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https://www.readbyqxmd.com/read/28539004/building-better-medicaid-care
#1
Joey Berlin
The trend away from fee-for-service and toward value-based payment models in the Texas Medicaid program shows some early promise.
May 1, 2017: Texas Medicine
https://www.readbyqxmd.com/read/28538055/high-reliability-principles-must-be-tied-to-value-based-outcomes
#2
Mitchell L Wasden
WellStar Health System and the Medical University of South Carolina (MUSC), highlighted in this issue's feature articles, are two organizations seeking to drive high reliability by educating leaders and incorporating high-reliability principles into their quality improvement (QI) efforts. The organizations have taken slightly different approaches to executing on high reliability, yet both are encouraged by the apparent success of high-reliability principles in other industries.The high-reliability framework is often applied to healthcare despite the limitations of comparing healthcare organizations to nuclear reactors, commercial airlines, and aircraft carriers...
July 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28537961/the-affordable-care-act-and-cancer-care-delivery
#3
Gabriel A Brooks, J Russell Hoverman, Carrie H Colla
The Affordable Care Act (ACA) has reformed US health care delivery through insurance coverage expansion, experiments in payment design, and funding for patient-centered clinical and health care delivery research. The impact on cancer care specifically has been far reaching, with new ACA-related programs that encourage coordinated, patient-centered, cost-effective care. Insurance expansions through private exchanges and Medicaid, along with preexisting condition clauses, have helped more than 20 million Americans gain health care coverage...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28537786/designing-a-community-based-population-health-model
#4
Christopher J Durovich, Peter W Roberts
The pace of change from volume-based to value-based payment in health care varies dramatically among markets. Regardless of the ultimate disposition of the Affordable Care Act, employers and public-private payers will continue to increase pressure on health care providers to assume financial risk for populations in the form of shared savings, bundled payments, downside risk, or even capitation. This article outlines a suggested road map and practical considerations for health systems that are building or planning to build population health capabilities to meet the needs of their local markets...
May 24, 2017: Population Health Management
https://www.readbyqxmd.com/read/28535104/measuring-the-value-of-new-drugs-validity-and-reliability-of-4-value-assessment-frameworks-in-the-oncology-setting
#5
Tanya G K Bentley, Joshua T Cohen, Elena B Elkin, Julie Huynh, Arnab Mukherjea, Thanh H Neville, Matthew Mei, Ronda Copher, Russell Knoth, Ioana Popescu, Jackie Lee, Jenelle M Zambrano, Michael S Broder
BACKGROUND: Several organizations have developed frameworks to systematically assess the value of new drugs. OBJECTIVE: To evaluate the convergent validity and interrater reliability of 4 value frameworks to understand the extent to which these tools can facilitate value-based treatment decisions in oncology. METHODS: Eight panelists used the American Society of Clinical Oncology (ASCO), European Society for Medical Oncology (ESMO), Institute for Clinical and Economic Review (ICER), and National Comprehensive Cancer Network (NCCN) frameworks to conduct value assessments of 15 drugs for advanced lung and breast cancers and castration-refractory prostate cancer...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28534221/measuring-outcomes-in-adult-spinal-deformity-surgery-a-systematic-review-to-identify-current-strengths-weaknesses-and-gaps-in-patient-reported-outcome-measures
#6
REVIEW
Sayf S A Faraj, Miranda L van Hooff, Roderick M Holewijn, David W Polly, Tsjitske M Haanstra, Marinus de Kleuver
PURPOSE: Adult spinal deformity (ASD) causes severe disability, reduces overall quality of life, and results in a substantial societal burden of disease. As healthcare is becoming more value based, and to facilitate global benchmarking, it is critical to identify and standardize patient-reported outcome measures (PROMs). This study aims to identify the current strengths, weaknesses, and gaps in PROMs used for ASD. METHODS: Studies were included following a systematic search in multiple bibliographic databases between 2000 and 2015...
May 22, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28532630/shared-decision-making-as-part-of-value-based-care-new-u-s-policies-challenge-our-readiness
#7
Erica S Spatz, Glyn Elwyn, Benjamin W Moulton, Robert J Volk, Dominick L Frosch
Shared decision making in the United States is increasingly being recognized as part of value-based care. During the last decade, several state and federal initiatives have linked shared decision making with reimbursement and increased protection from litigation. Additionally, private and public foundations are increasingly funding studies to identify best practices for moving shared decision making from the research world into clinical practice. These shifts offer opportunities and challenges for ensuring effective implementation...
