keyword
MENU ▼
Read by QxMD icon Read
search

outcomes based payment

keyword
https://www.readbyqxmd.com/read/29349248/association-of-financial-hardship-with-poor-sleep-health-outcomes-among-men-who-have-sex-with-men
#1
Dustin T Duncan, Su Hyun Park, Yazan A Al-Ajlouni, Lauren Hale, Girardin Jean-Louis, William C Goedel, Basile Chaix, Brian Elbel
Previous studies have identified an association between socioeconomic status and sleep health. While some research has studied this association among sexual minority groups, including men who have sex with men (MSM), they exclusively focused on US-based populations. The interplay between the two in shaping sleep health has not been previously examined on populations residing outside the US. This study considers both determinants, by investigating whether financial hardship is associated with sleep health among a sample of MSM in Paris, France...
December 2017: SSM—Population Health
https://www.readbyqxmd.com/read/29338994/both-patients-and-maternity-care-providers-can-benefit-from-payment-reform-four-steps-to-prepare
#2
Malini A Nijagal, Neel T Shah, Jeff Levin-Scherz
Many Medicaid programs and private health plans are implementing new models of maternity care reimbursement, and clinicians face mounting pressure to demonstrate high quality care at lower cost. Clinicians will be better prepared to meet these challenges with a fuller understanding of new payment models and the opportunities they present. We describe the structure of maternity care "episode payments" and recommend four ways that clinicians can prepare for success as value-based payment models are implemented: identify opportunities to improve outcomes and experience, measure quality, reduce waste and work in teams across settings...
January 12, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29337604/the-current-status-of-outcomes-based-contracting-for-manufacturers-and-payers-an-amcp-membership-survey
#3
Amy Duhig, Soumi Saha, Stacie Smith, Stew Kaufman, Janet Hughes
BACKGROUND: As the United States health care system shifts from traditional volume-based payments to value-based payments, outcomes-based contracts (OBCs) are gaining popularity among payers and manufacturers as a mechanism for the shift toward value. Under this model, stakeholders hope to align drug payment and value to real-world performance metrics (e.g., biomarkers and health care resource utilization). OBJECTIVE: To understand the experiences, perceptions, and needs of payers and manufacturers related to OBCs...
December 22, 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29313756/data-needs-for-a-serious-illness-care-accountability-system-a-framework-and-recommendations
#4
Tom Valuck, Russ Montgomery
BACKGROUND: Successful implementation of a comprehensive accountability system for community-based serious illness care will require a robust data infrastructure. Data will be needed to support care delivery, quality measurement, value-based payment, and evaluation and monitoring. OBJECTIVE: The specific data needs in these areas need to be identified and understood, so that gaps in currently available data may be addressed. DESIGN: We developed a framework that includes the needed data and data infrastructure to support the features and characteristics of a serious illness care accountability system...
March 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29313755/accountability-for-the-quality-of-care-provided-to-people-with-serious-illness
#5
Maureen Henry, Sarah Hudson Scholle, Jessica Briefer French
BACKGROUND: Care for patients with serious illness is an emerging practice area that has gained attention as value-based purchasing has increased. While the number of programs is growing, their impact on care quality and outcomes is unknown. OBJECTIVE: With support from the Gordon and Betty Moore Foundation, the National Committee for Quality Assurance (NCQA) is assessing the feasibility of creating an accountability program focused on serious illness care. METHODS: This article describes the process of developing an accountability program, findings from our initial work, and our plans to develop measures for a serious illness care accountability program...
March 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29295772/differences-in-post-operative-outcome-between-conversion-and-primary-total-hip-arthroplasty
#6
Charles D Qin, Mia M Helfrich, David W Fitz, Mark A Oyer, Kevin D Hardt, David W Manning
BACKGROUND: The demand for conversion of prior hip surgery to total hip arthroplasty (conversion THA) is likely to increase as a function of increasing US hip fracture burden in addition to its application in managing other conditions. Thus, outcome analysis is warranted to better inform value-based reimbursement schemes in the era of bundled payments. METHODS: Via Current Procedural Terminology codes, the National Surgical Quality Improvement Project data files were queried for all patients who underwent primary THA and conversion of previous hip surgery to THA from 2005 to 2014...
November 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29275113/alternative-payment-models-should-risk-adjust-for-conversion-total-hip-arthroplasty-a-propensity-score-matched-study
#7
Alexander S McLawhorn, William W Schairer, Ran Schwarzkopf, David A Halsey, Richard Iorio, Douglas E Padgett
BACKGROUND: For Medicare beneficiaries, hospital reimbursement for nonrevision hip arthroplasty is anchored to either diagnosis-related group code 469 or 470. Under alternative payment models, reimbursement for care episodes is not further risk-adjusted. This study's purpose was to compare outcomes of primary total hip arthroplasty (THA) vs conversion THA to explore the rationale for risk adjustment for conversion procedures. METHODS: All primary and conversion THAs from 2007 to 2014, excluding acute hip fractures and cancer patients, were identified in the National Surgical Quality Improvement Program database...
