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https://www.readbyqxmd.com/read/27905814/medicare-and-medicaid-programs-cy-2017-home-health-prospective-payment-system-rate-update-home-health-value-based-purchasing-model-and-home-health-quality-reporting-requirements-final-rule
#1
(no author information available yet)
This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP)...
November 3, 2016: Federal Register
https://www.readbyqxmd.com/read/27864167/testing-the-feasibility-of-remote-patient-monitoring-in-prenatal-care-using-a-mobile-app-and-connected-devices-a-prospective-observational-trial
#2
Kathryn I Marko, Jill M Krapf, Andrew C Meltzer, Julia Oh, Nihar Ganju, Anjali G Martinez, Sheetal G Sheth, Nancy D Gaba
BACKGROUND: Excessive weight gain and elevated blood pressure are significant risk factors for adverse pregnancy outcomes such as gestational diabetes, premature birth, and preeclampsia. More effective strategies to facilitate adherence to gestational weight gain goals and monitor blood pressure may have a positive health benefit for pregnant women and their babies. The impact of utilizing a remote patient monitoring system to monitor blood pressure and weight gain as a component of prenatal care has not been previously assessed...
November 18, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27353455/pennsylvania-s-medical-home-initiative-reductions-in-healthcare-utilization-and-cost-among-medicaid-patients-with-medical-and-psychiatric-comorbidities
#3
Karin V Rhodes, Simon Basseyn, Robert Gallop, Elizabeth Noll, Aileen Rothbard, Paul Crits-Christoph
BACKGROUND: The Chronic Care Initiative (CCI) was a large state-wide patient-centered medical home (PCMH) initiative in Pennsylvania in place from 2008-2011. OBJECTIVE: Determine whether the CCI impacted the utilization and costs for Medicaid patients with chronic medical conditions and comorbid psychiatric or substance use disorders. DESIGN: Analysis of Medicaid claims using difference-in-difference regression analyses to compare changes in utilization and costs for patients treated at CCI practices to propensity score-matched patients treated at comparison non-CCI practices...
June 25, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27148476/payment-reform-unprecedented-and-evolving-impact-on-gynecologic-oncology
#4
REVIEW
Sachin M Apte, Kavita Patel
With the signing of the Medicare Access and CHIP Reauthorization Act in April 2015, the Centers for Medicare and Medicaid Services (CMS) is now positioned to drive the development and implementation of sweeping changes to how physicians and hospitals are paid for the provision of oncology-related services. These changes will have a long-lasting impact on the sub-specialty of gynecologic oncology, regardless of practice structure, physician employment and compensation model, or local insurance market. Recently, commercial payers have piloted various models of payment reform via oncology-specific clinical pathways, oncology medical homes, episode payment arrangements, and accountable care organizations...
2016: Frontiers in Oncology
https://www.readbyqxmd.com/read/27036924/you-want-a-successful-bundle-what-about-post-discharge-care
#5
James D Slover
BACKGROUND: The postacute care strategies after total joint arthroplasty, including the use of postacute rehabilitation centers and home therapy services are associated with different costs. Providers in bundled payment programs are incentivized to use the most cost-effective strategies while maintaining quality and value for patients. METHODS: We discuss the impact of postacute care on a bundled payment program and strategies for optimizing the value of this component of the care episode using the experience of a large academic urban medical center participating in the Centers for Medicare and Medicaid Services Bundled Payments for Care Improvement Initiative...
May 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/26552111/medicare-and-medicaid-programs-cy-2016-home-health-prospective-payment-system-rate-update-home-health-value-based-purchasing-model-and-home-health-quality-reporting-requirements-final-rule
#6
(no author information available yet)
This final rule will update Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2016. As required by the Affordable Care Act, this rule implements the 3rd year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates...
November 5, 2015: Federal Register
https://www.readbyqxmd.com/read/26526856/prevalence-of-pseudobulbar-affect-symptoms-and-clinical-correlates-in-nursing-home-residents
#7
Kevin Foley, R Tamara Konetzka, Anthony Bunin, Charles Yonan
OBJECTIVE: Pseudobulbar affect (PBA) is a neurological disorder of emotional expression, characterized by uncontrollable episodes of crying or laughing in patients with certain neurological disorders affecting the brain. The purposes of this study were to estimate the prevalence of PBA in US nursing home residents and examine the relationship between PBA symptoms and other clinical correlates, including the use of psychopharmacological medications. METHODS: A retrospective study was conducted between 2013 and 2014 with a convenience sample of residents from nine Michigan nursing homes...
July 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/26122802/the-use-of-telemedicine-to-address-access-and-physician-workforce-shortages
#8
James P Marcin, Mary Ellen Rimsza, William B Moskowitz
The use of telemedicine technologies by primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists (henceforth referred to as "pediatric physicians") has the potential to transform the practice of pediatrics. The purpose of this policy statement is to describe the expected and potential impact that telemedicine will have on pediatric physicians' efforts to improve access and physician workforce shortages. The policy statement also describes how the American Academy of Pediatrics can advocate for its members and their patients to best use telemedicine technologies to improve access to care, provide more patient- and family-centered care, increase efficiencies in practice, enhance the quality of care, and address projected shortages in the clinical workforce...
