keyword
MENU ▼
Read by QxMD icon Read
search

Value based reimbursement

keyword
https://www.readbyqxmd.com/read/28535102/why-value-framework-assessments-arrive-at-different-conclusions-a-multiple-myeloma-case-study
#1
Kimberly Westrich, Lisabeth Buelt, Robert W Dubois
As the United States transitions from a volume-based health care system to one that rewards value, new frameworks are emerging to help patients, providers, and payers assess the value of medical services and biopharmaceutical products. These value assessment frameworks are intended to support various types of health care decision making. They have the potential to substantially affect patients, whether as tools for shared decision making with their doctors, as an input to care pathways used by providers, or through payer use of the frameworks to make coverage or reimbursement decisions...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28532630/shared-decision-making-as-part-of-value-based-care-new-u-s-policies-challenge-our-readiness
#2
Erica S Spatz, Glyn Elwyn, Benjamin W Moulton, Robert J Volk, Dominick L Frosch
Shared decision making in the United States is increasingly being recognized as part of value-based care. During the last decade, several state and federal initiatives have linked shared decision making with reimbursement and increased protection from litigation. Additionally, private and public foundations are increasingly funding studies to identify best practices for moving shared decision making from the research world into clinical practice. These shifts offer opportunities and challenges for ensuring effective implementation...
May 20, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28511946/national-incidence-of-patient-safety-indicators-in-the-total-hip-arthroplasty-population
#3
Joseph E Tanenbaum, Derrick M Knapik, Glenn D Wera, Steven J Fitzgerald
BACKGROUND: The Centers for Medicare & Medicaid Services use the incidence of patient safety indicators (PSIs) to determine health care value and hospital reimbursement. The national incidence of PSI has not been quantified in the total hip arthroplasty (THA) population, and it is unknown if patient insurance status is associated with PSI incidence after THA. METHODS: All patients in the Nationwide Inpatient Sample (NIS) who underwent THA in 2013 were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification codes...
April 12, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28511830/personality-disorders-and-the-difficult-dermatology-patient-maximizing-patient-satisfaction
#4
Mio Nakamura, John Koo
Personality disorders (PDs) are stable and enduring patterns of thought, feeling, and behavior that deviate from one's cultural norms and cause impairment in functionality. Patients with PDs are commonly encountered in the dermatologic setting and can be perceived by providers as "difficult." Given that PDs are chronic, rigid, and frustrating to deal with, it is important to be skillful in the approach to such patients, especially in the era of the value-based reimbursement system, in which patient satisfaction is crucial for reimbursement...
May 2017: Clinics in Dermatology
https://www.readbyqxmd.com/read/28502850/cost-effectiveness-of-a-bronchial-genomic-classifier-for-the-diagnostic-evaluation-of-lung-cancer
#5
David Feller-Kopman, Shan Liu, Benjamin P Geisler, Malcolm M DeCamp, Jan B Pietzsch
BACKGROUND: The use of a bronchial genomic classifier has been shown to improve the diagnostic accuracy of bronchoscopy for suspected lung cancer by identifying patients who may be more suitable for radiographic surveillance as opposed to undergoing invasive procedures. Our objective was to assess the cost-effectiveness of bronchoscopy plus genomic classifier versus bronchoscopy alone in the diagnostic work-up of patients at intermediate risk for lung cancer. METHODS: A decision-analytic Markov model was developed to project the costs and effects of two competing strategies, using test performance from the AEGIS-1 and AEGIS-2 studies...
May 9, 2017: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/28502549/reimbursement-in-hospital-based-vascular-surgery-physician-and-practice-perspective
#6
Jennifer L Perri, Robert M Zwolak, Philip P Goodney, Gretchen A Rutherford, Richard J Powell
OBJECTIVE: The purpose of this study was to determine change in value of a vascular surgery division to the health care system during 6 years at a hospital-based academic practice and to compare physician vs hospital revenue earned during this period. METHODS: Total revenue generated by the vascular surgery service line at an academic medical center from 2010 through 2015 was evaluated. Total revenue was measured as the sum of physician (professional) and hospital (technical) net revenue for all vascular-related patient care...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28488405/dollars-and-stents-a-brave-new-world
#7
EDITORIAL
Sandeep K Krishnan, Larry S Dean
Reimbursement in the healthcare system is shifting from pure volume to a mixed volume/value-based metric. Using complex statistical modeling to adjust for unknowns, the study provides real world data that the use of Co-Cr EES is more cost effective than BMS assuming that clinicians select clopidogrel for P2Y12 inhibition. More cost-effectiveness analyses should be conducted to guide the use of ever costlier novel medical devices and drugs.
