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Health Care Reform

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https://www.readbyqxmd.com/read/28108154/collaborative-design-of-a-health-care-experience-survey-for-persons-with-disability
#1
Lisa I Iezzoni, Holly Matulewicz, Sarah A Marsella, Kimberley S Warsett, Dennis Heaphy, Karen Donelan
BACKGROUND: When assessing results of health care delivery system reforms targeting persons with disability, quality metrics must reflect the experiences and perspectives of this population. OBJECTIVE: For persons with disability and researchers to develop collaboratively a survey that addresses critical quality questions about a new Massachusetts health care program for persons with disability dually-eligible for Medicare and Medicaid. METHODS: Persons with significant physical disability or serious mental health diagnoses participated fully in all research activities, including co-directing the study, co-moderating focus groups, performing qualitative analyses, specifying survey topics, cognitive interviewing, and refining survey language...
January 8, 2017: Disability and Health Journal
https://www.readbyqxmd.com/read/28107703/how-universal-is-coverage-and-access-to-diagnosis-and-treatment-for-chagas-disease-in-colombia-a-health-systems-analysis
#2
Zulma M Cucunubá, Jennifer M Manne-Goehler, Diana Díaz, Pierre Nouvellet, Oscar Bernal, Andrea Marchiol, María-Gloria Basáñez, Lesong Conteh
Limited access to Chagas disease diagnosis and treatment is a major obstacle to reaching the 2020 World Health Organization milestones of delivering care to all infected and ill patients. Colombia has been identified as a health system in transition, reporting one of the highest levels of health insurance coverage in Latin America. We explore if and how this high level of coverage extends to those with Chagas disease, a traditionally marginalised population. Using a mixed methods approach, we calculate coverage for screening, diagnosis and treatment of Chagas...
January 4, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28107372/cohort-randomised-controlled-trial-of-a-multifaceted-podiatry-intervention-for-the-prevention-of-falls-in-older-people-the-reform-trial
#3
Sarah Cockayne, Joy Adamson, Arabella Clarke, Belen Corbacho, Caroline Fairhurst, Lorraine Green, Catherine E Hewitt, Kate Hicks, Anne-Maree Kenan, Sarah E Lamb, Caroline McIntosh, Hylton B Menz, Anthony C Redmond, Zoe Richardson, Sara Rodgers, Wesley Vernon, Judith Watson, David J Torgerson
BACKGROUND: Falls are a major cause of morbidity among older people. A multifaceted podiatry intervention may reduce the risk of falling. This study evaluated such an intervention. DESIGN: Pragmatic cohort randomised controlled trial in England and Ireland. 1010 participants were randomised (493 to the Intervention group and 517 to Usual Care) to either: a podiatry intervention, including foot and ankle exercises, foot orthoses and, if required, new footwear, and a falls prevention leaflet or usual podiatry treatment plus a falls prevention leaflet...
2017: PloS One
https://www.readbyqxmd.com/read/28103923/risk-adjustment-methods-for-all-payer-comparative-performance-reporting-in-vermont
#4
Karl Finison, MaryKate Mohlman, Craig Jones, Melanie Pinette, David Jorgenson, Amy Kinner, Tim Tremblay, Daniel Gottlieb
BACKGROUND: As the emphasis in health reform shifts to value-based payments, especially through multi-payer initiatives supported by the U.S. Center for Medicare & Medicaid Innovation, and with the increasing availability of statewide all-payer claims databases, the need for an all-payer, "whole-population" approach to facilitate the reporting of utilization, cost, and quality measures has grown. However, given the disparities between the different populations served by Medicare, Medicaid, and commercial payers, risk-adjustment methods for addressing these differences in a single measure have been a challenge...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28098133/-the-need-of-a-new-integral-approach-to-the-care-of-patient-with-severe-mental-disorder-thirty-years-after-the-psychiatric-reform
#5
Agustín Madoz-Gúrpide, Juan Carlos Ballesteros Martín, Mónica Leira Sanmartín, Ernesto García Yagüe
More than thirty years have passed since the beginning of the psychiatric reform, a period of intense and relevant social, scientific and cultural changes which have directly impacted on mental disorders and their management. Improvement in psychopharmacological treatment, a new model of physician-patient relationship, patient´s empowerment as a key issue and the fight against social stigma related to mental health disorders, changes in clinical governance and health policy, the assistential burden derived from the treatment of less severe pathology in mental health community centers, improvements in teamwork and coordination with other resources involved… are some of the relevant changes which determine the scene of community-based mental health assistance...
January 18, 2017: Revista Española de Salud Pública
https://www.readbyqxmd.com/read/28098016/story-in-numbers
#6
(no author information available yet)
Mental health care funding and reform package announced by prime minister Theresa May.
