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https://www.readbyqxmd.com/read/29211623/quality-of-care-improves-for-patients-with-diabetes-in-medicare-shared-savings-accountable-care-organizations-organizational-characteristics-associated-with-performance
#1
Taressa K Fraze, Valerie A Lewis, Emily Tierney, Carrie H Colla
Accountable care organizations (ACOs), a primary care-centric delivery and payment model, aim to promote integrated population health, which may improve care for those with chronic conditions such as diabetes. Research has shown that, overall, the ACO model is effective at reducing costs, but there is substantial variation in how effective different types of ACOs are at impacting costs and improving care delivery. This study examines how ACO organizational characteristics - such as composition, staffing, care management, and experiences with health reform - were associated with quality of care delivered to patients with diabetes...
December 6, 2017: Population Health Management
https://www.readbyqxmd.com/read/29194494/impact-of-bundled-payments-on-hip-fracture-outcomes-a-nationwide-population-based-study
#2
Yu-Chi Tung, Hsien-Yen Chang, Guann-Ming Chang
Objective: Establishing one price for all bundled services for a particular illness, which has become the key to healthcare reform efforts, is designed to encourage health professionals to coordinate their care for patients. Limited information is available, however, concerning whether bundled payments are associated with changes in patient outcomes. Nationwide longitudinal population-based data were used to examine the effect of bundled payments on hip fracture outcomes. Design: An interrupted time series design with a comparison group...
November 29, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29191139/potential-benefits-to-patients-and-payers-from-increased-measurement-of-antipsychotic-plasma-levels-in-the-management-of-schizophrenia
#3
Zachary Predmore, Soeren Mattke, Marcela Horvitz-Lennon
Approximately 40% of patients with schizophrenia either do not respond to the prescribed antipsychotic drug or cannot tolerate it because of side effects, resulting in poor disease control and negative health and economic outcomes. Identifying the root cause of such complicated courses of treatment is a critical step in the treatment of these patients. Although measurement of antipsychotic plasma levels can be used to discern potential root causes, this tool is not routinely used in the United States. The authors of this column discuss the potential effects on patient outcomes and on the value of care from greater use of this diagnostic tool, especially under emerging payment models and delivery system reform efforts...
December 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29180377/comparison-of-canadian-public-medication-insurance-plans-and-the-impact-on-out-of-pocket-costs
#4
David J T Campbell, Braden J Manns, Lesley J J Soril, Fiona Clement
BACKGROUND: Research from 2006 documented substantial variation in medication coverage for residents across Canada. Since then, some provinces have implemented major medication plan reforms. We aimed to update the information on publicly funded medication insurance plans available across Canada and to compare out-of-pocket costs across the country. METHODS: We compared provincial medication insurance plans using data from public websites and other public source documents...
November 22, 2017: CMAJ Open
https://www.readbyqxmd.com/read/29167886/payment-reform-to-enhance-collaboration-of-primary-care-and-cardiology-a-review
#5
Steven A Farmer, Paul N Casale, Linda D Gillam, John S Rumsfeld, Shari Erickson, Neil M Kirschner, Kevin de Regnier, Bruce R Williams, R Shawn Martin, Mark B McClellan
Importance: The US health care system faces an unsustainable trajectory of high costs and inconsistent outcomes. The fee-for-service payment model has contributed to inefficiency, and new payment methods are a promising approach to improving value. Health reforms are needed to increase patient access, reduce costs, and improve health care quality, and the landmark Medicare Access and CHIP Reauthorization Act presents a roadmap for reform. The product of a collaboration between primary care and cardiology clinicians, this review describes a conceptual approach to delivery and payment reforms that aim to better support primary care-cardiology comanagement of chronic cardiovascular disease (CVD)...
November 22, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29161393/quality-safety-and-outcomes-in-anaesthesia-what-s-to-be-done-an-international-perspective
#6
C J Peden, M Campbell, G Aggarwal
This article reviews of some of the key topics and challenges in quality, safety, and the measurement and improvement of outcomes in anaesthesia. The topics were selected based on the perspective of an individual with quality and safety expertise and recent experience of the specialty in both the UK and USA. The review does not seek to be exhaustive or systematic, but to highlight current areas of concern and potential solutions. The topic is subdivided into sections where the system of health care is viewed from different levels...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29157566/is-health-care-payment-reform-impacting-nurses-work-settings-roles-and-education-preparation
#7
Mary Val Palumbo, Betty Rambur, Vicki Hart
This study explores nurses' work settings and educational preparation in the five years before passage of the Affordable Care Act (ACA) and five years after ACA passage, with the aim of identifying areas for nurse educators' attention. The study setting was one small state undergoing rapid transition away from fee-for-service service and thus provided the ideal laboratory to assess the impact of health reform on the nursing workforce. A secondary analysis of data gathered during relicensure compared the nursing workforce at an interval of one decade, with surveys in 2005 (n=4075; 65% response rate) and in 2015 (n=6723; 97% response rate)...