May 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28446383/development-and-validation-of-the-parenteral-nutrition-impact-questionnaire-pniq-a-patient-centric-outcome-measure-for-home-parenteral-nutrition
#8
Jeanette Wilburn, Stephen P McKenna, Alice Heaney, Matthew Rouse, Michael Taylor, Alison Culkin, Simon Gabe, Sorrel Burden, Simon Lal
BACKGROUND & AIMS: Patients with Type 3 Intestinal Failure (IF) who need Home Parenteral Nutrition (HPN) face several clinical, psychological and social problems. The study was designed to produce and test the first patient-centric measure for HPN ('PNIQ: Parenteral Nutrition Impact Questionnaire'). The new measure focused on the extent to which patients were able to fulfil their human needs. METHODS: Questionnaire content was derived from the analysis of transcripts of interviews conducted with UK HPN patients...
April 12, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28441617/the-magic-survey-in-hormone-receptor-positive-hr-her2-negative-her2-breast-cancer-when-might-multigene-assays-be-of-value
#9
Matti Aapro, Michelino De Laurentiis, Dan Rea, Juan Enrique Bargallo Rocha, Roberto Elizalde, László Landherr, Barbro Linderholm, Eleftherios Mamounas, Christos Markopoulos, Patrick Neven, Alexander Petrovsky, Roman Rouzier, Vincent Smit, Christer Svedman, Daniel Schneider, Christoph Thomssen, Miguel Martin
BACKGROUND: A modest proportion of patients with early stage hormone receptor-positive (HR+), HER2-negative (HER2-) breast cancer benefit from adjuvant chemotherapy. Traditionally, treatment recommendations are based on clinical/pathologic criteria that are not predictive of chemotherapy benefit. Multigene assays provide prognostic and predictive information that can help to make more informed treatment decisions. The MAGIC survey evaluated international differences in treatment recommendations, how traditional parameters are used for making treatment choices, and for which patients treating physicians feel most uncertain about their decisions...
June 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28441271/alternative-payment-models-and-urology
#10
Deborah R Kaye, David C Miller, Chad Ellimoottil
PURPOSE OF REVIEW: The Medicare Access and CHIP Reauthorization Act (MACRA) is a historic bill that was recently passed that establishes how quality measurement and practice patterns will affect physician reimbursement. Alternative payment models (APMs) are an essential component of MACRA and Medicare's vision of paying for high-value care. This review describes APMs in the context of MACRA and their impact on urology. RECENT FINDINGS: The majority of urologists will be affected by MACRA...
April 22, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28434843/becoming-a-winning-radiology-group-in-a-value-based-medical-reimbursement-system-a-summary-of-the-acr-rbma-practice-leaders-forum-2017
#11
Suraj Jay Kabadi
No abstract text is available yet for this article.
April 20, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28426107/controversies-and-consensus-in-the-innovation-access-for-cancer-therapy-in-the-european-countries-on-the-subject-of-metastatic-prostate-cancer
#12
S Oudard, F Courbon
Innovative cancer therapies and advances in drug development have created new hopes for patients and health providers. The purpose of this article was to evaluate the discrepancies in the assessment of the magnitude of benefit of four new drugs (abiraterone acetate, enzalutamide, cabazitaxel, radium-223 dichloride) for the treatment of metastatic castration-resistant prostate cancer (mCRPC). The comparison was done among three European countries (UK, Germany and France) and Canada, according to the statement of each country and to the European Society of Medical Oncology (ESMO) Magnitude of Clinical Benefit Scale...
February 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28419343/utilizing-a-modified-care-coordination-measurement-tool-to-capture-value-for-a-pediatric-outpatient-parenteral-and-prolonged-oral-antibiotic-therapy-program
#13
Louise E Vaz, Cindi L Farnstrom, Kimberly K Felder, Judith Guzman-Cottrill, Hannah Rosenberg, Richard C Antonelli
Background.: Outpatient parenteral or prolonged oral antibiotic therapy (OPAT) programs reduce inpatient healthcare costs by shifting care to outpatient settings. Care coordination (CC) is a necessary component to successfully transition patients. Our objective was to assess outcomes of provider time spent on nonreimbursable CC activities in a pediatric OPAT program. Methods.: We used a qualitative feasibility pilot design and modified the Care Coordination Measurement Tool...
April 17, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28416322/nephrologists-and-integrated-kidney-disease-care-roles-and-skills-essential-for-nephrologists-for-future-success
#14
Allen R Nissenson, Franklin W Maddux
As the costs of caring for patients with end-stage renal disease have grown, so has the pressure to provide high-quality care at a lower cost. Prompted in large part by regulatory and legislative changes, reimbursement is shifting from a fee-for-service environment to one of value-based payment models. Nephrologists in this new environment are increasingly responsible not only for direct patient care, but also for population management and the associated clinical outcomes for this vulnerable population. This Perspective article aims to recognize the key role and skills needed in order to successfully practice within these new value-based care models...