December 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29261249/real-world-economic-value-of-a-21-gene-assay-in-early-stage-breast-cancer
#8
Stanley E Waintraub, Donna McNamara, Deena Mary Atieh Graham, Andrew L Pecora, John Min, Tommy Wu, Hyun Gi Noh, Jacqueline Connors, Ruth Pe Benito, Kelly Choi, Eric Schultz, Stuart L Goldberg
OBJECTIVES: Value-based payment reforms shift cost-containment responsibilities to the physician. Although gene expression profiling (GEP) utilizing a 21-gene panel among patients with early-stage, axillary lymph node-negative, hormone receptor-positive, HER2/neu oncogene-negative breast cancer is able to identify a cohort that may achieve excellent outcomes without adjuvant chemotherapy, high up-front costs (list price, $4175) could dissuade usage. STUDY DESIGN: Retrospective review of consecutive patients with breast cancer treated at a single cancer center...
December 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29247095/effectiveness-and-cost-effectiveness-of-implementing-hiv-testing-in-primary-care-in-east-london-protocol-for-an-interrupted-time-series-analysis
#9
Werner Leber, Lee Beresford, Claire Nightingale, Estela Capelas Barbosa, Stephen Morris, Farah El-Shogri, Heather McMullen, Kambiz Boomla, Valerie Delpech, Alison Brown, Jane Hutchinson, Vanessa Apea, Merle Symonds, Samantha Gilliham, Sarah Creighton, Maryam Shahmanesh, Naomi Fulop, Claudia Estcourt, Jane Anderson, Jose Figueroa, Chris Griffiths
INTRODUCTION: HIV remains underdiagnosed. Guidelines recommend routine HIV testing in primary care, but evidence on implementing testing is lacking. In a previous study, the Rapid HIV Assessment 2 (RHIVA2) cluster randomised controlled trial, we showed that providing training and rapid point-of-care HIV testing at general practice registration (RHIVA2 intervention) in Hackney led to cost-effective, increased and earlier diagnosis of HIV. However, interventions effective in a trial context may be less so when implemented in routine practice...
December 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29243347/cost-effectiveness-of-increasing-the-reach-of-smoking-cessation-interventions-in-germany-results-from-the-equiptmod
#10
Manuel B Huber, Maximilian Präger, Kathryn Coyle, Doug Coyle, Adam Lester-George, Marta Trapero-Bertran, Bertalan Nemeth, Kei Long Cheung, Renee Stark, Matthias Vogl, Subhash Pokhrel, Reiner Leidl
AIMS: To evaluate costs, effects and cost-effectiveness of increased reach of specific smoking cessation interventions in Germany. DESIGN: A Markov-based state transition return on investment model (EQUIPTMOD) was used to evaluate current smoking cessation interventions as well as two prospective investment scenarios. A health-care perspective (extended to include out-of-pocket payments) with life-time horizon was considered. A probabilistic analysis was used to assess uncertainty concerning predicted estimates...
December 15, 2017: Addiction
https://www.readbyqxmd.com/read/29242239/defining-quality-in-cardiovascular-imaging-a-scientific-statement-from-the-american-heart-association
#11
REVIEW
Leslee J Shaw, Ron Blankstein, Jill E Jacobs, Jonathon A Leipsic, Raymond Y Kwong, Viviany R Taqueti, Rob S B Beanlands, Jennifer H Mieres, Scott D Flamm, Thomas C Gerber, John Spertus, Marcelo F Di Carli
The aims of the current statement are to refine the definition of quality in cardiovascular imaging and to propose novel methodological approaches to inform the demonstration of quality in imaging in future clinical trials and registries. We propose defining quality in cardiovascular imaging using an analytical framework put forth by the Institute of Medicine whereby quality was defined as testing being safe, effective, patient-centered, timely, equitable, and efficient. The implications of each of these components of quality health care are as essential for cardiovascular imaging as they are for other areas within health care...
December 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29239903/proposed-performance-based-metrics-for-the-future-funding-of-graduate-medical-education-starting-the-conversation
#12
Kelly J Caverzagie, Susan W Lane, Niraj Sharma, John Donnelly, Jeffrey R Jaeger, Heather Laird-Fick, John P Moriarty, Darilyn V Moyer, Sara L Wallach, Richard M Wardrop, Alwin F Steinmann
Graduate medical education (GME) in the United States is financed by contributions from both federal and state entities that total over $15 billion annually. Within institutions, these funds are distributed with limited transparency to achieve ill-defined outcomes. To address this, the Institute of Medicine convened a committee on the governance and financing of GME to recommend finance reform that would promote a physician training system that meets society's current and future needs. The resulting report provided several recommendations regarding the oversight and mechanisms of GME funding, including implementation of performance-based GME payments, but did not provide specific details about the content and development of metrics for these payments...
December 12, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29239587/redefining-medical-care
#13
Lauren R Roth
President Donald J. Trump has said he will repeal the Affordable Care Act (ACA) and replace it with health savings accounts (HSAs). Conservatives have long preferred individual accounts to meet social welfare needs instead of more traditional entitlement programs. The types of "medical care" that can be reimbursed through an HSA are listed in section 213(d) of the Internal Revenue Code (Code) and include expenses "for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body...