July 2015: Pediatrics
https://www.readbyqxmd.com/read/26024330/relationships-between-polypharmacy-and-the-sleep-cycle-among-active-duty-service-members
#9
R Gregory Lande, Cynthia Gragnani
CONTEXT: Sleep disorders are frequent clinical presentations, especially among active-duty service members. Medications are one factor that can affect sleep in many ways. OBJECTIVE: To determine the effect of increasing numbers of medications on the sleep cycle of active-duty service members. METHODS: Medical records for active-duty service members who completed enhanced sleep assessments at the Psychiatry Continuity Service at Walter Reed National Military Medical Center from October 1, 2010, through November 30, 2013, were retrospectively reviewed...
June 2015: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/25993243/the-patient-centered-medical-home-in-oncology-from-concept-to-reality
#10
Ray D Page, Lee N Newcomer, John D Sprandio, Barbara L McAneny
In recent years, the cost of providing quality cancer care has been subject to an epic escalation causing concerns on the verge of a health care crisis. Innovative patient-management models in oncology based on patient-centered medical home (PCMH) principles, coupled with alternative payments to traditional fee for service (FFS), such as bundled and episodes payment are now showing evidence of effectiveness. These efforts have the potential to bend the cost curve while also improving quality of care and patient satisfaction...
2015: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/25972432/catheter-salvage-after-catheter-related-bloodstream-infection-during-home-parenteral-nutrition
#11
Jithinraj Edakkanambeth Varayil, Jennifer A Whitaker, Akiko Okano, Jennifer J Carnell, Jacob B Davidson, Mark J Enzler, Darlene G Kelly, Manpreet S Mundi, Ryan T Hurt
BACKGROUND: Catheter-related bloodstream infection (CRBSI) is a common complication in patients receiving home parenteral nutrition (HPN). Data regarding catheter salvage after a CRBSI episode are limited. We aimed to determine the incidence of CRBSI and rates of catheter salvage in adult patients receiving HPN. MATERIALS AND METHODS: We retrospectively searched our prospectively maintained HPN database for the records of all adult patients receiving HPN from January 1, 1990, to December 31, 2013, at our tertiary referral center...
May 13, 2015: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/25670755/evaluating-the-impact-of-an-integrated-computer-based-decision-support-with-person-centered-analytics-for-the-management-of-asthma-in-primary-care-a-randomized-controlled-trial
#12
RANDOMIZED CONTROLLED TRIAL
Robyn Tamblyn, Pierre Ernst, Nancy Winslade, Allen Huang, Roland Grad, Robert W Platt, Sara Ahmed, Teresa Moraga, Tewodros Eguale
BACKGROUND: Computer-based decision support has been effective in providing alerts for preventive care. Our objective was to determine whether a personalized asthma management computer-based decision support increases the quality of asthma management and reduces the rate of out-of-control episodes. METHODS: A cluster-randomized trial was conducted in Quebec, Canada among 81 primary care physicians and 4447 of their asthmatic patients. Patients were followed from the first visit for 3-33 months...
July 2015: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/25403703/right-versus-left-atrial-pacing-in-patients-with-sick-sinus-syndrome-and-paroxysmal-atrial-fibrillation-riverleft-study-study-protocol-for-randomized-controlled-trial
#13
RANDOMIZED CONTROLLED TRIAL
Tanwier T T K Ramdjan, Lisette J M E van der Does, Paul Knops, Jan C J Res, Natasja M S de Groot
BACKGROUND: The incidence of sick sinus syndrome will increase due to population ageing. Consequently, this will result in an increase in the number of pacemaker implantations. The atrial lead is usually implanted in the right atrial appendage, but this position may be ineffective for prevention of atrial fibrillation. It has been suggested that pacing distally in the coronary sinus might be more successful in preventing atrial fibrillation episodes. The aim of this trial is to study the efficacy of distal coronary sinus versus right atrial appendage pacing in preventing atrial fibrillation episodes in patients with sick sinus syndrome...
2014: Trials
https://www.readbyqxmd.com/read/25251757/a-qualitative-investigation-of-patients-and-caregivers-experiences-of-severe-sepsis
#14
Katy H Gallop, Cicely E P Kerr, Annabel Nixon, Lara Verdian, Joseph B Barney, Richard J Beale
OBJECTIVES: To explore and describe the subjective experiences and long-term impact of severe sepsis on survivors of severe sepsis and their informal caregivers (e.g., spouse or family member) through qualitative research methods. DESIGN: A qualitative exploratory study using semi-structured interviews with survivors of severe sepsis and their informal caregivers in the United Kingdom and United States. Participants also completed a demographic background form and sites provided medical history details...
