, Chunyu Yang, William Hsiao
Low- and middle-income countries (LMICs) have been searching for effective strategies to reform their inefficient and wasteful public hospitals. Recently, China developed a model of systemic reforms called the Sanming model to address the inefficiency and waste at public hospitals. In this article, we explain and evaluate how the Sanming model reformed its 22 public hospitals in 2013 by simultaneously restructuring the hospital governance structure, altering the payment system to hospitals, and realigning physicians' incentives...
May 20, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28498198/development-of-a-risk-adjustment-model-for-the-inpatient-rehabilitation-facility-discharge-self-care-functional-status-quality-measure
#19
Anne Deutsch, Poonam Pardasaney, Jeniffer Iriondo-Perez, Melvin J Ingber, Kristie A Porter, Tara McMullen
BACKGROUND: Functional status measures are important patient-centered indicators of inpatient rehabilitation facility (IRF) quality of care. We developed a risk-adjusted self-care functional status measure for the IRF Quality Reporting Program. This paper describes the development and performance of the measure's risk-adjustment model. METHODS: Our sample included IRF Medicare fee-for-service patients from the Centers for Medicare & Medicaid Services' 2008-2010 Post-Acute Care Payment Reform Demonstration...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28493177/what-is-single-payer-health-care-a-review-of-definitions-and-proposals-in-the-u-s
#20
Jodi L Liu, Robert H Brook
BACKGROUND: Single-payer systems have been proposed as a health care reform alternative in the United States. However, there is no consensus on the definition of single-payer. Most definitions characterize single-payer as one entity that collects funds and pays for health care on behalf on an entire population. Increased flexibility for state health care reform may provide opportunities for state-based single-payer systems to be considered. OBJECTIVE: To explore the concept of single-payer and to describe the contents of single-payer health care proposals...
May 10, 2017: Journal of General Internal Medicine
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"