May 20, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28530525/cost-effectiveness-of-nivolumab-ipilimumab-combination-therapy-compared-with-monotherapy-for-first-line-treatment-of-metastatic-melanoma-in-the-united-states
#8
Anna Oh, Dang M Tran, Leann C McDowell, Dor Keyvani, Jay Andrew Barcelon, Oscar Merino, Leslie Wilson
BACKGROUND: The approval of new immunotherapies has dramatically changed the treatment landscape of metastatic melanoma. These survival gains come with trade-offs in side effects and costs, as well as important considerations for third-party payer systems, physicians, and patients. OBJECTIVE: To develop a Markov model to determine the cost-effectiveness of nivolumab, ipilimumab, and nivolumab-ipilimumab combination as firstline therapy in metastatic melanoma, while accounting for differential effectiveness in programmed death-ligand 1 (PD-L1) positive and negative patients...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28528621/using-lean-to-rapidly-and-sustainably-transform-a-behavioral-health-crisis-program-impact-on-throughput-and-safety
#9
Margaret E Balfour, Kathleen Tanner, Paul J Jurica, Dawn Llewellyn, Robert G Williamson, Chris A Carson
BACKGROUND: Lean has been increasingly applied in health care to reduce waste and improve quality, particularly in fast-paced and high-acuity clinical settings such as emergency departments. In addition, Lean's focus on engagement of frontline staff in problem solving can be a catalyst for organizational change. In this study, ConnectionsAZ demonstrates how they applied Lean principles to rapidly and sustainably transform clinical operations in a behavioral health crisis facility. METHODS: A multidisciplinary team of management and frontline staff defined values-based outcome measures, mapped the current and ideal processes, and developed new processes to achieve the ideal...
June 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28525558/electronic-clinical-quality-measure-reporting-challenges-findings-from-the-medicare-ehr-incentive-program-s-controlling-high-blood-pressure-measure
#10
Dawn M Heisey-Grove, Hilary K Wall, Janet S Wright
Objective: To identify physician and practice characteristics associated with high clinical and technical performance on the electronic clinical quality measure (eCQM) that calculates the proportion of patients with hypertension who have controlled blood pressure. Materials and Methods: The study included 268 602 physicians participating in the Medicare Electronic Health Record Incentive Program between 2011 and 2014. Independent variables included delivery reform participation and physician, practice level, and area characteristics...
May 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28525404/growth-hormone-treatment-for-growth-hormone-deficiency-and-idiopathic-short-stature-new-guidelines-shaped-by-the-presence-and-absence-of-evidence
#11
Adda Grimberg, David B Allen
PURPOSE OF REVIEW: The Pediatric Endocrine Society recently published new guidelines for the use of human growth hormone (hGH) and human insulin-like growth factor-I (hIGF-I) treatment for growth hormone deficiency, idiopathic short stature, and primary IGF-I deficiency in children and adolescents. This review places the new guidelines in historical contexts of the life cycle of hGH and the evolution of US health care, and highlights their future implications. RECENT FINDINGS: The new hGH guidelines, the first to be created by the Grading of Recommendations Assessment, Development and Evaluation approach, are more conservative than their predecessors...
May 18, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28514910/value-based-healthcare-measurement-as-a-context-for-organizational-learning
#12
Patrik Nordin, Anna-Aurora Kork, Inka Koskela
Purpose The purpose of this paper is to shed light on the potential of organizational learning for developing effectiveness of care. Value-based healthcare measurement recognizes patient value as a driver for improving health outcomes at the societal and individual levels. By using the action learning method, this paper examines the phases of organizational learning in a private healthcare organization that has developed a novel Big Data screening tool for the treatment of patients with type 2 diabetes mellitus (DM2)...
May 2, 2017: Leadership in Health Services
https://www.readbyqxmd.com/read/28513604/exploring-the-statistical-uncertainty-in-acceptable-exposure-limit-values-for-hexavalent-chromium-exposure
#13
Göran Kauermann, Heiko Becher, Verena Maier
Exposure limit values give the exposure level at which an accepted (or acceptable) number of additional work related diseases are expected. The values are derived from dose-response curves and carry a large amount of uncertainty. In this paper we aim to quantify some of this uncertainty with statistical means. We explore the limit value issued by the European Chemical Agency (ECHA) for occupational exposure to hexavalent chromium, CR(VI). We investigate how the dose-response model and statistical estimation variability influences the data-based fixation of exposure limit values...
