keyword
MENU ▼
Read by QxMD icon Read
search

outcomes based payment

keyword
https://www.readbyqxmd.com/read/29150151/evaluating-short-and-long-term-impacts-of-a-medicaid-lock-in-program-on-opioid-and-benzodiazepine-prescriptions-dispensed-to-beneficiaries
#1
Rebecca B Naumann, Stephen W Marshall, Jennifer L Lund, Nisha C Gottfredson, Christopher L Ringwalt, Asheley C Skinner
BACKGROUND: Insurance-based "lock-in" programs (LIPs) have become a popular strategy to address controlled substance (CS) (e.g., opioid) misuse. However, little is known about their impacts. We examined changes in CS dispensing to beneficiaries in the 12-month North Carolina Medicaid LIP. METHODS: We analyzed Medicaid claims linked to Prescription Drug Monitoring Program (PDMP) records for beneficiaries enrolled in the LIP between October 2010 and September 2012 (n=2702)...
November 6, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29143609/survey-of-programmatic-experiences-and-challenges-in-delivery-of-hepatitis-b-and-c-testing-in-low-and-middle-income-countries
#2
Azumi Ishizaki, Julie Bouscaillou, Niklas Luhmann, Stephanie Liu, Raissa Chua, Nick Walsh, Sarah Hess, Elena Ivanova, Teri Roberts, Philippa Easterbrook
BACKGROUND: There have been few reports on programmatic experience of viral hepatitis testing and treatment in resource-limited settings. To inform the development of the 2017 World Health Organization (WHO) viral hepatitis testing guidance and in particular the feasibility of proposed recommendations, we undertook a survey across a range of organisations engaged with hepatitis testing in low- and middle-income countries (LMICs). Our objective was to describe current hepatitis B and C testing practices across a range of settings in different countries, as well as key barriers or challenges encountered and proposed solutions to promote testing scale-up...
November 1, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29132497/from-micro-to-macro-assessing-implementation-of-integrated-care-in-australia
#3
Lisa Angus, Pim P Valentijn
Many countries and health systems are pursuing integrated care as a means of achieving better outcomes. However, no standard approaches exist for comparing integration approaches across models or settings, and for evaluating whether the key components of integrated care are present in different initiatives. This study sheds light on how integrated care is being implemented in Australia, using a new tool to characterise and compare integration strategies at micro, meso and macro levels. In total, 114 staff from a purposive sample of 38 integrated care projects completed a survey based on the Rainbow Model of Integrated Care...
November 14, 2017: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/29129345/defining-value-based-care-in-cardiac-and-vascular-anesthesiology-the-past-present-and-future-of-perioperative-cardiovascular-care
#4
REVIEW
Lavinia M Kolarczyk, Harendra Arora, Michael W Manning, David A Zvara, Robert S Isaak
Health care reimbursement models are transitioning from volume-based to value-based models. Value-based models focus on patient outcomes both during the hospital admission and postdischarge. These models place emphasis on cost, quality of care, and coordination of multidisciplinary services. Perioperative physicians are challenged to evaluate traditional practices to ensure coordinated, cost-effective, and evidence-based care. With the Centers for Medicare and Medicaid Services planned introduction of bundled payments for coronary artery bypass graft surgery, cardiovascular anesthesiologists are financially responsible for postdischarge outcomes...
September 28, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29126109/do-prospective-payment-systems-ppss-lead-to-desirable-providers-incentives-and-patients-outcomes-a-systematic-review-of-evidence-from-developing-countries
#5
Si Ying Tan, G J Melendez-Torres
The reform of provider payment systems, from retrospective to prospective payment, has been heralded as the right move to contain costs in the light of rising health expenditures in many countries. However, there are concerns on quality trade-off. The heightened attention given to prospective payment system (PPS) reforms and the rise of empirical evidence regarding PPS interventions among developing countries suggest that a systematic review is necessary to understand the effects of PPS reforms in developing countries...
November 6, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29124043/activities-of-daily-living-measured-by-the-harvard-automated-phone-task-track-with-cognitive-decline-over-time-in-non-demented-elderly
#6
Gad A Marshall, Sarah L Aghjayan, Maria Dekhtyar, Joseph J Locascio, Kamal Jethwani, Rebecca E Amariglio, Keith A Johnson, Reisa A Sperling, Dorene M Rentz
Background: Impairment in activities of daily living is a major burden to both patients and caregivers. Mild impairment in instrumental activities of daily living is often seen at the stage of mild cognitive impairment. The field of Alzheimer's disease is moving toward earlier diagnosis and intervention and more sensitive and ecologically valid assessments of instrumental or complex activities of daily living are needed. The Harvard Automated Phone Task, a novel performance-based activities of daily living instrument, has the potential to fill this gap...
