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https://www.readbyqxmd.com/read/29452972/does-preoperative-opioid-use-increase-the-risk-of-early-revision-total-hip-arthroplasty
#1
Nicholas A Bedard, David E DeMik, S Blake Dowdle, Jessell M Owens, Steve S Liu, John J Callaghan
BACKGROUND: The purpose of this study is to evaluate the impact of preoperative opioid use on the risk of subsequent revison after primary total hip arthroplasty (THA). METHODS: The Humana database was queried for unilateral THA between 2007-2015. Patients were tracked for the occurrence of an ipsilateral revision THA for 2. Factors analyzed included preoperative opioid use (defined as a history of opioid prescription filled within 3 months preceding primary THA), age, sex, diabetes, anxiety/depression, chronic kidney disease, and obesity (body mass index > 30 kg/m 2 )...
February 13, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29452560/health-care-efficiencies-consolidation-and-alternative-models-vs-health-care-and-antitrust-regulation-irreconcilable-differences
#2
Michael W King
Despite the U.S. substantially outspending peer high income nations with almost 18% of GDP dedicated to health care, on any number of statistical measurements from life expectancy to birth rates to chronic disease, 1 the U.S. achieves inferior health outcomes. In short, Americans receive a very disappointing return on investment on their health care dollars, causing economic and social strain. 2 Accordingly, the debates rage on: what is the top driver of health care spending? Among the culprits: poor communication and coordination among disparate providers, paperwork required by payors and regulations, well-intentioned physicians overprescribing treatments, drugs and devices, outright fraud and abuse, and medical malpractice litigation...
November 2017: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29451464/bundled-payment-for-bundles-of-joy
#3
Lola Butcher
Episode payments for maternity care, however, are particularly challenging for many reasons, including the fact that a full course of care starts with one patient and usually ends with at least two. Something needs to be done, because pregnancy, labor, and birth account for seven of the top 20 most expensive hospitalized conditions.
February 2018: Managed Care
https://www.readbyqxmd.com/read/29442297/a-single-center-cost-analysis-of-treating-primary-and-metastatic-brain-cancers-with-either-brain-laser-interstitial-thermal-therapy-litt-or-craniotomy
#4
Eric C Leuthardt, Jeff Voigt, Albert H Kim, Pete Sylvester
BACKGROUND: Brain laser interstitial thermal therapy (LITT) under magnetic resonance imaging (MRI) guidance has recently gained US clinical approval for the ablation of soft, neurological tissue. LITT is a minimally invasive alternative to craniotomy. OBJECTIVE: While safety and efficacy are the focus of most current LITT studies, it is unclear how acute care costs (inpatient care ± aftercare) of LITT compare to craniotomy in an academic medical center. Therefore, the purpose of this analysis is to examine these costs of using brain LITT under MRI guidance compared to craniotomy in complex anatomies...
March 2017: PharmacoEconomics Open
https://www.readbyqxmd.com/read/29419821/the-use-of-individual-provider-performance-reports-by-us-hospitals
#5
Joshua A Rolnick, Kira L Ryskina
Medicare reimbursement for hospitals is increasingly tied to performance. The use of individual provider performance reports offers the potential to improve clinical outcomes through social comparison, and isolated cases of clinical dashboard uses at specific institutions have been previously reported. However, little is known about overall trends in how hospitals use the electronic health record to track and provide feedback on provider performance. We used data from 2013 to 2015 from the American Hospital Association (AHA) Annual Survey Information Technology Supplement, which asked hospitals if they have used electronic data to create performance profiles...
February 7, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29403570/prospective-bundled-payments-in-a-changing-environment-the-experience-of-a-self-funded-state-sponsored-plan
#6
Frank H Lawler, Frank R Wilson, G Keith Smith, Lynn V Mitchell
Background: Healthcare reimbursement, which has traditionally been based on the quantity of services delivered, is currently moving toward value-based reimbursement-a system that addresses the quantity, quality, and cost of services. One such arrangement has been the evolution of bundled payments for a specific procedure or for an episode of care, paid prospectively or through post-hoc reconciliation. Objective: To evaluate the impact of instituting bundled payments that incorporate facility charges, physician fees, and all ancillary charges by the State of Oklahoma HealthChoice public employee insurance plan...
