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https://www.readbyqxmd.com/read/28930760/medical-education-and-health-care-delivery-a-call-to-better-align-goals-and-purposes
#1
David P Sklar, Paul A Hemmer, Steven J Durning
The transformation of the U.S. health care system is under way, driven by the needs of an aging population, rising health care spending, and the availability of health information. However, the speed and effectiveness of the transformation of health care delivery will depend, in large part, upon engagement of the health professions community and changes in clinicians' practice behaviors. Current efforts to influence practice behaviors emphasize changes in the health payment system with incentives to move from fee-for-service to alternative payment models...
September 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28929875/using-structured-incentives-to-increase-value-for-money-in-an-academic-health-sciences-centre
#2
Guy J Hébert, Connie Colasante, Renate G Ilse, Alan J Forster
As healthcare continues to consume more and more of provincial government spending, there is a continuing pressure to improve efficiency and cut overall costs. In this increasingly constrained healthcare system, value for money is a growing focus of discussions around accountability and system sustainability; healthcare leaders are required to find ways of measuring, enforcing, and reporting on that value. In 2014, our organization began implementing an innovative system of structured incentives, linking distribution of Ministry of Health and Long-Term Care academic physician funding to quality and performance goals...
July 2017: Healthcare Management Forum
https://www.readbyqxmd.com/read/28922902/from-directed-donation-to-kidney-sale-does-the-argument-hold-up
#3
James Stacey Taylor
The UCLA Medical Center has initiated a "voucher program" under which a person who donated a kidney would receive a voucher that she could provide to someone of her choosing who could then use it to move to the top of the renal transplantation waiting list. If the use of such vouchers as incentives for donors is morally permissible, then cash payments for kidneys are also morally permissible. But, that argument faces five objections. First, there are some goods whose nature allows them to be exchanged for similar goods but renders them monetarily inalienable...
October 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28887347/pharmacists-supporting-population-health-in-patient-centered-medical-homes
#4
Antoinette B Coe, Hae Mi Choe
PURPOSE: The integral role of pharmacists in supporting population health initiatives in the patient-centered medical home (PCMH) model of care is described. SUMMARY: Population health initiatives focus on the health outcomes of a group of patients; in the PCMH model, such groups of patients, known as panels, may be defined as patients assigned to a care team or provider. The basic characteristics of the PCMH model include physician-led, team-based practice; coordinated and integrated care within the PCMH and in the patient's community; provision of safe, evidence-based, high-quality care; incorporation of health information technology and continuous quality improvement strategies into panel identification, documentation, and care processes; improved access to care (e...
September 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28885288/early-effects-of-medicare-s-bundled-payment-for-care-improvement-bpci-program-for-lumbar-fusion
#5
Brook I Martin, Jon D Lurie, Farrokh R Farrokhi, Kevin J McGuire, Sohail K Mirza
STUDY DESIGN: Retrospective analysis of Medicare claims linked to hospital participation in the Center for Medicare and Medicaid Innovation's episode-based Bundled Payment for Care Improvement (BPCI) program for lumbar fusion. OBJECTIVES: To describe the early effects of BPCI participation for lumbar fusion on 90-day reimbursement, procedure volume, reoperation, and readmission. SUMMARY OF BACKGROUND DATA: Initiated on January 1st, 2013, BPCI's voluntary bundle payment program provides a predetermined payment for services related to a Diagnosis Related Group-defined "triggering event" over a defined time period...
September 6, 2017: Spine
https://www.readbyqxmd.com/read/28872535/the-opportunity-awaits-to-lead-orthopaedic-telehealth-innovation-aoa-critical-issues
#6
Montri D Wongworawat, Gary Capistrant, John M Stephenson
Telehealth is a way to provide health-care services to a patient from a provider who is at another location. The most common methods include a live interactive visit with the patient, interpretation of imaging, and monitoring of patient progress. Principally, telehealth is a way of providing a service rather than a type of service. It is about patient care, not data care.Examples of orthopaedic applications include conducting patient examinations, interpreting imaging studies, and providing postoperative care...
September 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28864710/principles-of-child-health-care-financing
#7
Mark L Hudak, Mark E Helm, Patience H White
After passage of the Patient Protection and Affordable Care Act, more children and young adults have become insured and have benefited from health care coverage than at any time since the creation of the Medicaid program in 1965. From 2009 to 2015, the uninsurance rate for children younger than 19 years fell from 9.7% to 5.3%, whereas the uninsurance rate for young adults 19 to 25 years of age declined from 31.7% to 14.5%. Nonetheless, much work remains to be done. The American Academy of Pediatrics (AAP) believes that the United States can and should ensure that all children, adolescents, and young adults from birth through the age of 26 years who reside within its borders have affordable access to high-quality and comprehensive health care, regardless of their or their families' incomes...
