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Health Care Reform

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https://www.readbyqxmd.com/read/29148333/geographic-variations-in-physician-relationships-over-time-implications-for-care-coordination
#1
Eva H DuGoff, Juhee Cho, Yajuan Si, Craig Evan Pollack
Care coordination may be more challenging when the specific physicians with whom primary care physicians (PCPs) are expected to coordinate care change over time. Using Medicare data on physician patient-sharing relationships and the Dartmouth Atlas, we explored the extent to which PCPs tend to share patients with other physicians over time. We found that 70.7% of ties between PCPs and other physicians that were present in 2012 persisted in 2013, and additional shared patients in 2012 increased the odds of being connected in 2013...
March 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29145982/impact-of-outpatient-total-joint-replacement-on-postoperative-outcomes
#2
REVIEW
Danielle Lovett-Carter, Zain Sayeed, Leila Abaab, Vinay Pallekonda, William Mihalko, Khaled J Saleh
Total joint arthroplasty (TJA) has demonstrated tremendous benefits to patients with osteoarthritis. Health care reform has influenced surgeons to optimize TJA care pathways as well as playing a role in the formation of outpatient TJA protocols. Understanding the outcomes of outpatient TJA is imperative to surgical predicate decision making. The aim of this review is to compare outcomes of outpatient TJA patients to standard-stay inpatients. Postoperative outcomes assessed include pain, complications, readmissions, reoperation, patient satisfaction, and cost...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29142907/social-effects-of-health-care-reform-medicaid-expansion-under-the-affordable-care-act-and-changes-in-volunteering
#3
Heeju Sohn, Stefan Timmermans
Do public health policy interventions result in pro-social behaviors? The Affordable Care Act (ACA)'s Medicaid expansions were responsible for the largest gains in public insurance coverage since its inception in 1965. These gains were concentrated in states that opted to expand Medicaid eligibility and provide a unique opportunity to study not just medical but also social consequences of increased public health coverage. This article examines the association between Medicaid and volunteer work. Volunteerism is implicated in individuals' health and well-being yet it is highly correlated with a person's existing socioeconomic resources...
January 2017: Socius
https://www.readbyqxmd.com/read/29141639/tobacco-use-and-health-insurance-literacy-among-vulnerable-populations-implications-for-health-reform
#4
Robert T Braun, Yaniv Hanoch, Andrew J Barnes
BACKGROUND: Under the Affordable Care Act (ACA), millions of Americans have been enrolling in the health insurance marketplaces. Nearly 20% of them are tobacco users. As part of the ACA, tobacco users may face up to 50% higher premiums that are not eligible for tax credits. Tobacco users, along with the uninsured and racial/ethnic minorities targeted by ACA coverage expansions, are among those most likely to suffer from low health literacy - a key ingredient in the ability to understand, compare, choose, and use coverage, referred to as health insurance literacy...
November 15, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29141177/health-care-reform-u-s-style
#5
Sally S Cohen
No abstract text is available yet for this article.
May 2017: Policy, Politics & Nursing Practice
https://www.readbyqxmd.com/read/29137555/impact-of-aca-health-reforms-for-people-with-mental-health-conditions
#6
Kathleen C Thomas, Adele Shartzer, Noelle K Kurth, Jean P Hall
OBJECTIVE: This brief report explores the impact of health reform for people with mental illness. METHODS: The Health Reform Monitoring Survey was used to examine health insurance, access to care, and employment for 1,550 people with mental health conditions pre- and postimplementation of the Affordable Care Act (ACA) and by state Medicaid expansion status. Multivariate logistic regressions with predictive margins were used. RESULTS: Post-ACA reforms, people with mental health conditions were less likely to be uninsured (5% versus 13%; t=-6...
