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Affordable Care Act Health Homes

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https://www.readbyqxmd.com/read/28242864/financing-of-pediatric-home-health-care
#1
Edwin Simpser, Mark L Hudak
Pediatric home health care is an effective and holistic venue of treatment of children with medical complexity or developmental disabilities who otherwise may experience frequent and/or prolonged hospitalizations or who may enter chronic institutional care. Demand for pediatric home health care is increasing while the provider base is eroding, primarily because of inadequate payment or restrictions on benefits. As a result, home care responsibilities assumed by family caregivers have increased and imposed financial, physical, and psychological burdens on the family...
February 27, 2017: Pediatrics
https://www.readbyqxmd.com/read/28182472/integrating-health-care-for-high-need-medicaid-beneficiaries-with-serious-mental-illness-and-chronic-physical-health-conditions-at-managed-care-provider-and-consumer-levels
#2
Jung Y Kim, Tricia Collins Higgins, Dominick Esposito, Allison Hamblin
OBJECTIVE: Policies supporting value-based care and alternative payment models, notably in the Affordable Care Act and the Medicare Access & CHIP Reauthorization Act of 2015, offer hope to advance care integration for individuals with behavioral and chronic physical health conditions. The potential for integration to improve quality while managing costs for individuals with high needs, coupled with the remaining financial, operational, and policy challenges, underscores a need for continued discussion of integration programs' preliminary outcomes and lessons...
February 9, 2017: Psychiatric Rehabilitation Journal
https://www.readbyqxmd.com/read/28152733/trends-in-cancer-care-with-the-affordable-care-act
#3
Robert Clell Miller
46 Background: Accountable Care Organizations (ACO), as proposed by the Affordable Care Act, will change the delivery of health care in the United States. ACO serve as a network of providers with primary care providers (PCP) set up as gate-keepers for referrals to specialists. Within the next several years, many trends will emerge and drive progress of change, requiring oncologist to take a lead role to adapt to the evolving landscape of health care. METHODS: Literature search of internet-based and academic sources for oncology and the Affordable Care, with a focus on ACO formation...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28138827/improving-receipt-and-preventive-care-delivery-for-adolescents-and-young-adults-initial-lessons-from-top-performing-states
#4
Claire D Brindis, Lauren Twietmeyer, M Jane Park, Sally Adams, Charles E Irwin
Purpose Provisions of the Patient Protection and Affordable Care Act (ACA) of 2010 hold promise for improving access to and receipt of preventive services for adolescents and young adults (AYAs). The Title V Block Grant transformation also includes a focus on improving adolescent preventive care. This brief report describes and discusses an inquiry of promising strategies for improving access and preventive care delivery identified in selected high-performing states. Methods Two data sources were used to identify top-performing states in insurance enrollment and preventive care delivery: National Survey of Children's Health for adolescents (ages 12-17 years) and Behavioral Risk Factors Surveillance System for young adults (ages 18-25 years)...
January 30, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28062813/the-transition-of-primary-care-group-practices-to-next-generation-models-satisfaction-of-staff-clinicians-and-patients
#5
Therese Zink, John Kralewski, Bryan Dowd
INTRODUCTION: Restructuring primary care is essential to achieve the triple aim. This case study examines the human factors of extensive redesign on 2 midsized primary care clinics (clinics A and B) in the Midwest United States that are owned by a large health care system. The transition occurred when while the principles for patient-centered medical home were being rolled out nationally, and before the Affordable Care Act. METHODS: After the transition, interviews and discussions were conducted with 5 stakeholder groups: health system leaders, clinic managers, clinicians, nurses, and reception staff...
January 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28033146/health-service-management-interns-serve-as-practice-facilitators-for-patient-centered-medical-home-recognition-east-carolina-university-appalachian-state-university-initiative
#6
Bonita Sasnett, R W Watkins, Marianne Ferlazzo
East Carolina University College of Allied Health Science's Department of Health Services Management program is partnering with Community Care of North Carolina and Access East to transform medical practices and educate students on the Patient-Centered Medical Home (PCMH) model of health care delivery. Why now? The Affordable Care Act (2010) and other health care reform changes brought to the forefront the need to focus on improving the quality of care while lowering the overall cost of care. This article describes the first year of implementation of a PCMH initiative where students in a health services management internship program act as facilitators to assist practices in the PCMH recognition process...
January 2017: Health Care Manager
https://www.readbyqxmd.com/read/27997478/establishing-a-baseline-community-benefit-spending-by-not-for-profit-hospitals-prior-to-implementation-of-the-affordable-care-act
#7
Jonathon P Leider, Greg J Tung, Richard C Lindrooth, Emily K Johnson, Rose Hardy, Brian C Castrucci
CONTEXT: Community Benefit spending by not-for-profit hospitals has served as a critical, formalized part of the nation's safety net for almost 50 years. This has occurred mostly through charity care. This article examines how not-for-profit hospitals spent Community Benefit dollars prior to full implementation of the Affordable Care Act (ACA). METHODS: Using data from 2009 to 2012 hospital tax and other governmental filings, we constructed national, hospital-referral-region, and facility-level estimates of Community Benefit spending...
