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https://www.readbyqxmd.com/read/28647838/preoperative-education-for-hip-and-knee-replacement-never-stop-learning
#1
REVIEW
Paul K Edwards, Simon C Mears, C Lowry Barnes
PURPOSE OF REVIEW: Participation in alternative payment models has focused efforts to improve outcomes and patient satisfaction while also lowering cost for elective hip and knee replacement. The purpose of this review is to determine if preoperative education classes for elective hip and knee replacement achieve these goals. RECENT FINDINGS: Recent literature demonstrates that patients who attend education classes prior to surgery have decreased anxiety, better post-operative pain control, more realistic expectations of surgery, and a better understanding of their surgery...
June 24, 2017: Current Reviews in Musculoskeletal Medicine
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
#2
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/28644939/an-economic-analysis-of-mac-versus-walant-a-trigger-finger-release-surgery-case-study
#3
Jason L Codding, Suneel B Bhat, Asif M Ilyas
BACKGROUND: There has been recent interest in wide awake hand surgery, also referred to as "wide awake local anesthesia with no tourniquet" (WALANT) surgery. Using a model of single trigger finger release (TFR) surgery, a hypothesis was made that WALANT would result in decreased hospital time and cost than patients receiving sedation with monitored anesthetic care (MAC). METHODS: Consecutive cases of single TFR surgery with MAC were compared with WALANT. All surgeries were performed in the same manner, at the same facility, and by the same surgeon...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28629906/can-bundled-payments-be-successful-in-the-medicaid-population-for-primary-joint-arthroplasty
#4
P Maxwell Courtney, Tori Edmiston, Brian Batko, Brett R Levine
BACKGROUND: Although some bundled payment models have had success in total joint arthroplasty, concerns exist about access to care for higher cost patients who use more resources. The purpose of this study is to determine whether Medicaid patients have increased hospital costs and more resource utilization in a 90-day episode of care than Medicare or privately insured patients. METHODS: We retrospectively reviewed a consecutive series of 7268 primary hip and knee arthroplasty patients at a single institution...
May 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28622969/probability-of-undiagnosed-obstructive-sleep-apnea-does-not-correlate-with-adverse-pulmonary-events-nor-length-of-stay-in-hip-and-knee-arthroplasty-using-intrathecal-opioid
#5
Matthew J Thompson, Bryce N Clinger, Robert M Simonds, Camille J Hochheimer, Laura A Lahaye, Gregory J Golladay
BACKGROUND: Recent emphasis on bundled payments and outcomes tracking has increased the focus on preoperative optimization in patients undergoing elective lower extremity arthroplasty. Since patients with obstructive sleep apnea (OSA) have an increased risk of adverse perioperative pulmonary events, screening for undiagnosed OSA is sometimes included as part of preoperative risk assessment. However, there are limited data regarding quantification of OSA risk in lower extremity arthroplasty patients, and little is known about the utility of quantitative OSA screening and the risk of pulmonary complications in hip and knee arthroplasty patients who receive intrathecal morphine anesthetic...
April 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28622186/a-90-day-bundled-payment-for-primary-single-level-lumbar-discectomy-decompression-what-does-big-data-say
#6
Nikhil Jain, Sohrab S Virk, Frank M Phillips, Elizabeth Yu, Safdar N Khan
Episode-based bundling may become the major form of reimbursement for many elective spine procedures. As the amount for a 90-day episode of care is not known for a lumbar discectomy, we analyzed the previous reimbursements from Commercial payers (2007-Q2 2015), Medicare Advantage (2007-Q2 2015), and Medicare (2005-2012) for a primary single-level lumbar discectomy/decompression. Distribution of payments among various service providers was studied and a 90-day bundle was simulated. Depending on the payer type, the average facility costs constituted 59...
June 15, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28590385/post-discharge-care-duration-charges-and-outcomes-among-medicare-patients-after-primary-total-hip-and-knee-arthroplasty
#7
Karthikeyan E Ponnusamy, Zan Naseer, Mostafa H El Dafrawy, Louis Okafor, Clayton Alexander, Robert S Sterling, Harpal S Khanuja, Richard L Skolasky
BACKGROUND: In April 2016, the U.S. Centers for Medicare & Medicaid Services initiated mandatory 90-day bundled payments for total hip and knee arthroplasty for much of the country. Our goal was to determine duration of care, 90-day charges, and readmission rates by discharge disposition and U.S. region after hip or knee arthroplasty. METHODS: Using the 2008 Medicare Provider Analysis and Review database 100% sample, we identified patients who had undergone elective primary total hip or knee arthroplasty...