November 2017: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
https://www.readbyqxmd.com/read/29154182/impact-of-ill-health-on-household-consumption-in-sri-lanka-evidence-from-household-survey-data
#8
Ajantha Sisira Kumara, Ramanie Samaratunge
With significant increases in chronic non-communicable diseases (NCDs) in recent years, Sri Lanka has witnessed a growing trend of increased out-of-pocket payments for healthcare, imposing a severe burden on household budgets. This is exacerbated by limited government health funding and inadequate financial security from formal social security. We examine the association of NCD-prevalence and healthcare utilization with household consumption, using the most recent Sri Lanka Household Income and Expenditure Survey 2012/2013...
November 11, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/29148320/the-extraregulatory-effect-of-nurse-practitioner-scope-of-practice-laws-on-physician-malpractice-rates
#9
Benjamin J McMichael, Barbara J Safriet, Peter I Buerhaus
Patients can hold physicians directly or vicariously liable for the malpractice of nurse practitioners under their supervision. Restrictive scope-of-practice laws governing nurse practitioners can ease patients' legal burdens in establishing physician liability. We analyze the effect of restrictive scope-of-practice laws on the number of malpractice payments made on behalf of physicians between 1999 and 2012. Enacting less restrictive scope-of-practice laws decreases the number of payments made by physicians by as much as 31%, suggesting that restrictive scope-of-practice laws have a salient extraregulatory effect on physician malpractice rates...
January 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29142964/impact-of-the-end-stage-renal-disease-prospective-payment-system-on-the-use-of-peritoneal-dialysis
#10
Qian Zhang, Mae Thamer, Onkar Kshirsagar, Yi Zhang
Introduction: The End Stage Renal Disease (ESRD) Prospective Payment System (PPS), implemented by the Centers for Medicare and Medicaid Services in January 2011, encouraged use of peritoneal dialysis (PD) through various financial incentives. Our goal was to determine whether PPS effectively increased PD use in incident dialysis patients. Methods: Our study used the United States Renal Data System (USRDS) to identify 430,927 adult patients who initiated dialysis between 2009 and 2012...
May 2017: KI Reports
https://www.readbyqxmd.com/read/29141634/the-effects-of-neoliberal-policies-on-access-to-healthcare-for-people-with-disabilities
#11
Dikaios Sakellariou, Elena S Rotarou
Neoliberal reforms lead to deep changes in healthcare systems around the world, on account of their emphasis on free market rather than the right to health. People with disabilities can be particularly disadvantaged by such reforms, due to their increased healthcare needs and lower socioeconomic status. In this article, we analyse the impacts of neoliberal reforms on access to healthcare for disabled people. This article is based on a critical analytical review of the literature and on two case studies, Chile and Greece...
November 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29132634/a-model-to-determine-payments-associated-with-radiology-procedures
#12
Thusitha Mabotuwana, Christopher S Hall, Shiby Thomas, Christoph Wald
OBJECTIVE: Across the United States, there is a growing number of patients in Accountable Care Organizations and under risk contracts with commercial insurance. This is due to proliferation of new value-based payment models and care delivery reform efforts. In this context, the business model of radiology within a hospital or health system context is shifting from a primary profit-center to a cost-center with a goal of cost savings. Radiology departments need to increasingly understand how the transactional nature of the business relates to financial rewards...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29132497/from-micro-to-macro-assessing-implementation-of-integrated-care-in-australia
#13
Lisa Angus, Pim P Valentijn
Many countries and health systems are pursuing integrated care as a means of achieving better outcomes. However, no standard approaches exist for comparing integration approaches across models or settings, and for evaluating whether the key components of integrated care are present in different initiatives. This study sheds light on how integrated care is being implemented in Australia, using a new tool to characterise and compare integration strategies at micro, meso and macro levels. In total, 114 staff from a purposive sample of 38 integrated care projects completed a survey based on the Rainbow Model of Integrated Care...
