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https://www.readbyqxmd.com/read/28526649/has-publish-or-perish-become-publish-and-payment-navigating-neurosurgical-research-in-an-innovative-industry
#1
Justin F Fraser
No abstract text is available yet for this article.
May 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28509721/bundled-payments-for-care-improvement-preparing-for-the-medical-diagnosis-related-groups
#2
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...
May 15, 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28491340/the-financial-impact-of-advanced-kidney-disease-on-canada-pension-plan-and-private-disability-insurance-costs
#3
Braden Manns, Susan Q McKenzie, Flora Au, Pamela M Gignac, Lawrence Ian Geller
BACKGROUND: Many working-age individuals with advanced chronic kidney disease (CKD) are unable to work, or are only able to work at a reduced capacity and/or with a reduction in time at work, and receive disability payments, either from the Canadian government or from private insurers, but the magnitude of those payments is unknown. OBJECTIVE: The objective of this study was to estimate Canada Pension Plan Disability Benefit and private disability insurance benefits paid to Canadians with advanced kidney failure, and how feasible improvements in prevention, identification, and early treatment of CKD and increased use of kidney transplantation might mitigate those costs...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28458797/linking-sustainable-use-policies-to-novel-economic-incentives-to-stimulate-antibiotic-research-and-development
#4
REVIEW
Ursula Theuretzbacher, Christine Årdal, Stephan Harbarth
There is now global recognition that antibiotic resistance is an emerging public health threat. Policy initiatives are underway to provide concrete suggestions for overcoming important obstacles in the fight against antibiotic resistance, like the alarming current paucity of antibacterial innovation. New economic models are needed as incentives for the discovery and development of novel antibacterial therapies especially for infections with too few patients today to justify private sector research and development (R&D) investments...
March 30, 2017: Infectious Disease Reports
https://www.readbyqxmd.com/read/28448782/amcp-partnership-forum-driving-value-and-outcomes-in-oncology
#5
(no author information available yet)
Innovation in cancer treatment has provided a wealth of recently available therapeutic agents and a healthy drug pipeline that promises to change the way we approach this disease and the lives of those affected in the years to come. However, the majority of these new agents, many of which are targeted to specific genomic features of various tumors, may challenge the health care system's ability to afford cancer care. This innovation drives the need to focus on the value of the treatments provided to patients with cancer and on methods to optimize the efficiency of the dollars we spend, in addition to the clinical value itself...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28438503/expanding-role-of-certified-electronic-health-records-technology-in-radiology-the-macra-mandate
#6
Gregory N Nicola, Andrew B Rosenkrantz, Joshua A Hirsch, Ezequiel Silva, Keith J Dreyer, Michael P Recht
Radiology has historically been at the forefront of innovation and the advancement of technology for the benefit of patient care. However, challenges to early implementation prevented most radiologists from adopting and integrating certified electronic health record technology (CEHRT) into their daily workflow despite the early and potential advantages it offered. This circumstance places radiology at a disadvantage in the two payment pathways of the Medicare Access and CHIP Reauthorization Act of 2015: the Merit-Based Incentive Payment System (MIPS) and advanced alternative payment models (APMs)...
April 19, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28438453/effect-of-bundled-payments-and-health-care-reform-as-alternative-payment-models-in-total-joint-arthroplasty-a-clinical-review
#7
REVIEW
Ahmed Siddiqi, Peter B White, Jaydev B Mistry, Chukwuweike U Gwam, James Nace, Michael A Mont, Ronald E Delanois
BACKGROUND: In an effort to control rising healthcare costs, healthcare reforms have developed initiatives to evaluate the efficacy of alternative payment models (APMs) for Medicare reimbursements. The Center for Medicare and Medicaid Services Innovation Center (CMMSIC) introduced the voluntary Bundled Payments for Care Improvement (BPCI) model experiment as a means to curtail Medicare cost by allotting a fixed payment for an episode of care. The purpose of this review is to (1) summarize the preliminary clinical results of the BPCI and (2) discuss how it has led to other healthcare reforms and alternative payment models...
March 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28390403/farm-fresh-foods-for-healthy-kids-f3hk-an-innovative-community-supported-agriculture-intervention-to-prevent-childhood-obesity-in-low-income-families-and-strengthen-local-agricultural-economies
#8
Rebecca A Seguin, Emily H Morgan, Karla L Hanson, Alice S Ammerman, Stephanie B Jilcott Pitts, Jane Kolodinsky, Marilyn Sitaker, Florence A Becot, Leah M Connor, Jennifer A Garner, Jared T McGuirt
BACKGROUND: Childhood obesity persists in the United States and is associated with serious health problems. Higher rates of obesity among children from disadvantaged households may be, in part, attributable to disparities in access to healthy foods such as fruits and vegetables. Community supported agriculture can improve access to and consumption of fresh produce, but the upfront payment structure, logistical barriers, and unfamiliarity with produce items may inhibit participation by low-income families...
