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"High value care"

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https://www.readbyqxmd.com/read/29329988/rethinking-medicaid-coverage-and-payment-policy-to-promote-high-value-care-the-case-of-long-acting-reversible-contraception
#1
Veronica X Vela, Elizabeth W Patton, Darshak Sanghavi, Susan F Wood, Peter Shin, Sara Rosenbaum
CONTEXT: Long-acting reversible contraception (LARC) is the most effective reversible method to prevent unplanned pregnancies. Variability in state-level policies and the high cost of LARC could create substantial inconsistencies in Medicaid coverage, despite federal guidance aimed at enhancing broad access. This study surveyed state Medicaid payment policies and outreach activities related to LARC to explore the scope of services covered. METHODS: Using publicly available information, we performed a content analysis of state Medicaid family planning and LARC payment policies...
January 9, 2018: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/29299607/comparison-of-accessibility-cost-and-quality-of-elective-coronary-revascularization-between-veterans-affairs-and-community-care-hospitals
#2
Paul G Barnett, Juliette S Hong, Evan Carey, Gary K Grunwald, Karen Joynt Maddox, Thomas M Maddox
Importance: The Veterans Affairs (VA) Community Care (CC) Program supplements VA care with community-based medical services. However, access gains and value provided by CC have not been well described. Objectives: To compare the access, cost, and quality of elective coronary revascularization procedures between VA and CC hospitals and to evaluate if procedural volume or publicly reported quality data can be used to identify high-value care. Design, Setting, and Participants: Observational cohort study of veterans younger than 65 years undergoing an elective coronary revascularization, controlling for differences in risk factors using propensity adjustment...
January 3, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29251606/issues-in-access-to-end-of-life-care-in-low-resource-areas
#3
Yogesh Jain, Gajanan Phutke
Even though 1% of people require palliative and end-of-life care in low-resource situations, it remains an uncharted arena. Yet it is as important as curative care to alleviate suffering. Palliative care is not only a need in cancer and HIV disease; but is needed in a diverse group of illnesses ranging from tuberculosis, renal failures, paraplegia to chronic lung diseases. In a lower resource setting, the gaps in palliation may be the need for more technology and interventions or more healthcare professionals...
October 25, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/29236093/trends-in-troponin-only-testing-for-ami-in-academic-teaching-hospitals-and-the-impact-of-choosing-wisely%C3%A2
#4
Micah T Prochaska, Samuel F Hohmann, Matthew Modes, Vineet M Arora
BACKGROUND: Identifying hospitals that are both early and consistent adopters of high-value care can help shed light on the culture and practices at those institutions that are necessary to promote high-value care nationwide. The use of troponin to diagnose acute myocardial infarction (AMI), and not to test for myoglobin or creatine kinase-MB (CK-MB), is a high-value recommendation of the Choosing Wisely® campaign. OBJECTIVE: To examine the variation in cardiac biomarker testing and the effect of the Choosing Wisely® troponin-only recommendation for the diagnosis of AMI...
December 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29225448/commentary-de-implementation-science-a-virtuous-cycle-of-ceasing-and-desisting-low-value-care-before-implementing-new-high-value-care
#5
EDITORIAL
Karina W Davidson, Siqin Ye, George A Mensah
Implementation science has traditionally focused on increasing the delivery of evidence-based care. The science of systematically stopping low-value and wasteful care is substantially under-recognized, and if successful, may decrease the workload of clinicians. De-implementation science identifies problem areas of low-value and wasteful practice, carries out rigorous scientific examination of the factors that initiate and maintain such behaviors, and then employs evidence-based interventions to cease these practices...
2017: Ethnicity & Disease
https://www.readbyqxmd.com/read/29214373/utilization-of-breast-cancer-screening-with-magnetic-resonance-imaging-in-community-practice
#6
Deirdre A Hill, Jennifer S Haas, Robert Wellman, Rebecca A Hubbard, Christoph I Lee, Jennifer Alford-Teaster, Karen J Wernli, Louise M Henderson, Natasha K Stout, Anna N A Tosteson, Karla Kerlikowske, Tracy Onega
BACKGROUND: Breast cancer screening with magnetic resonance imaging (MRI) may be a useful adjunct to screening mammography in high-risk women, but MRI uptake may be increasing rapidly among low- and average-risk women for whom benefits are unestablished. Comparatively little is known about use of screening MRI in community practice. OBJECTIVE: To assess relative utilization of MRI among women who do and do not meet professional society guidelines for supplemental screening, and describe utilization according to breast cancer risk indications...
December 6, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29196176/assessing-value-in-breast-reconstruction-a-systematic-review-of-cost-effectiveness-studies
#7
Clifford C Sheckter, Evan Matros, Arash Momeni
INTRODUCTION: Breast reconstruction is one of the most common procedures performed by plastic surgeons and is achieved through various choices in both technology and method. Cost-effectiveness analyses are increasingly important in assessing differences in value between treatment options, which is relevant in a world of confined resources. A thorough evaluation of the cost-effectiveness literature can assist surgeons and health systems evaluate high-value care models. METHODS: A systematic review of PubMed, Web of Science, and the Cost-Effectiveness Analysis Registry was conducted...