November 14, 2017: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/29126109/do-prospective-payment-systems-ppss-lead-to-desirable-providers-incentives-and-patients-outcomes-a-systematic-review-of-evidence-from-developing-countries
#14
Si Ying Tan, G J Melendez-Torres
The reform of provider payment systems, from retrospective to prospective payment, has been heralded as the right move to contain costs in the light of rising health expenditures in many countries. However, there are concerns on quality trade-off. The heightened attention given to prospective payment system (PPS) reforms and the rise of empirical evidence regarding PPS interventions among developing countries suggest that a systematic review is necessary to understand the effects of PPS reforms in developing countries...
November 6, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29109204/correction-to-american-heart-association-s-call-to-action-for-payment-and-delivery-system-reform
#15
(no author information available yet)
No abstract text is available yet for this article.
November 7, 2017: Circulation
https://www.readbyqxmd.com/read/29075552/patient-copayments-provider-incentives-and-income-effects-theory-and-evidence-from-the-essential-medications-list-under-china-s-2009-healthcare-reform
#16
Brian K Chen, Y Tony Yang, Karen Eggleston
Expanding access through insurance expansion can increase healthcare utilization through moral hazard. Reforming provider incentives to introduce more supply-side cost sharing is increasingly viewed as crucial for affordable, sustainable access. Using both difference-in-differences and segmented regression analyses on a panel of 1,466 hypertensive and diabetic patients, we empirically examine Shandong province's initial implementation of China's 2009 Essential Medications List policy. The policy reduced drug sale markups to providers but also increased drug coverage benefits for patients...
March 2017: World Medical & Health Policy
https://www.readbyqxmd.com/read/29073234/the-effects-of-patient-cost-sharing-on-inpatient-utilization-cost-and-outcome
#17
Yuan Xu, Ning Li, Mingshan Lu, Elijah Dixon, Robert P Myers, Rachel J Jelley, Hude Quan
BACKGROUND: Health insurance and provider payment reforms all over the world beg a key empirical question: what are the potential impacts of patient cost-sharing on health care utilization, cost and outcomes? The unique health insurance system and rich electronic medical record (EMR) data in China provides us a unique opportunity to study this topic. METHODS: Four years (2010 to 2014) of EMR data from one medical center in China were utilized, including 10,858 adult patients with liver diseases...
2017: PloS One
https://www.readbyqxmd.com/read/29072894/medicaid-payment-and-delivery-system-reform-early-insights-from-10-medicaid-expansion-states
#18
Sara Rosenbaum, Sara Schmucker, Sara Rothenberg, Rachel Gunsalus, J Zoe Beckerman
Issue: Expanded Medicaid enrollment under the Affordable Care Act has heightened the importance of states’ roles as principal purchasers of health care for low-income and medically vulnerable populations. Concurrently, the federal government has augmented states’ purchasing tools. Goal: To examine the evolution of payment and delivery system reform in 10 ACA Medicaid expansion states. Methods: Analysis of state managed care policies, including a detailed review of purchasing documents as well as interviews with senior agency officials in 10 states...
October 1, 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29070074/integrated-care-reform-in-urban-china-a-qualitative-study-on-design-supporting-environment-and-implementation
#19
Yi Qian, Zhiyuan Hou, Wei Wang, Donglan Zhang, Fei Yan
BACKGROUND: Initiatives on integrated care between hospitals and community health centers (CHCs) have been introduced to transform the current fragmented health care delivery system into an integrated system in China. Up to date no research has analyzed in-depth the experiences of these initiatives based on perspectives from various stakeholders. This study analyzed the integrated care pilot in Hangzhou City by investigating stakeholders' perspectives on its design features and supporting environment, their acceptability of this pilot, and further identifying the enabling and constraining factors that may influence the implementation of the integrated care reform...
October 25, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29070050/potential-barriers-in-healthcare-access-of-the-elderly-population-influenced-by-the-economic-crisis-and-the-troika-agreement-a-qualitative-case-study-in-lisbon-portugal
#20
Julia Doetsch, Eva Pilot, Paula Santana, Thomas Krafft
BACKGROUND: The recent economic and financial crisis in Portugal urged the Portuguese Government in April 2011 to request financial assistance from the troika austerity bail out program to get aid for its government debt. The troika agreement included health reforms and austerity measures of the National Health Service (NHS) in Portugal to save non-essential health care costs. This research aimed to identify potential barriers among the elderly population (aged 65 and above) to healthcare access influenced by the economic crisis and the troika agreement focussing on the Memorandum of Understanding on Specific Economic Policy Conditionality (MoU) in Lisbon metropolitan area, Portugal...
October 25, 2017: International Journal for Equity in Health
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