December 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/29398036/what-matters-after-sleeve-gastrectomy-patient-characteristics-or-surgical-technique
#7
Vikrom K Dhar, Dennis J Hanseman, Brad M Watkins, Ian M Paquette, Shimul A Shah, Jonathan R Thompson
BACKGROUND: The impact of operative technique on outcomes in laparoscopic sleeve gastrectomy has been explored previously; however, the relative importance of patient characteristics remains unknown. Our aim was to characterize national variability in operative technique for laparoscopic sleeve gastrectomy and determine whether patient-specific factors are more critical to predicting outcomes. METHODS: We queried the database of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program for laparoscopic sleeve gastrostomies performed in 2015 (n = 88,845)...
February 2, 2018: Surgery
https://www.readbyqxmd.com/read/29395312/society-of-gynecologic-oncology-clinical-outcomes-registry-from-small-beginnings-come-great-things
#8
REVIEW
Summer B Dewdney, Amy C Dancisak, Jason A Lachance, Edward C Grendys, Sean C Dowdy, Matthew Powell, John O Schorge
OBJECTIVE: Clinical registries within medical societies have demonstrated the capacity to promote quality improvement. Opportunities for well-designed data repositories could yield reliable national standards for informing reimbursement, determining adherence to care guidelines, maintaining board certification, and developing bundled payment models. Looking to the future, we set out to develop a gynecologic cancer registry serving the members of the Society of Gynecologic Oncology (SGO)...
January 30, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29377277/business-of-dialysis-and-the-role-of-the-medical-director
#9
Paul J Scheel
Since the inception of the Medicare End Stage Renal Disease Program in 1972, the medical director has been an important leader in the dialysis unit. The initial duties of the medical director were focused on quality and safety but were gradually expanded over the decades to include the development and oversight of protocols to manage metabolic bone disease and anemia. As the total cost of ESRD care has escalated, there have been progressive attempts to control costs through additional bundling and the creation of alternative payment schemes...
January 28, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29369981/discussion-conceptual-considerations-for-payment-bundling-in-breast-reconstruction
#10
Arjun Kanuri, David H Song
No abstract text is available yet for this article.
February 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29369980/conceptual-considerations-for-payment-bundling-in-breast-reconstruction
#11
Clifford C Sheckter, Shantanu N Razdan, Joseph J Disa, Babak J Mehrara, Evan Matros
Rising health care costs and quality demands have driven both the Centers for Medicare and Medicaid Services and the private sector to seek innovations in health system design by placing institutions at financial risk. Novel care models, such as bundled reimbursement, aim to boost value though quality improvement and cost reduction. The Center for Medicare and Medicaid Innovation is leading the charge in this area with multiple pilots and mandates, including Comprehensive Care for Joint Replacement. Other high-cost and high-volume procedures could be considered for bundling in the future, including breast reconstruction...
February 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29369155/distribution-and-determinants-of-90-day-payments-for-multilevel-posterior-lumbar-fusion-a-medicare-analysis
#12
Nikhil Jain, Frank M Phillips, Safdar N Khan
STUDY DESIGN: A retrospective, economic analysis. OBJECTIVE: The objective of this article is to analyze the distribution of 90-day payments, sources of variation, and reimbursement for complications and readmissions for primary ≥3-level posterior lumbar fusion (PLF) from Medicare data. A secondary objective was to identify risk factors for complications. SUMMARY OF BACKGROUND DATA: Bundled payments represent a single payment system to cover all costs associated with a single episode of care, typically over 90 days...