October 9, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29159414/hepatitis-b-vaccination-screening-and-linkage-to-care-best-practice-advice-from-the-american-college-of-physicians-and-the-centers-for-disease-control-and-prevention
#8
Winston E Abara, Amir Qaseem, Sarah Schillie, Brian J McMahon, Aaron M Harris
Background: Vaccination, screening, and linkage to care can reduce the burden of chronic hepatitis B virus (HBV) infection. However, recommendations vary among organizations, and their implementation has been suboptimal. The American College of Physicians' High Value Care Task Force and the Centers for Disease Control and Prevention developed this article to present best practice statements for hepatitis B vaccination, screening, and linkage to care. Methods: A narrative literature review of clinical guidelines, systematic reviews, randomized trials, and intervention studies on hepatitis B vaccination, screening, and linkage to care published between January 2005 and June 2017 was conducted...
November 21, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29159367/promoting-high-value-practice-by-reducing-unnecessary-transfusions-with-a-patient-blood-management-program
#9
Divyajot Sadana, Ariella Pratzer, Lauren J Scher, Harry S Saag, Nicole Adler, Frank M Volpicelli, Moises Auron, Steven M Frank
Although blood transfusion is a lifesaving therapy for some patients, transfusion has been named 1 of the top 5 overused procedures in US hospitals. As unnecessary transfusions only increase risk and cost without providing benefit, improving transfusion practice is an effective way of promoting high-value care. Most high-quality clinical trials supporting a restrictive transfusion strategy have been published in the past 5 to 10 years, so the value of a successful patient blood management program has only recently been recognized...
November 20, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29155338/financial-toxicity-in-bladder-cancer-patients-reasons-for-delay-in-care-and-effect-on-quality-of-life
#10
Marianne M Casilla-Lennon, Seul Ki Choi, Allison M Deal, Jeannette T Bensen, Gopal Narang, Pauline Filippou, Benjamin McCormick, Raj Pruthi, Eric Wallen, Hung-Jui Tan, Michael Woods, Matthew Nielsen, Angela Smith
PURPOSE: Costly surveillance and treatment of bladder cancer can lead to financial toxicity (FT), a treatment-related financial burden. Our objective was to define the prevalence of FT among bladder cancer patients and identify delays in care and its effect on health-related quality of life (HRQOL). METHODS: We identified bladder cancer patients in the UNC Health Registry/Cancer Survivorship Cohort. FT was defined as agreement with having "to pay more for medical care than you can afford...
November 16, 2017: Journal of Urology
https://www.readbyqxmd.com/read/29151009/risk-stratification-triage-and-implementation-of-an-expedited-hip-fracture-treatment-protocol-is-it-safe-and-effective
#11
William Zelenty, Richard Yoon, Lorraine Hutzler, Nirmal Tejwani, Joseph Bosco
INTRODUCTION: The population of patients in the USA over the age of 65 is expected to significantly increase over the next 40 years. These patients are at increased risk for hip fractures and will pose a burden to providers in the near future. In order to provide high value care, providers will need to maintain positive outcomes, mitigate complications, and reduce overall cost burdens. This study was designed to investigate the safety and efficacy of a patient transfer protocol between a large academic medical center and a single specialty orthopaedic institution...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29145981/total-hip-arthroplasty-in-the-outpatient-setting-what-you-need-to-know-part-2
#12
REVIEW
Zain Sayeed, Leila Abaab, Mouhanad El-Othmani, Vinay Pallekonda, William Mihalko, Khaled J Saleh
The intra- and postoperative phases of outpatient total hip arthroplasty (THA) vary by institution and surgeon. An understanding of an evidence-based approach to enhancing the intra- and postoperative phases of the care continuum is warranted to offer high-value care to outpatient candidates. This article will discuss methods for implementing successful outpatient THA protocols. Specifically it reviews information regarding anesthesia and analgesia modalities, intraoperative considerations, and postoperative rehabilitation amenable to outpatient THA...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145584/critical-lessons-from-high-value-oncology-practices
#13
Douglas W Blayney, Melora K Simon, Beatrice Podtschaske, Scott Ramsey, Margaret Shyu, Craig Lindquist, Arnold Milstein
Importance: Cancer care is expensive. Cancer care provided by practice organizations varies in total spending incurred by patients and payers during treatment episodes and in quality of care, and this unnecessary variation contributes to the high cost. Objective: To use the variation in total spending and quality of care to assess oncology practice attributes distinguishing "high value" that may be tested and adopted by others to produce similar results. Design, Setting, and Participants: "Positive deviance" was used in this exploratory mixed-methods (quantitative and qualitative) analysis of interview results...