May 17, 2017: Journal of Exposure Science & Environmental Epidemiology
https://www.readbyqxmd.com/read/28511946/national-incidence-of-patient-safety-indicators-in-the-total-hip-arthroplasty-population
#14
Joseph E Tanenbaum, Derrick M Knapik, Glenn D Wera, Steven J Fitzgerald
BACKGROUND: The Centers for Medicare & Medicaid Services use the incidence of patient safety indicators (PSIs) to determine health care value and hospital reimbursement. The national incidence of PSI has not been quantified in the total hip arthroplasty (THA) population, and it is unknown if patient insurance status is associated with PSI incidence after THA. METHODS: All patients in the Nationwide Inpatient Sample (NIS) who underwent THA in 2013 were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification codes...
April 12, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28511830/personality-disorders-and-the-difficult-dermatology-patient-maximizing-patient-satisfaction
#15
Mio Nakamura, John Koo
Personality disorders (PDs) are stable and enduring patterns of thought, feeling, and behavior that deviate from one's cultural norms and cause impairment in functionality. Patients with PDs are commonly encountered in the dermatologic setting and can be perceived by providers as "difficult." Given that PDs are chronic, rigid, and frustrating to deal with, it is important to be skillful in the approach to such patients, especially in the era of the value-based reimbursement system, in which patient satisfaction is crucial for reimbursement...
May 2017: Clinics in Dermatology
https://www.readbyqxmd.com/read/28511768/telemedicine-seems-to-work-but-payment-creates-a-disconnect
#16
Richard G Stefanacci
As American health care shifts from the fee-for-service, disconnected health care to value-based, holistic care, an alignment between providers and total cost of care should encourage the use of telemedicine-especially in cases where it has been shown to reduce costs and improve individual care and population.
April 2017: Managed Care
https://www.readbyqxmd.com/read/28511435/agreement-and-correlation-between-arterial-and-central-venous-blood-gas-following-coronary-artery-bypass-graft-surgery
#17
Masoumeh Esmaeilivand, Alireza Khatony, Gholamreza Moradi, Farid Najafi, Alireza Abdi
INTRODUCTION: Arterial blood sampling, used to assess patients in acute conditions, may result in complications such as thrombosis and embolism. However, it can be replaced by venous blood sampling, but there is a dearth of information on this. AIM: To assess the correlation and agreement between the arterial and central venous blood gases analyses in patients undergoing elective Coronary Artery Bypass Graft (CABG) surgery. MATERIALS AND METHODS: In this cross-sectional study, 100 ICU patients undergoing elective CABG surgery were recruited...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28509711/trends-in-governance-structure-and-activities-among-not-for-profit-u-s-hospitals-2009-2015
#18
Olena Mazurenko, Taleah Collum, Nir Menachemi
BACKGROUND: In U.S. hospitals, boards of directors (BODs) have numerous governance responsibilities including overseeing hospital activities and guiding strategic decisions. BODs can help hospitals adapt to changes in their markets including those stemming from a shift from fee-for-service to value-based purchasing. The recent increase in market turbulence for hospitals has brought renewed attention to the work of BODs. PURPOSE: The aim of the study was to examine trends in hospital BOD structure and activities and determine whether these changes are commensurate with approaches designed to respond to market pressures...
May 15, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28508629/inorganic-ligand-thiosulfate-capped-quantum-dots-for-efficient-quantum-dot-sensitized-solar-cells
#19
Zhenwei Ren, Juan Yu, Zhenxiao Pan, Jizheng Wang, Xinhua Zhong
The insulating nature of organic ligands containing long hydrocarbon tails brings forward serious limitations for presynthesized quantum dots (QDs) in photovoltaic applications. Replacing the initial organic hydrocarbon chain ligands with simple, cheap, and small inorganic ligands is regarded as an efficient strategy for improving the performance of the resulting photovoltaic devices. Herein, thiosulfate (S2O3(2-)), and sulfide (S(2-)) were employed as ligand-exchange reagents to get access to the inorganic ligand S2O3(2-)- and S(2-)-capped CdSe QDs...
May 24, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28506982/social-risk-factors-and-performance-under-medicare-s-value-based-purchasing-programs
#20
Karen E Joynt, Rachael Zuckerman, Arnold M Epstein
No abstract text is available yet for this article.
May 2017: Circulation. Cardiovascular Quality and Outcomes
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