April 8, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28384084/strengthening-integrated-care-through-population-focused-primary-care-services-international-experiences-outside-the-united-states
#9
Rene Loewenson, Sarah Simpson
Many high- and middle-income countries (HMICs) are experiencing a burden of comorbidity and chronic diseases. Together with increasing patient expectations, this burden is raising demand for population health-oriented innovation in health care. Using desk review and country case studies, we examine strategies applied in HMICs outside the United States to address these challenges, with a focus on and use of a new framework for analyzing primary care (PC). The article outlines how a population health approach has been supported by focusing assessment on and clustering services around social groups and multimorbidity, with support for community roles...
March 20, 2017: Annual Review of Public Health
https://www.readbyqxmd.com/read/28375589/health-care-s-other-big-deal-direct-primary-care-regulation-in-contemporary-american-health-law
#10
Glenn E Chappell
Direct primary care is a promising, market-based alternative to the fee-for-service payment structure that shapes doctor–patient relationships in America. Instead of billing patients and insurers service by service, direct primary care doctors charge their patients a periodic, prenegotiated fee in exchange for providing a wide range of healthcare services and increased availability compared to traditional practices. This “subscription” model is intended to eliminate the administrative burdens associated with insurer interaction, which, in theory, allows doctors to spend more time with their patients and less time doing paperwork...
March 2017: Duke Law Journal
https://www.readbyqxmd.com/read/28375499/episode-based-payment-and-direct-employer-purchasing-of-healthcare-services-recent-bundled-payment-innovations-and-the-geisinger-health-system-experience
#11
Jonathan R Slotkin, Olivia A Ross, Eric D Newman, Janet L Comrey, Victoria Watson, Rachel V Lee, Megan M Brosious, Gloria Gerrity, Scott M Davis, Jacquelyn Paul, E Lynn Miller, David T Feinberg, Steven A Toms
One significant driver of the disjointed healthcare often observed in the United States is the traditional fee-for-service payment model which financially incentivizes the volume of care delivered over the quality and coordination of care. This problem is compounded by the wide, often unwarranted variation in healthcare charges that purchasers of health services encounter for substantially similar episodes of care. The last 10 years have seen many stakeholder organizations begin to experiment with novel financial payment models that strive to obviate many of the challenges inherent in customary quantity-based cost paradigms...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28352466/systems-for-physical-health-care-for-mental-health-patients-in-the-community-different-approaches-to-improve-patient-care-and-safety-in-an-early-intervention-in-psychosis-service
#12
Josie Mouko, Rebecca Sullivan
Patients with mental illnesses have a high rate of physical comorbidity, and specifically, those with psychosis are at an increased risk of cardiometabolic disease and shortened lifespans, due to medication, lifestyle and illness factors. There are recognised challenges with physical health care in this group. At baseline, no patients on the Bath and North East Somerset Early Intervention in Psychosis caseload had a fully completed physical health assessment. Our aim was to offer a physical health check, blood tests, and ECG for all patients, trialling four phases of interventions...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28340128/crossing-the-health-it-chasm-considerations-and-policy-recommendations-to-overcome-current-challenges-and-enable-value-based-care
#13
Julia Adler-Milstein, Peter J Embi, Blackford Middleton, Indra Neil Sarkar, Jeff Smith
While great progress has been made in digitizing the US health care system, today's health information technology (IT) infrastructure remains largely a collection of systems that are not designed to support a transition to value-based care. In addition, the pursuit of value-based care, in which we deliver better care with better outcomes at lower cost, places new demands on the health care system that our IT infrastructure needs to be able to support. Provider organizations pursuing new models of health care delivery and payment are finding that their electronic systems lack the capabilities needed to succeed...
March 15, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28291598/identifying-radiology-s-place-in-the-expanding-landscape-of-episode-payment%C3%A2-models
#14
Andrew B Rosenkrantz, Joshua A Hirsch, Bibb Allen, H Benjamin Harvey, Gregory N Nicola
The current fee-for-service system for health care reimbursement in the United Stated is argued to encourage fragmented care delivery and a lack of accountability that predisposes to insufficient focus on quality as well as unnecessary or duplicative resource utilization. Episode payment models (EPMs) seek to improve coordination by linking payments for all services related to a patient's condition or procedure, thereby improving quality and efficiency of care. The CMS Innovation Center has implemented a broadening array of EPMs...