April 14, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28412775/defining-value-in-radiation-oncology-approaches-to-weighing-benefits-vs-costs
#15
REVIEW
Andre A Konski
The passage of the Affordable Care Act in 2010 initiated discussion regarding transitioning from a fee-for-service arrangement of care reimbursement to value-based care. Cost-effectiveness analysis (CEA) has been used in the past to quantify value as it relates to the provision of healthcare. New treatments or techniques being compared with other new or existing therapies or approaches to care were determined to be cost-effective if the incremental cost-effectiveness ratio was less than $50,000/life-year or quality-adjusted life-year...
April 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28408255/supraorbital-versus-endoscopic-endonasal-approaches-for-olfactory-groove-meningiomas-a-cost-minimization-study
#16
Gurpreet S Gandhoke, Matthew Pease, Kenneth J Smith, Raymond F Sekula
INTRODUCTION: We performed a cost-minimization study comparing the supraorbital and endoscopic, endonasal (EEA) approaches with or without the addition of craniotomy for the resection of olfactory groove meningioma. METHODS: We built a decision tree using probabilities of gross total resection and CSF leak rates with the supraorbital approach versus EEA with and without additional craniotomy. The cost (not charge or reimbursement) at each 'stem' of this decision tree, for both surgical options was obtained from our hospital's finance department...
April 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28407260/the-value-of-nursing-care-a-concept-analysis
#17
Tracey K Dick, Patricia A Patrician, Lori A Loan
AIM: To report an analysis of the concept of value of nursing care. BACKGROUND: Value-based health care delivery and reimbursement models are focused on value as a product of quality and cost. Nursing care provides tangible and intangible contributions to patient and organizational outcomes. The nursing profession must be able to proactively and effectively communicate the value of nursing care. DESIGN: Concept analysis. DATA SOURCES: Thirty-five separate sources were chosen from database searches of CINAHL Complete and ABI/INFORM Complete...
April 13, 2017: Nursing Forum
https://www.readbyqxmd.com/read/28402750/an-efficient-nurse-practitioner-led-community-based-service-model-for-delivering-coordinated-care-to-persons-with-serious-mental-illness-at-risk-for-homelessness
#18
Jeannemarie Baker, Jasmine L Travers, Penelope Buschman, Jacqueline A Merrill
BACKGROUND: Access to mental health care is a struggle for those with serious mental illness (SMI). About 25% of homeless suffer from SMI, compared with 4.2% of the general population. OBJECTIVE: From 2003 to 2012, St. Paul's Center (SPC) operated a unique model to provide quality care to the homeless and those at risk for homelessness, incarceration, and unnecessary hospitalization because of SMI. Data were available for analysis for the years 2008 to 2010. DESIGN: The SPC was developed, managed, and staffed by board-certified psychiatric/mental health nurse practitioners, offering comprehensive mental health services and coordinated interventions...
April 1, 2017: Journal of the American Psychiatric Nurses Association
https://www.readbyqxmd.com/read/28389134/private-bundles-the-nuances-of-contracting-and-managing-total-joint-arthroplasty-episodes
#19
Ameer M Elbuluk, Owen R O'Neill
In recent years, bundled payment reimbursement models have been used to address the unsustainable rising cost of healthcare. Centers for Medicare and Medicaid Services initiatives, such as Bundled Payment for Care Improvement Program, have already demonstrated their ability to create financial and performance accountability in the public sector. More recently, these value-based models have been introduced among private payers to increase coordination, quality, and efficiency. Bundled payment strategies provide incentives for physicians and healthcare professionals to eliminate unnecessary services and reduce costs...
February 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28359063/reimbursed-price-of-orphan-drugs-current-strategies-and-potential-improvements
#20
Pierpaolo Mincarone, Carlo Giacomo Leo, Saverio Sabina, Antonio Sarriá-Santamera, Domenica Taruscio, Pedro Guillermo Serrano-Aguilar, Panos Kanavos
The pricing and reimbursement policies for pharmaceuticals are relevant to balance timely and equitable access for all patients, financial sustainability, and reward for valuable innovation. The proliferation of high-cost specialty medicines is particularly true in rare diseases (RDs) where the pricing mechanism is characterised by a lack of transparency. This work provides an overall picture of current strategies for the definition of the reimbursed prices of orphan drugs (ODs) and highlights some potential improvements...
March 31, 2017: Public Health Genomics
keyword
keyword
22992
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"