November 16, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/29122544/population-health-management-for-inflammatory-bowel-disease
#14
REVIEW
Parambir S Dulai, Siddharth Singh, Lucilla Ohno-Machado, William J Sandborn
Inflammatory bowel diseases (IBDs) are chronic and impose significant, multidimensional burdens on patients and health care systems. The increasing prevalence of IBD will only worsen this problem globally-population health management (PHM) strategies are needed to increase quality of care and population health outcomes while reducing health care costs. We discuss the key components of PHM in IBD. Effective implementation of PHM strategies requires accurate identification of at-risk patients and key areas of variability in care...
January 2018: Gastroenterology
https://www.readbyqxmd.com/read/29095705/transitioning-to-a-high-value-health-care-model-academic-accountability
#15
Pamela T Johnson, Matthew D Alvin, Roy C Ziegelstein
Health care spending in the United States has increased to unprecedented levels, and these costs have broken medical providers' promise to do no harm. Medical debt is the leading contributor to U.S. personal bankruptcy, more than 50% of household foreclosures are secondary to medical debt and illness, and patients are choosing to avoid necessary care because of its cost. Evidence that the health care delivery model is contributing to patient hardship is a call for action to the profession to transition to a high value model, one that delivers the highest health care quality and safety at the lowest personal and financial cost to patients...
November 1, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29091509/a-person-centered-registry-based-learning-health-system-for-palliative-care-a-path-to-coproducing-better-outcomes-experience-value-and-science
#16
Arif H Kamal, Kathryn B Kirkland, Diane E Meier, Tamara S Morgan, Eugene C Nelson, Steven Z Pantilat
BACKGROUND: Palliative care offers an approach to the care of people with serious illness that focuses on quality of life and aligning care with individual and family goals, and values in the context of what is medically achievable. OBJECTIVE: Measurement of the impact of palliative care is critical for determining what works for which patients in what settings, to learn, improve care, and ensure access to high value care for people with serious illness. METHODS: A learning health system that includes patients and families partnering with clinicians and care teams, is directly linked to a registry to support networks for improvement and research, and offers an ideal framework for measuring what matters to a range of stakeholders interested in improving care for this population...
November 1, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29075388/delivery-and-measurement-of-high-value-care-in-standardized-patient-encounters
#17
Jennifer DeLuca Baldwin, Jaclyn Cox, Zhao Helen Wu, Anne Kenny, Steven Angus
BACKGROUND : Residencies have incorporated high-value care (HVC) training to contain health care expenditures. Assessment methods of HVC curricula are limited. OBJECTIVE : In our clinical skills laboratory, we evaluated the effectiveness of HVC curricula using standardized patients (SPs) to determine if there is a correlation with performance in counseling, history and physical, HVC knowledge, and demographics. METHODS : Through ambulatory cases, SPs evaluated postgraduate year 2 (PGY-2) residents using checklists to determine if they obtained the chief complaint, medical and social history, focused physical examination, and conveyed information regarding patient management...
October 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/29075387/high-value-consults-a-curriculum-to-promote-point-of-care-evidence-based-recommendations
#18
Deepa Rani Nandiwada, Amar Kohli, Megan McNamara, Kenneth J Smith, Shanta Zimmer, Melissa McNeil, Carla Spagnoletti, Doris Rubio, Kathryn Berlacher
BACKGROUND : In an era when value-based care is paramount, teaching trainees to explicitly communicate the evidence behind recommendations fosters high-value care (HVC) in the consultation process. OBJECTIVE : To implement an HVC consult curriculum highlighting the need for clear consult questions, evidence-based recommendations to improve consult teaching, clinical decision-making, and the educational value of consults. METHODS : A pilot curriculum was implemented for residents on cardiology consult electives utilizing faculty and fellows as evidence-based medicine (EBM) coaches...
October 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/29068816/concerns-and-responses-for-integrating-health-systems-science-into-medical-education
#19
Jed D Gonzalo, Kelly J Caverzagie, Richard E Hawkins, Luan Lawson, Daniel R Wolpaw, Anna Chang
With the aim of improving the health of individuals and populations, medical schools are transforming curricula to ensure physician competence encompasses health systems science (HSS), which includes population health, health policy, high-value care, interprofessional teamwork, leadership, quality improvement, and patient safety. Large-scale, meaningful integration remains limited, however, and a major challenge in HSS curricular transformation efforts relates to the receptivity and engagement of students, educators, clinicians, scientists, and health system leaders...
October 24, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28987504/aga-institute-high-value-care-statement-is-high-resolution-manometry-always-needed-for-the-diagnosis-of-achalasia
#20
Dustin A Carlson, C Prakash Gyawali
No abstract text is available yet for this article.
October 5, 2017: Clinical Gastroenterology and Hepatology
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