March 10, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28264941/strategies-for-assessing-delivery-system-innovations
#15
Elizabeth A McGlynn, Mark McClellan
Driven by evidence of continuing gaps in health care quality and efficiency and inspired by the emergence of new value-based payment models, both large and small health care organizations are developing and deploying a wide range of care delivery innovations. But how can decision makers in these organizations determine if the innovations really improve service delivery, patient experience, clinical outcomes, or costs? Organization leaders need appropriate, timely evidence to inform their decision making. In this article we describe a range of approaches to evaluating innovations and pose key questions about the validity of the results...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28264938/delivery-innovations
#16
(no author information available yet)
The need for innovations in care delivery is recognized by providers, payers, and patients alike. Hospitals, physicians, and other clinicians are experimenting with new models of care designed to better meet patients' needs, reduce administrative burdens, and lower costs. The Affordable Care Act placed the Medicare and Medicaid programs at the center of a national effort to experiment with delivery and payment models designed to improve care and contain costs. These public-sector efforts have often aligned with private initiatives, such as the use of reference pricing-in which an insurer will only pay for a service at the price available from the lowest-cost provider...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28245661/value-based-contracting-innovated-medicare-advantage-healthcare-delivery-and-improved-survival
#17
Aloke K Mandal, Gene K Tagomori, Randell V Felix, Scott C Howell
OBJECTIVES: In Medicare Advantage (MA) with its CMS Hierarchical Condition Categories (CMS-HCC) payment model, CMS reimburses private plans (Medicare Advantage Organizations [MAOs]) with prospective, monthly, health-based or risk-adjusted, capitated payments. The effect of this payment methodology on healthcare delivery remains debatable. How value-based contracting generates cost efficiencies and improves clinical outcomes in MA is studied. STUDY DESIGN: A difference in contracting arrangements between an MAO and 2 provider groups facilitated an intervention-control, preintervention-postintervention, difference-in-differences approach among statistically similar, elderly, community-dwelling MA enrollees within one metropolitan statistical area...
February 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28225461/faculty-development-for-medical-school-community-based-faculty-a-council-of-academic-family-medicine-educational-research-alliance-study-exploring-institutional-requirements-and-challenges
#18
Joanna Drowos, Suzanne Baker, Suzanne Leonard Harrison, Suzanne Minor, Alexander W Chessman, Dennis Baker
PURPOSE: Community-based faculty play a large role in training medical students nationwide and require faculty development. The authors hypothesized that positive relationships exist between clerkships paying preceptors and requiring faculty development, and between protected clerkship directors' time and delivering face-to-face preceptor training, as well as with the number or length of community-based preceptor visits. Through under standing the quantity, delivery methods, barriers, and institutional support for faculty development provided to community-based preceptors teaching in family medicine clerkships, best practices can be developed...
February 21, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28212967/decision-making-on-medical-innovations-in-a-changing-health-care-environment-insights-from-accountable-care-organizations-and-payers-on-personalized-medicine-and-other-technologies
#19
Julia R Trosman, Christine B Weldon, Michael P Douglas, Patricia A Deverka, John B Watkins, Kathryn A Phillips
BACKGROUND: New payment and care organization approaches, such as those of accountable care organizations (ACOs), are reshaping accountability and shifting risk, as well as decision making, from payers to providers, within the Triple Aim context of health reform. The Triple Aim calls for improving experience of care, improving health of populations, and reducing health care costs. OBJECTIVES: To understand how the transition to the ACO model impacts decision making on adoption and use of innovative technologies in the era of accelerating scientific advancement of personalized medicine and other innovations...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28187994/defining-the-value-of-magnetic-resonance-imaging-in-prostate-brachytherapy-using-time-driven-activity-based-costing
#20
Nikhil G Thaker, Peter F Orio, Louis Potters
Magnetic resonance imaging (MRI) simulation and planning for prostate brachytherapy (PBT) may deliver potential clinical benefits but at an unknown cost to the provider and healthcare system. Time-driven activity-based costing (TDABC) is an innovative bottom-up costing tool in healthcare that can be used to measure the actual consumption of resources required over the full cycle of care. TDABC analysis was conducted to compare patient-level costs for an MRI-based versus traditional PBT workflow. TDABC cost was only 1% higher for the MRI-based workflow, and utilization of MRI allowed for cost shifting from other imaging modalities, such as CT and ultrasound, to MRI during the PBT process...
February 7, 2017: Brachytherapy
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