November 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29137510/accountable-care-reforms-improve-women-s-and-children-s-health-in-nepal
#7
Duncan Maru, Sheela Maru, Isha Nirola, Jonathan Gonzalez-Smith, Andrea Thoumi, Prajwol Nepal, Pushpa Chaudary, Indira Basnett, Krishna Udayakumar, Mark McClellan
Over the past decade the Ministry of Health of Nepal and the nonprofit Possible have partnered to deliver primary and secondary health care via a public-private partnership. We applied an accountable care framework that we previously developed to describe the delivery of their integrated reproductive, maternal, newborn, and child health services in the Achham district in rural Nepal. In a prospective pre-post study, examining pregnancies at baseline and 541 pregnancies in follow-up over the course of eighteen months, we found an improvement in population-level indicators linked to reducing maternal and infant mortality: receipt of four antenatal care visits (83 percent to 90 percent), institutional birth rate (81 percent to 93 percent), and the prevalence of postpartum contraception (19 percent to 47 percent)...
November 2017: Health Affairs
https://www.readbyqxmd.com/read/29137499/improving-care-and-lowering-costs-evidence-and-lessons-from-a-global-analysis-of-accountable-care-reforms
#8
Mark McClellan, Krishna Udayakumar, Andrea Thoumi, Jonathan Gonzalez-Smith, Kushal Kadakia, Natalia Kurek, Mariam Abdulmalik, Ara W Darzi
Policy makers and providers are under increasing pressure to find innovative approaches to achieving better health outcomes as efficiently as possible. Accountable care, which holds providers accountable for results rather than specific services, is emerging in many countries to support such care innovations. However, these reforms are challenging and complex to implement, requiring significant policy and delivery changes. Despite global interest, the evidence on how to implement accountable care successfully remains limited...
November 2017: Health Affairs
https://www.readbyqxmd.com/read/29135978/association-between-the-2012-health-and-social-care-act-and-specialist-visits-and-hospitalisations-in-england-a-controlled-interrupted-time-series-analysis
#9
James A Lopez Bernal, Christine Y Lu, Antonio Gasparrini, Steven Cummins, J Frank Wharham, Steven B Soumerai
BACKGROUND: The 2012 Health and Social Care Act (HSCA) in England led to among the largest healthcare reforms in the history of the National Health Service (NHS). It gave control of £67 billion of the NHS budget for secondary care to general practitioner (GP) led Clinical Commissioning Groups (CCGs). An expected outcome was that patient care would shift away from expensive hospital and specialist settings, towards less expensive community-based models. However, there is little evidence for the effectiveness of this approach...
November 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29134396/comparing-perceived-adequacy-of-help-received-among-different-classes-of-individuals-with-severe-mental-disorders-at-five-year-follow-up-a-longitudinal-cluster-analysis
#10
Marie-Josée Fleury, Guy Grenier, Jean-Marie Bamvita
This study developed a typology describing change in the perceived adequacy of help received among 204 individuals with severe mental disorders, 5 years after transfer to the community following a major mental health reform in Quebec (Canada). Participant typologies were constructed using a two-step cluster analysis. There were significant differences between T0 and T2 for perceived adequacy of help received and other independent variables, including seriousness of needs, help from services or relatives, and care continuity...
November 13, 2017: Community Mental Health Journal
https://www.readbyqxmd.com/read/29133338/social-work-s-scope-of-practice-in-the-provision-of-primary-mental-health-care-protocol-for-a-scoping-review
#11
Rachelle Ashcroft, Toula Kourgiantakis, Judith Belle Brown
INTRODUCTION: Social work is a key member of interprofessional primary healthcare teams and foundational to primary healthcare reforms that aim to improve the provision of mental healthcare. Little is known, however, about social work's scope of practice within primary healthcare settings, particularly in the provision of mental healthcare. The objective of this study is to identify and describe social work's scope of practice as it relates to mental healthcare in primary healthcare settings...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29132634/a-model-to-determine-payments-associated-with-radiology-procedures
#12
Thusitha Mabotuwana, Christopher S Hall, Shiby Thomas, Christoph Wald
OBJECTIVE: Across the United States, there is a growing number of patients in Accountable Care Organizations and under risk contracts with commercial insurance. This is due to proliferation of new value-based payment models and care delivery reform efforts. In this context, the business model of radiology within a hospital or health system context is shifting from a primary profit-center to a cost-center with a goal of cost savings. Radiology departments need to increasingly understand how the transactional nature of the business relates to financial rewards...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29132497/from-micro-to-macro-assessing-implementation-of-integrated-care-in-australia
#13
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/29130271/the-impact-of-state-medical-malpractice-reform-on-individual-level-health-care-expenditures
#14
Hao Yu, Michael Greenberg, Amelia Haviland
BACKGROUND: Past studies of the impact of state-level medical malpractice reforms on health spending produced mixed findings. Particularly salient is the evidence gap concerning the effect of different types of malpractice reform. This study aims to fill the gap. It extends the literature by examining the general population, not a subgroup or a specific health condition, and controlling for individual-level sociodemographic and health status. METHODS: We merged the Database of State Tort Law Reforms with the Medical Expenditure Panel Survey between 1996 and 2012...