June 7, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28586574/bundled-payment-for-physician-group-practices-and-organized-delivery-systems
#8
Barry Liss
No abstract text is available yet for this article.
2017: MD Advisor: a Journal for New Jersey Medical Community
https://www.readbyqxmd.com/read/28583761/bundled-payments-for-care-improvement-boom-or-bust
#9
Brian M Curtin, Robert D Russell, Susan M Odum
BACKGROUND: As early implementors of the Centers for Medicare and Medicaid Services (CMS) Bundled Payments for Care Improvement (BPCI) initiative, our private practice sought to compare our readmission rates, post-acute care utilization, and length of stay for the first year under BPCI compared to baseline data. METHODS: We used CMS data to compare total expenditures of all diagnosis-related groups (DRGs). Medicare patients who underwent orthopedic surgery between 2009 and 2012 were defined as non-BPCI (n = 8415) and were compared to Medicare BPCI patients (n = 4757) who had surgery in 2015...
May 15, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28569737/nursing-care-management-influence-on-bundled-payments-erratum
#10
(no author information available yet)
No abstract text is available yet for this article.
March 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28562404/bundle-payment-program-initiative-roles-of-a-nurse-navigator-and-home-health-professionals
#11
Heather Peiritsch
With the passage of the Affordable Care Act, The Centers for Medicare and Medicaid (CMS) introduced a new value-based payment model, the Bundle Payment Care Initiative. The CMS Innovation (Innovation Center) authorized hospitals to participate in a pilot to test innovative payment and service delivery models that have a potential to reduce Medicare expenditures while maintaining or improving the quality of care for beneficiaries. A hospital-based home care agency, Abington Jefferson Health Home Care Department, led the initiative for the development and implementation of the Bundled Payment Program...
June 2017: Home Healthcare Now
https://www.readbyqxmd.com/read/28562307/the-eye-of-the-beholder-a-discussion-of-value-and-quality-from-the-perspective-of-families-of-children-and-youth-with-special-health-care-needs
#12
Betsy Anderson, Julie Beckett, Nora Wells, Meg Comeau
There is broad agreement that increasing the cost-effectiveness and quality of health care services, thereby achieving greater value, is imperative given this country's current spiraling costs and poor health outcomes. However, how individuals or stakeholder groups define value may differ significantly. Discussion of value in the context of health care, in particular value-based purchasing and value-based insurance design, must acknowledge that there is no universal consensus definition as to what constitutes value...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28561691/improving-quality-and-value-of-cancer-care-for-older-adults
#13
Erika E Ramsdale, Valerie Csik, Andrew E Chapman, Arash Naeim, Beverly Canin
The concepts of quality and value have become ubiquitous in discussions about health care, including cancer care. Despite their prominence, these concepts remain difficult to encapsulate, with multiple definitions and frameworks emerging over the past few decades. Defining quality and value for the care of older adults with cancer can be particularly challenging. Older adults are heterogeneous and often excluded from clinical trials, severely limiting generalizable data for this population. Moreover, many frameworks for quality and value focus on traditional outcomes of survival and toxicity and neglect goals that may be more meaningful for older adults, such as quality of life and functional independence...
2017: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/28537786/designing-a-community-based-population-health-model
#14
Christopher J Durovich, Peter W Roberts
The pace of change from volume-based to value-based payment in health care varies dramatically among markets. Regardless of the ultimate disposition of the Affordable Care Act, employers and public-private payers will continue to increase pressure on health care providers to assume financial risk for populations in the form of shared savings, bundled payments, downside risk, or even capitation. This article outlines a suggested road map and practical considerations for health systems that are building or planning to build population health capabilities to meet the needs of their local markets...