February 2015: Critical Care Medicine
https://www.readbyqxmd.com/read/25005353/the-impact-of-home-based-hiv-counseling-and-testing-on-care-seeking-and-incidence-of-common-infectious-disease-syndromes-in-rural-western-kenya
#15
Godfrey Bigogo, Manase Amolloh, Kayla F Laserson, Allan Audi, Barrack Aura, Warren Dalal, Marta Ackers, Deron Burton, Robert F Breiman, Daniel R Feikin
BACKGROUND: In much of Africa, most individuals living with HIV do not know their status. Home-based counseling and testing (HBCT) leads to more HIV-infected people learning their HIV status. However, there is little data on whether knowing one's HIV-positive status necessarily leads to uptake of HIV care, which could in turn, lead to a reduction in the prevalence of common infectious disease syndromes. METHODS: In 2008, Kenya Medical Research Institute (KEMRI) in collaboration with the Centers for Disease Control and Prevention (CDC) offered HBCT to individuals (aged ≥13 years) under active surveillance for infectious disease syndromes in Lwak in rural western Kenya...
2014: BMC Infectious Diseases
https://www.readbyqxmd.com/read/24705524/pain-management-screening-and-assessment-of-pain-as-part-of-a-comprehensive-case-management-process
#16
Jolynne Jo Carter, Annette C Watson, Patrice V Sminkey
PURPOSE/OBJECTIVE: Pain management, episodic and chronic, is a major issue in health care today, affecting more than 76 million people across care-delivery settings from acute care to rehabilitation, workers' compensation to primary care. As a result, professional case managers occupy an important role within an interdisciplinary care team to address pain as part of a comprehensive case management process, from intake and assessment through care delivery and transitions of care. PRIMARY PRACTICE SETTING: Pain management, as part of the comprehensive case management process, is applicable across the case management spectrum, including hospitals, accountable care organizations, patient-centered medical homes, physician practices, clinics, occupational health clinics, workers' compensation, and other settings in which case managers work with clients and their support systems...
May 2014: Professional Case Management
https://www.readbyqxmd.com/read/24580063/a-retrospective-review-of-isolated-gliptin-exposure-cases-reported-to-a-state-poison-control-system
#17
M A Darracq, J M Toy, T Chen, C Mo, F L Cantrell
BACKGROUND: The dipeptidyl peptidase-4 (DPP-4) inhibitors sitagliptin, saxagliptin, and linagliptin are approved by the US Food and Drug Administration in the treatment of type-2 diabetes. Given the limited published information regarding human overdoses to these medications, our goal was to characterize such exposures. METHODS: A state poison system database was retrospectively reviewed for all single-agent exposures to sitagliptin, saxagliptin, and linagliptin from 2006 to 2012...
March 2014: Clinical Toxicology
https://www.readbyqxmd.com/read/24428952/a-qualitative-comparison-of-primary-care-clinicians-and-their-patients-perspectives-on-achieving-depression-care-implications-for-improving-outcomes
#18
COMPARATIVE STUDY
Robert D Keeley, David R West, Brandon Tutt, Paul A Nutting
BACKGROUND: Improving the patient experience of primary care is a stated focus of efforts to transform primary care practices into "Patient-centered Medical Homes" (PCMH) in the United States, yet understanding and promoting what defines a positive experience from the patient's perspective has been de-emphasized relative to the development of technological and communication infrastructure at the PCMH. The objective of this qualitative study was to compare primary care clinicians' and their patients' perceptions of the patients' experiences, expectations and preferences as they try to achieve care for depression...
2014: BMC Family Practice
https://www.readbyqxmd.com/read/24344490/clinical-outcomes-in-elderly-more-than-80-years-of-age-peritoneal-dialysis-patients-five-years-experience-at-two-centers
#19
MULTICENTER STUDY
Takanori Otowa, Tsutomu Sakurada, Motonori Nagasawa, Sayaka Shimizu, Takeshi Yokoyama, Nagayuki Kaneshiro, Yusuke Konno, Yugo Shibagaki, Kenjiro Kimura
The proportion of elderly people requiring renal replacement therapy has been increasing in Japan. Although several studies have shown the benefits of peritoneal dialysis (PD) in the elderly, few have reported on outcomes, including prognosis, in elderly PD patients, especially those more than 80 years of age. The purpose of the present study was to evaluate clinical outcomes in elderly (more than 80 years of age) PD patients. We retrospectively evaluated the medical records of elderly PD patients who commenced PD between 2007 and 2011...
2013: Advances in Peritoneal Dialysis
https://www.readbyqxmd.com/read/24334312/developing-a-viable-alternative-to-medicare-s-physician-payment-strategy
#20
Gail R Wilensky
Since 1992 Medicare has reimbursed physicians on a fee-for-service basis that weights physician services according to the effort and expense of providing those services and converts the weights to dollars using a conversion factor. In 1997 Congress replaced an existing spending constraint with the Sustainable Growth Rate (SGR) to reduce reimbursements if overall physician spending exceeded the growth in the economy. Congress, however, has routinely overridden the SGR because of concerns that reduced payments to physicians would limit patients' access to care...
January 2014: Health Affairs
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