December 2017: Health Services Research
https://www.readbyqxmd.com/read/29130265/the-economics-of-public-health-missing-pieces-to-the-puzzle-of-health-system-reform
#15
Glen P Mays, Adam J Atherly, Alan M Zaslavsky
The United States continues to experiment with health care delivery and financing innovations, but relatively little attention is given to the public health system and its capacity for improving health status in the U.S. population at large. The public health system operates as a multisector enterprise in which government agencies work in conjunction with private and voluntary organizations to identify health risks in the population and to mobilize community-wide actions that prevent and contain these risks...
December 2017: Health Services Research
https://www.readbyqxmd.com/read/29127541/the-bargaining-of-professionalism-in-emergency-care-practice-nhs-paramedics-and-higher-education
#16
Assaf Givati, Chris Markham, Ken Street
Over the past 2 decades, as part of reforms to the National Health Service and with it organizational changes to ambulance work in the UK, paramedic education has undergone a process of academisation and a shift from in-house, apprenticeship weeks-long occupational training, to university-based undergraduate programs. While the professional regulation and standardization of Allied Health Professionals' education in high-income countries has captured scholarly attention, the study of paramedic practice is still in its infancy and there is a need to explore its evolvement in relation to the fluid societal-political circumstances affecting its provision and demand...
November 10, 2017: Advances in Health Sciences Education: Theory and Practice
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
#17
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/29121236/directors-of-public-health-as-a-protected-species-qualitative-study-of-the-changing-role-of-public-health-professionals-in-england-following-the-2013-reforms
#18
Llinos Mary Jehu, Shelina Visram, Linda Marks, David J Hunter, Howard Davis, Anne Mason, Dan Liu, Joanne Smithson
Background: The Health and Social Care Act 2012 gave councils in England responsibility for improving the health of their populations. Public health teams were transferred from the National Health Service (NHS), accompanied by a ring-fenced public health grant. This study examines the changing role of these teams within local government. Methods: In-depth case study research was conducted within 10 heterogeneous councils. Initial interviews (n = 90) were carried out between October 2015 and March 2016, with follow-up interviews (n = 21) 12 months later...
November 7, 2017: Journal of Public Health
https://www.readbyqxmd.com/read/29120318/impacts-of-the-interim-federal-health-program-reforms-a-stakeholder-analysis-of-barriers-to-health-care-access-and-provision-for-refugees
#19
Valentina Antonipillai, Andrea Baumann, Andrea Hunter, Olive Wahoush, Timothy O'Shea
BACKGROUND: Changes to the Interim Federal Health Program (IFHP) in 2012 reduced health care access for refugees and refugee claimants, generating concerns among key stakeholders. In 2014, a new IFHP temporarily reinstated access to some health services; however, little is known about these changes, and more information is needed to map the IFHP's impact. OBJECTIVE: This study explores barriers occurring during the time period of the IFHP reforms to health care access and provision for refugees...
November 9, 2017: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/29118145/access-to-oral-health-care-a-national-crisis-and-call-for-reform
#20
Catherine H Bersell
Purpose: According to the report Healthy People 2020, oral health is integral to overall health and access to dental services is essential to promoting and maintaining good oral health. Yet, those who need dental care the most are often the least likely to receive it. The dental hygiene profession is poised to play a pivotal role in the resolution of oral health disparities. The purpose of this manuscript is to examine the critical issue of access to oral health care in the United States from various perspectives and consider potential implications for dental professionals and the oral health care system...
February 2017: Journal of Dental Hygiene: JDH
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