2017: Journal of Prevention of Alzheimer's Disease
https://www.readbyqxmd.com/read/29117915/drg-migration-a-novel-measure-of-inefficient-surgical-care-in-a-value-based-world
#7
Byron D Hughes, Hemalkumar B Mehta, Eric Sieloff, Yong Shan, Anthony J Senagore
BACKGROUND: Diagnosis-Related Group (DRG) migration, DRG 331 to 330, is defined by the assignment to a higher cost DRG due only to post admission comorbidity or complications (CC). METHODS: We assessed the 5% national Medicare data set (2011-2014) for colectomy (DRG's 331/330), excluding present on admission CC's and selecting patients with one or more CC's post-admission to define the impact on payments, cost, and length of stay (LOS). RESULTS: The incidence of DRG migration was 14...
October 26, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29106531/medicaid-savings-from-the-new-york-university-caregiver-intervention-for-families-with-dementia
#8
Steven S Foldes, James P Moriarty, Paul H Farseth, Mary S Mittelman, Kirsten Hall Long
Purpose of the study: The economic burden of dementia is substantially borne by state Medicaid programs. We estimated savings, from the state payer perspective, from offering the New York University Caregiver Intervention (NYUCI), a well-studied caregiver support and counseling program, to eligible Minnesota Medicaid enrollees. Design and Methods: A population-based microsimulation Markov model predicted and compared costs over 15 years with and without implementation of the NYUCI for family caregivers of community-based Medicaid eligibles with dementia...
July 5, 2017: Gerontologist
https://www.readbyqxmd.com/read/29104320/earning-spending-and-drug-use-in-a-therapeutic-workplace
#9
Shrinidhi Subramaniam, Anthony DeFulio, Brantley P Jarvis, August F Holtyn, Kenneth Silverman
Drug addiction is a chronic, relapsing health problem that is associated with the degree to which individuals choose small, immediate monetary outcomes over larger, delayed outcomes. This study was a secondary analysis exploring the relation between financial choices and drug use in opioid-dependent adults in a therapeutic workplace intervention. Sixty-seven participants were randomly assigned to a condition in which access to paid job training was contingent upon naltrexone adherence (N = 35) or independent of naltrexone adherence (N = 32)...
June 2017: Psychological Record
https://www.readbyqxmd.com/read/29103917/physician-specialty-and-radiologist-characteristics-associated-with-higher-medicare-patient-complexity
#10
Andrew B Rosenkrantz, Wenyi Wang, Arvind Vijayasarathi, Richard Duszak
RATIONALE AND OBJECTIVES: Meaningfully measuring physician outcomes and resource utilization requires appropriate patient risk adjustment. We aimed to assess Medicare patient complexity by physician specialty and to further identify radiologist characteristics associated with higher patient complexity. MATERIALS AND METHODS: The average beneficiary Hierarchical Condition Category (HCC) risk scores (Medicare's preferred measure of clinical complexity) were identified for all physicians using 2014 Medicare claims data...
November 3, 2017: Academic Radiology
https://www.readbyqxmd.com/read/29083973/amcp-partnership-forum-advancing-value-based-contracting
#11
(no author information available yet)
During the past decade, payment models for the delivery of health care have undergone a dramatic shift from focusing on volume to focusing on value. This shift began with the Affordable Care Act and was reinforced by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which increased the emphasis on payment for delivery of quality care. Today, value-based care is a primary strategy for improving patient care while managing costs. This shift in payment models is expanding beyond the delivery of health care services to encompass models of compensation between payers and biopharmaceutical manufacturers...
November 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29083971/patient-outcomes-health-care-resource-use-and-costs-associated-with-high-versus-low-hedis-asthma-medication-ratio
#12
Allan T Luskin, Evgeniya N Antonova, Michael S Broder, Eunice Chang, Karina Raimundo, Paul G Solari
BACKGROUND: The Healthcare Effectiveness Data and Information Set (HEDIS) quality measures for asthma include the asthma medication ratio (AMR) as a marker of quality of care for patients with asthma. Few data are available to describe the association between health care use and costs in patients with high versus low AMR. OBJECTIVE: To characterize health care use and costs associated with high versus low AMR in patients participating in commercial health plans...
November 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29081000/association-between-medicare-s-mandatory-hospital-value-based-purchasing-program-and-cost-inefficiency
#13
Germán M Izón, Chelsea A Pardini
BACKGROUND: The Patient Protection and Affordable Care Act instituted pay-for-performance programs, including Hospital Value-Based Purchasing (HVBP), designed to encourage hospital quality and efficiency. OBJECTIVE AND METHOD: While these programs have been evaluated with respect to their implications for care quality and financial viability, this is the first study to assess the relationship between hospitals' cost inefficiency and their participation in the programs...
October 28, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/29071495/open-treatment-of-ankle-fracture-as-inpatient-increases-risk-of-complication
#14
Michelle S Shen, Ashley C Dodd, Nikita Lakomkin, Idine Mousavi, Catherine Bulka, A Alex Jahangir, Manish K Sethi
BACKGROUND: Ankle fracture is one of the most common injuries treated by orthopaedic surgeons, and its incidence is only expected to rise with an aging population. It is also associated with often costly complications, yet there is little literature on risk factors, especially modifiable ones, driving these complications. The aim of this study is to reveal whether inpatient treatment after ankle fracture is associated with higher incidence of postoperative complications. As the USA moves towards a bundled payment healthcare system, it is imperative that orthopaedists maximize patient outcome and quality of care while also reducing overall costs...