May 24, 2017: Population Health Management
https://www.readbyqxmd.com/read/28535996/time-driven-activity-based-costing-in-health-care-a-systematic-review-of-the-literature
#15
REVIEW
George Keel, Carl Savage, Muhammad Rafiq, Pamela Mazzocato
Health care organizations around the world are investing heavily in value-based health care (VBHC), and time-driven activity-based costing (TDABC) has been suggested as the cost-component of VBHC capable of addressing costing challenges. The aim of this study is to explore why TDABC has been applied in health care, how its application reflects a seven-step method developed specifically for VBHC, and implications for the future use of TDABC. This is a systematic review following the PRISMA statement. Qualitative methods were employed to analyze data through content analyses...
May 10, 2017: Health Policy
https://www.readbyqxmd.com/read/28535101/design-challenges-of-an-episode-based-payment-model-in-oncology-the-centers-for-medicare-medicaid-services-oncology-care-model
#16
Ronald M Kline, L Daniel Muldoon, Heidi K Schumacher, Larisa M Strawbridge, Andrew W York, Laura K Mortimer, Alison F Falb, Katherine J Cox, Carol Bazell, Ellen W Lukens, Mary C Kapp, Rahul Rajkumar, Amy Bassano, Patrick H Conway
The Centers for Medicare & Medicaid Services developed the Oncology Care Model as an episode-based payment model to encourage participating practitioners to provide higher-quality, better-coordinated care at a lower cost to the nearly three-quarter million fee-for-service Medicare beneficiaries with cancer who receive chemotherapy each year. Episode payment models can be complex. They combine into a single benchmark price all payments for services during an episode of illness, many of which may be delivered at different times by different providers in different locations...
May 23, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28509721/bundled-payments-for-care-improvement-preparing-for-the-medical-diagnosis-related-groups
#17
Lauran Hardin, Adam Kilian, Elizabeth Murphy
BACKGROUND: The Centers for Medicare and Medicaid Services Innovation Center introduced the Bundled Payments for Care Improvement (BPCI) initiative in 2011 as 1 strategy to encourage healthcare organizations and clinicians to improve healthcare delivery for patients, both when they are in the hospital and after they are discharged. Mercy Health Saint Mary's, a large urban academic medical center, engaged in BPCI primarily with a group of medical diagnosis-related groups (DRGs). OBJECTIVES: In this article, we describe our experience creating a system of response for the diverse people and diagnoses that fall into the medical DRG bundles and specifically identify organizational factors for enabling successful implementation of bundled payments...
June 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28490435/home-dialysis-in-the-prospective-payment-system-era
#18
Eugene Lin, Xingxing S Cheng, Kuo-Kai Chin, Talhah Zubair, Glenn M Chertow, Eran Bendavid, Jayanta Bhattacharya
The ESRD Prospective Payment System introduced two incentives to increase home dialysis use: bundling injectable medications into a single payment for treatment and paying for home dialysis training. We evaluated the effects of the ESRD Prospective Payment System on home dialysis use by patients starting dialysis in the United States from January 1, 2006 to August 31, 2013. We analyzed data on dialysis modality, insurance type, and comorbidities from the United States Renal Data System. We estimated the effect of the policy on home dialysis use with multivariable logistic regression and compared the effect on Medicare Parts A/B beneficiaries with the effect on patients with other types of insurance...
May 10, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28486280/payor-reform-opportunities-for-spine-surgery-part-iii-population-health-programs-and-converging-strategies
#19
Jason Scalise, David Jacofsky
As the cost of health care continues to rise, government and commercial payors are implementing strategies as a means of reducing the overall expenditure of health care dollars. The largest savings will be not just in more cost-effective treatments but in strategies that can avoid the need for treatments in the first place. Although the savings from popular payor reform strategies like bundled payments are tied to the initiation of the clinical episode, population health programs utilize a variety of tactics to decrease the need for health care utilization overall...
May 8, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28486279/payor-reform-opportunities-for-spine-surgery-part-i-background-and-stimulus-for-bundled-payments
#20
Jason Scalise, David Jacofsky
Spine surgery, and orthopedic surgery overall, is being increasingly scrutinized by payors due to large projected increases in utilization. The unsustainability of the fee-for-service payment system has lead payors to investigate novel value and risk-based contracting strategies on an episode of care basis and on a population health basis. These forays into progressive models for spine surgery have been supported by the successes demonstrated by advanced payor reform programs from The Centers for Medicare and Medicaid Services in other areas of musculoskeletal medicine...
June 2017: Clinical Spine Surgery
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