September 2017: Pediatrics
https://www.readbyqxmd.com/read/28857975/finding-like-minded-partners-to-span-the-continuum-of-care
#8
Bruce Lawrence
This is an era of profound industry transformation, characterized by such forces as acceleration away from inpatient-centered care and toward alternative payment models, rising rates of chronic disease, and an aging population. Add to this mix physician and nurse shortages and a newfound understanding that today's patients are informed consumers, and the reality becomes clear: Healthcare providers must be adaptable, agile, and innovative to survive. Sometimes, the best way forward in transformative times is collaboration with other like-minded organizations...
October 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28854593/gynaecologists-and-industry-ain-t-no-sunshine
#9
Cynthia M Farquhar, Paolo Vercellini, Jane Marjoribanks
The field of reproductive medicine is known for its innovations, and where there is innovation there is marketing and engagement with the doctors who are potential prescribers and users of those innovations. Financial connections between drug and device manufacturers with doctors have been extensively debated over the past decade. On one hand, relationships between doctors and industry could be considered synergistic by allowing the development of improved treatments. On the other hand, payment (and other benefits) from industry to doctors may subtly shift the main objective of the collaboration from patients' health to mutual benefits for both doctors and industry...
August 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28839525/annuity-payments-can-increase-patient-access-to-innovative-cell-and-gene-therapies-under-england-s-net-budget-impact-test
#10
Jesper Jørgensen, Panos Kefalas
Background: Cell and gene therapies have the potential to provide therapeutic breakthroughs, but the high costs of researching, developing, manufacturing and delivering them translate into prices that may challenge healthcare budgets. Various measures exist that aim to address the affordability challenge, including reducing price, limiting patient numbers and/or linking remuneration to product performance. Objective: To explore how the net budget impact test recently introduced in England can affect patient access to high-value, one-off cell and gene therapies, and how managed entry agreements can improve access...
2017: Journal of Market Access & Health Policy
https://www.readbyqxmd.com/read/28725789/improving-american-healthcare-through-clinical-lab-2-0-a-project-santa-fe-report
#11
James M Crawford, Khosrow Shotorbani, Gaurav Sharma, Michael Crossey, Tarush Kothari, Thomas S Lorey, Jeffrey W Prichard, Myra Wilkerson, Nancy Fisher
Project Santa Fe was established both to provide thought leadership and to help develop the evidence base for the valuation of clinical laboratory services in the next era of American healthcare. The participants in Project Santa Fe represent major regional health systems that can operationalize laboratory-driven innovations and test their valuation in diverse regional marketplaces in the United States. We provide recommendations from the inaugural March 2016 meeting of Project Santa Fe. Specifically, in the transition from volume-based to value-based health care, clinical laboratories are called upon to provide programmatic leadership in reducing total cost of care through optimization of time-to-diagnosis and time-to-effective therapeutics, optimization of care coordination, and programmatic support of wellness care, screening, and monitoring...
January 2017: Acad Pathol
https://www.readbyqxmd.com/read/28724460/health-and-well-being-promotion-strategies-for-hard-to-reach-older-people-in-england-a-mapping-exercise
#12
Steve Iliffe, Kate Walters, Jill Manthorpe, Claire Goodman, Kalpa Kharicha
BACKGROUND: Older people from deprived areas, the oldest old and those from ethnic minorities engage less in health promotion interventions and related research, potentially generating inequities. Aim To explore and map the extent to which such 'hard to reach' groups of older people, are the focus of local health and well-being strategies in England. METHODS: Document analysis of current health and well-being promotion strategies in a purposive sample of 10 localities in England with high proportions of some or all of the three hard to reach groups...
July 20, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28722553/travelling-models-and-the-challenge-of-pragmatic-contexts-and-practical-norms-the-case-of-maternal-health
#13
REVIEW
Jean-Pierre Olivier de Sardan, Aïssa Diarra, Mahaman Moha
As in other areas of international development, we are witnessing the proliferation of 'traveling models' developed by international experts and introduced in an almost identical format across numerous countries to improve some aspect of maternal health systems in low- and middle-income countries. These policies and protocols are based on 'miracle mechanisms' that have been taken out of their original context but are believed to be intrinsically effective in light of their operational devices.In reality, standardised interventions are, in Africa and elsewhere, confronted with pragmatic implementation contexts that are always varied and specific, and which lead to drifts, distortions, dismemberments and bypasses...