October 26, 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29068312/the-role-of-proteomic-testing-in-improving-prognosis-and-care-planning-quality-measures-for-lung-cancer
#15
Ray D Page, A Christine Argento, David B Nash, Alexandria Skoufalos, Eric S Schaefer
PURPOSE: The Oncology Care Model (OCM) is a payment model from the Centers for Medicare and Medicaid Services designed to reduce costs and improve quality in cancer care. Key components of quality for the OCM originate from the 13-component cancer care plan. We surveyed the literature to understand the value of prognosis in OCM-directed planning for non-small-cell lung cancer (NSCLC) care and to investigate how the results of a prognostic, proteomic biomarker test, the VeriStrat test, can help OCM-participating providers meet the specific quality measures...
September 2017: Managed Care
https://www.readbyqxmd.com/read/29066110/hospital-consumer-assessment-of-healthcare-providers-and-systems-scores-do-not-predict-outcomes-after-total-hip-arthroplasty
#16
Utkarsh Anil, Ameer M Elbuluk, Jacob Ziegler, Ran Schwarzkopf, William J Long
BACKGROUND: With the establishment of the Hospital Value-Based Purchasing program, the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) score has been incorporated into the calculation of the total performance score, which determines redistribution of up to 2% of Medicare payments. This study aims to assess whether the HCAHPS score correlates with validated outcome measures after total hip arthroplasty. METHODS: Data from 63 patients who underwent a total hip arthroplasty and completed both an HCAHPS score and patient-reported outcome measures (PROMs) at our institution during the study period from January 1, 2015 to September 2016 were analyzed...
October 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29064835/spine-registries-where-do-we-stand
#17
Ian D Kaye, Joseph S Butler, Patrick B Morrissey, Arjun S Sebastian, Scott C Wagner, Alexander R Vaccaro
To curb the unsustainable rise in health care costs, novel payment models are being explored which focus on value rather than volume. Underlying this reform is an accurate understanding of costs and outcomes. The Patient Protection and Affordable Care Act, the Institute of Medicine, and the Agency for Healthcare Research and Quality have specifically advocated for the use of registries to help define the real-world effectiveness of surgical interventions to help guide health care reform. Registries can help define value by documenting surgical efficacy, and specifically by reporting patient-based outcome measures...
October 23, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29064320/the-hospital-acquired-conditions-hac-reduction-program-using-cranberry-treatment-to-reduce-catheter-associated-urinary-tract-infections-and-avoid-medicare-payment-reduction-penalties
#18
T L Saitone, R J Sexton, A Sexton Ward
OBJECTIVE: The Affordable Care Act (ACA) established the Hospital-Acquired Condition (HAC) Reduction Program. The Centers for Medicare and Medicaid Services (CMS) established a total HAC scoring methodology to rank hospitals based upon their HAC performance. Hospitals that rank in the lowest quartile based on their HAC score are subject to a 1% reduction in their total Medicare reimbursements. In FY 2017, 769 hospitals incurred payment reductions totaling $430 million. This study analyzes how improvements in the rate of catheter-associated urinary tract infections (CAUTI), based on the implementation of a cranberry-treatment regimen, impact hospitals' HAC scores and likelihood of avoiding the Medicare-reimbursement penalty...
November 14, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/29061207/sales-of-healthy-snacks-and-beverages-following-the-implementation-of-healthy-vending-standards-in-city-of-philadelphia-vending-machines
#19
Meagan L Pharis, Lisa Colby, Amanda Wagner, Giridhar Mallya
OBJECTIVE: We examined outcomes following the implementation of employer-wide vending standards, designed to increase healthy snack and beverage options, on the proportion of healthy v. less healthy sales, sales volume and revenue for snack and beverage vending machines. DESIGN: A single-arm evaluation of a policy utilizing monthly sales volume and revenue data provided by the contracted vendor during baseline, machine conversion and post-conversion time periods...
October 24, 2017: Public Health Nutrition
https://www.readbyqxmd.com/read/29055519/good-better-best-a-comprehensive-comparison-of-healthcare-providers-performance-an-application-to-physiotherapy-practices-in-primary-care
#20
Sander Steenhuis, Niels Groeneweg, Xander Koolman, France Portrait
Most payment methods in healthcare stimulate volume-driven care, rather than value-driven care. Value-based payment methods such as Pay-For-Performance have the potential to reduce costs and improve quality of care. Ideally, outcome indicators are used in the assessment of providers' performance. The aim of this paper is to describe the feasibility of assessing and comparing the performances of providers using a comprehensive set of quality and cost data. We had access to unique and extensive datasets containing individual data on PROMs, PREMs and costs of physiotherapy practices in Dutch primary care...
October 13, 2017: Health Policy
keyword
keyword
32664
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"