2017: Cornell Journal of Law and Public Policy
https://www.readbyqxmd.com/read/29236539/no-equity-no-triple-aim-strategic-proposals-to-advance-health-equity-in-a-volatile-policy-environment
#14
Geoffrey W Wilkinson, Alan Sager, Sara Selig, Richard Antonelli, Samantha Morton, Gail Hirsch, Celeste Reid Lee, Abigail Ortiz, Durrell Fox, Monica Valdes Lupi, Cecilia Acuff, Madeline Wachman
Health professionals, including social workers, community health workers, public health workers, and licensed health care providers, share common interests and responsibilities in promoting health equity and improving social determinants of health-the conditions in which people live, work, play, and learn. We summarize the underlying causes of health inequity and comparatively poor health outcomes in the United States. We describe barriers to realizing the hope embedded in the 2010 Patient Protection and Affordable Care Act, that moving away from fee-for-service payments will naturally drive care upstream as providers respond to greater financial risk by undertaking greater prevention efforts for the health of their patients...
December 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/29223847/funding-breakthrough-therapies-a-systematic-review-and-recommendation
#15
REVIEW
E Hanna, M Toumi, C Dussart, B Borissov, O Dabbous, K Badora, P Auquier
BACKGROUND: Advanced therapy medicinal products (ATMPs) are innovative therapies likely associated with high prices. Payers need guidance to create a balance between ensuring patient access to breakthrough therapies and maintaining the financial sustainability of the healthcare system. OBJECTIVE: The aims of this study were to identify, define, classify and compare the approaches to funding high-cost medicines proposed in the literature, to analyze their appropriateness for ATMP funding and to suggest an optimal funding model for ATMPs...
December 2, 2017: Health Policy
https://www.readbyqxmd.com/read/29200944/cost-utility-analysis-of-cervical-therapeutic-medial-branch-blocks-in-managing-chronic-neck-pain
#16
Laxmaiah Manchikanti, Vidyasagar Pampati, Alan D Kaye, Joshua A Hirsch
Background: Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/29194494/impact-of-bundled-payments-on-hip-fracture-outcomes-a-nationwide-population-based-study
#17
Yu-Chi Tung, Hsien-Yen Chang, Guann-Ming Chang
Objective: Establishing one price for all bundled services for a particular illness, which has become the key to healthcare reform efforts, is designed to encourage health professionals to coordinate their care for patients. Limited information is available, however, concerning whether bundled payments are associated with changes in patient outcomes. Nationwide longitudinal population-based data were used to examine the effect of bundled payments on hip fracture outcomes. Design: An interrupted time series design with a comparison group...
November 29, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29188286/association-of-dermatologist-density-with-the-volume-and-costs-of-dermatology-procedures-among-medicare-beneficiaries
#18
Sally Y Tan, Daphne Tsoucas, Arash Mostaghimi
Importance: The persistent shortage of dermatologists in the United States affects access to care and patient outcomes. Objective: To characterize the effect of geographic variations in dermatologist density on the provision of dermatology procedures within Medicare. Design, Setting, and Participants: This was a cross-sectional study using the 2013 Medicare Provider Utilization and Payment Database. Dermatology-related procedures were defined by the top 50 billing codes accounting for more than 95% of procedures billed by dermatologists...
November 29, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/29182487/using-electronic-health-records-for-quality-measurement-and-accountability-in-care-of-the-seriously-ill-opportunities-and-challenges
#19
J Randall Curtis, Seelwan Sathitratanacheewin, Helene Starks, Robert Y Lee, Erin K Kross, Lois Downey, James Sibley, William Lober, Elizabeth T Loggers, James A Fausto, Charlotta Lindvall, Ruth A Engelberg
BACKGROUND: As our population ages and the burden of chronic illness rises, there is increasing need to implement quality metrics that measure and benchmark care of the seriously ill, including the delivery of both primary care and specialty palliative care. Such metrics can be used to drive quality improvement, value-based payment, and accountability for population-based outcomes. METHODS: In this article, we examine use of the electronic health record (EHR) as a tool to assess quality of serious illness care through narrative review and description of a palliative care quality metrics program in a large healthcare system...
November 28, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29181511/the-value-based-payment-modifier-program-outcomes-and-implications-for-disparities
#20
Eric T Roberts, Alan M Zaslavsky, J Michael McWilliams
Background: When risk adjustment is inadequate and incentives are weak, pay-for-performance programs, such as the Value-Based Payment Modifier (Value Modifier [VM]) implemented by the Centers for Medicare & Medicaid Services, may contribute to health care disparities without improving performance on average. Objective: To estimate the association between VM exposure and performance on quality and spending measures and to assess the effects of adjusting for additional patient characteristics on performance differences between practices serving higher-risk and those serving lower-risk patients...
November 28, 2017: Annals of Internal Medicine
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"