July 12, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28720160/the-incidence-of-health-financing-in-south-africa-findings-from-a-recent-data-set
#14
John E Ataguba, Di McIntyre
There is an international call for countries to ensure universal health coverage. This call has been embraced in South Africa (SA) in the form of a National Health Insurance (NHI). This is expected to be financed through general tax revenue with the possibility of additional earmarked taxes including a surcharge on personal income and/or a payroll tax for employers. Currently, health services are financed in SA through allocations from general tax revenue, direct out-of-pocket payments, and contributions to medical scheme...
July 19, 2017: Health Economics, Policy, and Law
https://www.readbyqxmd.com/read/28691084/cost-effective-conservation-of-amphibian-ecology-and-evolution
#15
Felipe S Campos, Ricardo Lourenço-de-Moraes, Gustavo A Llorente, Mirco Solé
Habitat loss is the most important threat to species survival, and the efficient selection of priority areas is fundamental for good systematic conservation planning. Using amphibians as a conservation target, we designed an innovative assessment strategy, showing that prioritization models focused on functional, phylogenetic, and taxonomic diversity can include cost-effectiveness-based assessments of land values. We report new key conservation sites within the Brazilian Atlantic Forest hot spot, revealing a congruence of ecological and evolutionary patterns...
June 2017: Science Advances
https://www.readbyqxmd.com/read/28686512/tracking-patients-in-community-based-palliative-care-through-the-centers-for-medicare-and-medicaid-services-healthcare-innovation-project
#16
Janet Bull, Arif H Kamal, Matthew Harker, Lindsay Bonsignore, John Morris, Lisa Massie, Parampal Singh Bhullar, Mark Hendrix, Deeana Bennett, Don Taylor
BACKGROUND: Although limited, the evidence base for Community Based Palliative Care (CBPC) has shown that it improves patient health outcomes, increases satisfaction, and decreases cost. Minimal data exist comparing points of entry into palliative care and patient transition outcomes. OBJECTIVES: In 2014, Four Seasons Compassion for Life was awarded a Centers for Medicare & Medicaid Services Healthcare Innovation Award to expand an existing CBPC model into additional counties and to propose a new payment approach...
July 7, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28673816/a-collective-national-approach-to-fostering-innovation-in-complex-care
#17
Rachel Davis, Stephen A Somers
The Complex Care Innovation Lab convenes 15 organizations from across the country that are innovators in health care delivery for low-income populations with complex needs. These organizations have identified several elements that are core to successful complex care programs, including: (1) incorporating patient-centered approaches to care; (2) utilizing a non-traditional workforce; (3) employing data-driven strategies; and (4) leveraging flexible payment models that assign accountability to providers and facilitate interventions to integrate health and social services...
June 22, 2017: Healthcare
https://www.readbyqxmd.com/read/28664439/sages-quality-initiative-an-introduction
#18
Anne Lidor, Dana Telem, Curtis Bower, Prashant Sinha, Rocco Orlando, John Romanelli
The Medicare program has transitioned to paying healthcare providers based on the quality of care delivered, not on the quantity. In May 2015, SAGES held its first ever Quality Summit. The goal of this meeting was to provide us with the information necessary to put together a strategic plan for our Society over the next 3-5 years, and to participate actively on a national level to help develop valid measures of quality of surgery. The transition to value-based medicine requires that providers are now measured and reimbursed based on the quality of services they provide rather than the quantity of patients in their care...
August 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28662250/surgeons-perspectives-on-premium-implants-in-total-joint-arthroplasty
#19
Amy S Wasterlain, Ricardo J Bello, Jonathan Vigdorchik, Ran Schwarzkopf, William J Long
Declining total joint arthroplasty reimbursement and rising implant prices have led many hospitals to restrict access to newer, more expensive total joint arthroplasty implants. The authors sought to understand arthroplasty surgeons' perspectives on implants regarding innovation, product launch, costs, and cost-containment strategies including surgeon gain-sharing and patient cost-sharing. Members of the International Congress for Joint Reconstruction were surveyed regarding attitudes about implant technology and costs...
June 29, 2017: Orthopedics
https://www.readbyqxmd.com/read/28652243/clinical-pathways-recommendations-for-putting-patients-at-the-center-of-value-based-care
#20
Edward Abrahams, Alan Balch, Patricia Goldsmith, Marcia Kean, Amy M Miller, Gilbert Omenn, Ellen Sonet, John Sprandio, Courtney Tyne, Kimberly Westrich
Two major trends that have been affecting the provision of oncology care in the United States are a shift from volume-based to value-based care and a push toward patient-centered healthcare. However, these two trends are not always completely aligned with each other. Value-based payment models, including clinical pathways, are one strategy being implemented by oncology stakeholders to help encourage the uptake of value-based oncology care. If structured with the patient in mind, they can improve quality of care for patients with cancer, decrease inappropriate care while enabling appropriate personalization of care, and constrain rising prices by demanding a stronger link between cost and value...
August 15, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
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