December 16, 2016: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/27992151/early-impacts-of-the-affordable-care-act-on-health-insurance-coverage-in-medicaid-expansion-and-non-expansion-states
#8
Charles Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata
The Affordable Care Act (ACA) aimed to achieve nearly universal health insurance coverage in the United States through a combination of insurance market reforms, mandates, subsidies, health insurance exchanges, and Medicaid expansions, most of which took effect in 2014. This paper estimates the causal effects of the ACA on health insurance coverage in 2014 using data from the American Community Survey. We utilize difference-in-difference-in-differences models that exploit cross-sectional variation in the intensity of treatment arising from state participation in the Medicaid expansion and local area pre-ACA uninsured rates...
2017: Journal of Policy Analysis and Management
https://www.readbyqxmd.com/read/27982671/payer-provider-patient-registry-utilized-in-a-behavioral-health-home
#9
Michele Mesiano, Meghna Parthasarathy, Shari L Hutchison, David Salai, Suzanne Daub, Mary Doyle, James M Schuster
OBJECTIVES: As defined by the Affordable Care Act, health homes seek to improve healthcare coordination through data exchange and health information technologies; however, few examples of how to use such technology are available. The present effort describes a payer-provider patient registry for behavioral health home service. STUDY DESIGN: An observational study design was used to describe characteristics of individuals identified by the payer-provider patient registry...
December 1, 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27974000/characteristics-of-hospital-emergency-room-visits-for-mental-and-substance-use-disorders
#10
Toluwalope Ayangbayi, Albert Okunade, Mustafa Karakus, Thierry Nianogo
OBJECTIVE: This study compared characteristics of visits to emergency rooms (ERs) for mental and substance use disorders and for physical health conditions to establish a baseline against which to measure changes after full implementation of the Affordable Care Act (ACA) and parity legislation. METHODS: The retrospective, cross-sectional analysis fit a logistic regression model to pooled data comprising 193,526 observations from National Hospital Ambulatory Medical Care Survey (NHAMCS) data from 2005 to 2011...
December 15, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27918408/full-practice-authority-for-nurse-practitioners
#11
Deborah Dillon, Faye Gary
Implementation of the Affordable Care Act (2010) enabled more than 30 million people to have new access to primary care services. On the basis of current utilization patterns, demand for primary care providers is expected to grow more rapidly than physician supply. This imbalance is expected to worsen, as the aging population requires more health care resources. In addition, more patients are requiring critical care services and physician numbers are not keeping with this growing need. Restrictions on resident physician practice hours have impacted inpatient care as well...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27837359/emergency-department-visits-and-hospitalizations-for-the-uninsured-in-illinois-before-and-after-affordable-care-act-insurance-expansion
#12
Aabha I Sharma, Scott M Dresden, Emilie S Powell, Raymond Kang, Joe Feinglass
We describe changes in emergency department (ED) visits and the proportion of patients with hospitalizations through the ED classified as Ambulatory Care Sensitive Hospitalization (ACSH) for the uninsured before (2011-2013) and after (2014-2015) Affordable Care Act (ACA) health insurance expansion in Illinois. Hospital administrative data from 201 non-federal Illinois hospitals for patients age 18-64 were used to analyze ED visits and hospitalizations through the ED. ACSH was defined using Agency for Healthcare Research and Quality (AHRQ) Prevention Quality Indicators (PQIs)...
November 12, 2016: Journal of Community Health
https://www.readbyqxmd.com/read/27805933/a-home-healthcare-nursing-competency-tool-kit
#13
Ruby M Gabbedon
As a result of the Affordable Care Act, increases in aging populations, and advances in technologies, there is a critical need for highly qualified, competent home healthcare nurses. According to the Joint Commission's Human Resource Standard, home healthcare nurses must demonstrate their competency at least every 3 years by participating in in-service education (). Unfortunately, not all home healthcare agencies (HHA) are accredited by the Joint Commissions. A review of several states healthcare regulatory rules-specifically California, New York, Nevada, and Virginia, reveals no mandates for home healthcare nurses to demonstrate competencies for skills specific for home healthcare nursing...
November 2016: Home Healthcare Now
https://www.readbyqxmd.com/read/27740673/patient-centered-medical-home-exposure-and-its-impact-on-pa-career-intentions
#14
Gerald Kayingo, Owais Gilani, Vasco Deon Kidd, Mary L Warner
BACKGROUND AND OBJECTIVES: The transformation of primary care (PC) training sites into patient-centered medical homes (PCMH) has implications for the education of health professionals. This study investigates the extent to which physician assistant (PA) students report learning about the PCMH model and how clinical exposure to PCMH might impact their interest in a primary care career. METHODS: An electronic survey was distributed to second-year PA students who had recently completed their PC rotation from 12 PA programs...