January 23, 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29364553/assessing-relative-cost-of-complications-following-orthotopic-liver-transplant
#13
Neal Bhutiani, Christopher M Jones, Robert M Cannon, David Wei, Laura Goldstein, Sanjoy Roy, Prejesh Philips, Charles R Scoggins, Kelly M McMasters, Robert Cg Martin
INTRODUCTION: Peri-operative complications impose both a clinical and financial burden on patients and the healthcare system. This study sought to identify the frequency and economic impact of complications following orthotopic liver transplantation (OLT). METHODS: The Premier Perspective® Hospital Database was queried for patients undergoing OLT between 2008 and 2015. Complications were identified by ICD-9 code and grouped by complication type. Complication frequency as well as impact on clinical and economic outcomes was calculated...
January 24, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29362780/cms-cancels-mandatory-hip-and-cardiac-payment-bundles
#14
Bridget M Kuehn
No abstract text is available yet for this article.
January 23, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29357548/re-medicare-s-acute-care-episode-demonstration-effects-of-bundled-payments-on-costs-and-quality-of-surgical-care
#15
David F Penson
No abstract text is available yet for this article.
February 2018: Journal of Urology
https://www.readbyqxmd.com/read/29327034/the-rise-and-fall-of-mandatory-cardiac-bundled-payments
#16
Rishi K Wadhera, Robert W Yeh, Karen E Joynt Maddox
No abstract text is available yet for this article.
January 11, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29325725/who-goes-to-inpatient-rehabilitation-or-skilled-nursing-facilities-unexpectedly-following-total-knee-arthroplasty
#17
Alexander J Rondon, Timothy L Tan, Max R Greenky, Karan Goswami, Noam Shohat, Jessica L Phillips, James J Purtill
BACKGROUND: Inpatient rehabilitation facilities (IRFs) and skilled nursing facilities (SNFs) represent a significant portion of post-operative expenses of bundled payments for total knee arthroplasty (TKA). Although many surgeons no longer routinely send patients to IRFs or SNFs, some patients are unable to be discharged directly home. This study identified patient factors for discharge to post-acute care facilities with an institutional protocol of discharging TKA patients home. METHODS: A retrospective review of patients undergoing primary unilateral TKA at a single institution from 2012 to 2017 was performed...
December 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29318267/participation-and-dropout-in-the-bundled-payments-for-care-improvement-initiative
#18
Karen E Joynt Maddox, E John Orav, Jie Zheng, Arnold M Epstein
No abstract text is available yet for this article.
January 9, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29299473/economic-evaluation-of-different-suture-closure-methods-barbed-versus-traditional-interrupted-sutures
#19
REVIEW
Randa K Elmallah, Anton Khlopas, Mhamad Faour, Morad Chughtai, Arthur L Malkani, Peter M Bonutti, Martin Roche, Steven F Harwin, Michael A Mont
Healthcare systems are receiving increasing pressures from payers, such as the Centers for Medicare and Medicaid (CMS), to reduce the costs associated with procedures, and with the implementation of the Affordable Care Act, high costs are addressed through pay-for-performance programs. Thus, multiple areas of total knee arthroplasty (TKA) surgery are under scrutiny, including surgical times, material costs, and the costs of associated complications and readmissions. Suture type has been determined to be a factor that may influence closure times, as well as direct material costs...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29295772/differences-in-post-operative-outcome-between-conversion-and-primary-total-hip-arthroplasty
#20
Charles D Qin, Mia M Helfrich, David W Fitz, Mark A Oyer, Kevin D Hardt, David W Manning
BACKGROUND: The demand for conversion of prior hip surgery to total hip arthroplasty (conversion THA) is likely to increase as a function of increasing US hip fracture burden in addition to its application in managing other conditions. Thus, outcome analysis is warranted to better inform value-based reimbursement schemes in the era of bundled payments. METHODS: Via Current Procedural Terminology codes, the National Surgical Quality Improvement Project data files were queried for all patients who underwent primary THA and conversion of previous hip surgery to THA from 2005 to 2014...
November 29, 2017: Journal of Arthroplasty
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