October 2016: Family Medicine
https://www.readbyqxmd.com/read/27567023/topical-review-building-competency-professional-skills-for-pediatric-psychologists-in-integrated-primary-care-settings
#15
Kathryn W Hoffses, Lisa Y Ramirez, Louise Berdan, Rachel Tunick, Sarah Morsbach Honaker, Tawnya J Meadows, Laura Shaffer, Paul M Robins, Lynne Sturm, Terry Stancin
OBJECTIVES : In the midst of large-scale changes across our nation's health care system, including the Affordable Care Act and Patient-Centered Medical Home initiatives, integrated primary care models afford important opportunities for those in the field of pediatric psychology. Despite the extensive and growing attention, this subspecialty has received in recent years, a comprehensive set of core professional competencies has not been established. METHODS : A subset of an Integrated Primary Care Special Interest Group used two well-established sets of core competencies in integrated primary care and pediatric psychology as a basis to develop a set of integrated pediatric primary care-specific behavioral anchors...
November 2016: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/27444260/public-health-nursing-practice-in-the-affordable-care-act-era-a-national-survey
#16
Joyce K Edmonds, Lisa A Campbell, Richard E Gilder
OBJECTIVES: To explore public health nurses' knowledge, perceptions, and practices under the Affordable Care Act (ACA). DESIGN AND SAMPLE: A cross-sectional, web-based survey was completed by a sample of 1,143 public health nurses (PHNs) in the United States. MEASURES: Descriptive statistics were analyzed for variables related to general knowledge and perception of the ACA and for the extent of involvement in activities related to the implementation of the ACA...
July 21, 2016: Public Health Nursing
https://www.readbyqxmd.com/read/27435723/cluster-randomized-trial-of-a-multilevel-evidence-based-quality-improvement-approach-to-tailoring-va-patient-aligned-care-teams-to-the-needs-of-women-veterans
#17
Elizabeth M Yano, Jill E Darling, Alison B Hamilton, Ismelda Canelo, Emmeline Chuang, Lisa S Meredith, Lisa V Rubenstein
BACKGROUND: The Veterans Health Administration (VA) has undertaken a major initiative to transform care through implementation of Patient Aligned Care Teams (PACTs). Based on the patient-centered medical home (PCMH) concept, PACT aims to improve access, continuity, coordination, and comprehensiveness using team-based care that is patient-driven and patient-centered. However, how VA should adapt PACT to meet the needs of special populations, such as women Veterans (WVs), was not considered in initial implementation guidance...
July 19, 2016: Implementation Science: IS
https://www.readbyqxmd.com/read/27294747/first-year-open-enrollment-findings-health-insurance-coverage-for-asian-americans-and-the-role-of-navigators
#18
Edwin Chandrasekar, Karen E Kim, Sharon Song, Ranjana Paintal, Michael T Quinn, Helen Vallina
The health insurance coverage established by the Patient Protection and Affordable Care Act has created an opportunity to reduce racial/ethnic disparities in healthcare. It is expected that of the 24 million individuals projected to join, nearly one-half will be non-white and one-fourth will speak a language other than English at home. Asian Americans are one of the fastest growing racial/ethnic groups in the USA. The majority are foreign born and experience limited English proficiency. The role of navigators has been shown to increase enrollment rates of public insurance programs...
September 2016: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/27269027/the-recovery-movement-implications-for-mental-health-care-and-enabling-people-to-participate-fully-in-life
#19
Larry Davidson
The recovery movement, which broadly recognizes the ability of people with mental illnesses to participate in the mainstream of society, stems from a confluence of factors, including longitudinal data showing that many people eventually recover from serious mental illness. Perhaps as important to the emergence and growth of the recovery movement has been the increasing role that people "in recovery" have played in advocating for person-centered care, greater self-determination for those with mental illnesses, and an enhanced focus on restoring functioning for individuals above and beyond symptom reduction...
June 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27239383/factors-influencing-discharge-destination-after-total-knee-arthroplasty-a-database-analysis
#20
Ran Schwarzkopf, Jenny Ho, John R Quinn, Nimrod Snir, Dana Mukamel
INTRODUCTION: The demand for total knee arthroplasty (TKA) continues to challenge hospital financial resources. Hospitals have countered this economic demand by reducing patient length of stay (LoS), thus requiring a higher utilization of extended care facilities (ECF) and home with home health care (HHC). With an increase in the number of insured low-income families following the Affordable Care Act (ACA), TKA patients' demographics are anticipated to change. Both trends have significant economic implications, and predicting the discharge destinations of TKA patients would help plan for future health expenditures...
June 2016: Geriatric Orthopaedic Surgery & Rehabilitation
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