January 18, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28096897/the-impact-of-organisational-change-and-fiscal-restraint-on-organisational-culture
#7
Frances Dark, Harvey Whiteford, Neal M Ashkanasy, Carol Harvey, Meredith Harris, David Crompton, Ellie Newman
BACKGROUND: Strategies to implement evidence-based practice have highlighted the bidirectional relationship of organisational change on organisational culture. The present study examined changes in perceptions of organisational culture in two community mental health services implementing cognitive therapies into routine psychosis care over 3 years. During the time of the study there were a number of shared planned and unplanned changes that the mental health services had to accommodate...
2017: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/28096037/the-future-is-here-but-there-is-no-reason-to-fear
#8
Nicole Fisher
Nicole Fisher, MPP, PhD, is the founder and chief executive officer at HHR Strategies, a health care and human rights focused advising firm. Additionally, she is a senior policy advisor and expert on health economics, technology, and reform, specifically as they affect vulnerable populations. Nicole runs a health innovation and policy page at Forbes, highlighting and advising companies, ideas, and people that are changing the health landscape. She also is currently pursuing her PhD at the University of North Carolina in the Health Policy and Management Department...
February 2017: Surgery
https://www.readbyqxmd.com/read/28089280/financial-hardship-on-the-path-to-universal-health-coverage-in-the-gulf-states
#9
Riyadh Alshamsan, Hannah Leslie, Azeem Majeed, Margaret Kruk
BACKGROUND: Countries globally are pursuing universal health coverage to ensure better healthcare for their populations and prevent households from catastrophic expenditure. The countries of the Gulf Cooperation Council (GCC) have and continue to implement reforms to strengthen their health systems. A common theme between the countries is their pursuit of universal health coverage to provide access to necessary health care without exposing people to financial hardship. METHODS: Using nationally representative data from the Global Findex study, we sought to analyze the hardship faced by individuals from four high-income countries in the GCC...
January 7, 2017: Health Policy
https://www.readbyqxmd.com/read/28088617/assessing-physician-productivity-following-norwegian-hospital-reform-a-panel-and-data-envelopment-analysis
#10
Karl Arne Johannessen, Sverre A C Kittelsen, Terje P Hagen
BACKGROUND: Although health care reforms may improve efficiency at the macro level, less is known regarding their effects on the utilization of health care personnel. Following the 2002 Norwegian hospital reform, we studied the productivity of the physician workforce and the effect of personnel mix on this measure in all nineteen Norwegian hospitals from 2001 to 2013. METHODS: We used panel analysis and non-parametric data envelopment analysis (DEA) to study physician productivity defined as patient treatments per full-time equivalent (FTE) physician...
January 6, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28080183/palliative-care-scorecard
#11
Sheri Kittelson, Read Pierce, Jeanie Youngwerth
BACKGROUND: In response to poor healthcare quality outcomes and rising costs, healthcare reform triple aim has increased requirements for providers to demonstrate value to payers, partners, and the public. OBJECTIVE: Electronically automating measurement of the meaningful impact of palliative care (PC) programs on clinical, operational, and financial systems over time is imperative to the success of the field and the goal of development of this automated PC scorecard...
January 12, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28077150/the-equity-of-china-s-emergency-medical-services-from-2010-2014
#12
Ke Yan, Yi Jiang, Jingfu Qiu, Xiaoni Zhong, Yang Wang, Jing Deng, Jingxi Lian, Tingting Wang, Cheng Cao
BACKGROUND: With the depth development of health care system reform in China, emergency medical services (EMS) is confronted with challenges as well as opportunities. This study aimed to analyze the equity of China's EMS needs, utilization, and resources distribution, and put forward proposal to improve the equity. METHOD: Three emergency needs indicators (mortality rate of cardiovascular and cerebrovascular diseases, harm, and digestive system disease), two utilization indicators (emergency outpatient visits and rate of utilization) and one resource allocation indicator (number of EMS facilities) were collected after the review of the China Statistical Yearbook and the National Disease Surveillance System...
January 11, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28073998/recent-health-care-use-and-medicaid-entry-of-medicare-beneficiaries
#13
Laura M Keohane, Amal N Trivedi, Vincent Mor
PURPOSE OF THE STUDY: To examine the relationship between Medicaid entry and recent health care use among Medicare beneficiaries. DESIGN AND METHODS: We identified Medicare beneficiaries without full Medicaid or use of hospital or nursing home services in 2008 (N = 2,163,387). A discrete survival analysis estimated beneficiaries' monthly likelihood of entry into the full Medicaid program between January 2009 and June 2010. RESULTS: During the 18-month study period, Medicaid entry occurred for 1...
January 9, 2017: Gerontologist
https://www.readbyqxmd.com/read/28073062/effects-of-payment-reform-in-more-versus-less-competitive-markets
#14
Neeraj Sood, Abby Alpert, Kayleigh Barnes, Peter Huckfeldt, José J Escarce
Policymakers are increasingly interested in reducing healthcare costs and inefficiencies through innovative payment strategies. These strategies may have heterogeneous impacts across geographic areas, potentially reducing or exacerbating geographic variation in healthcare spending. In this paper, we exploit a major payment reform for home health care to examine whether reductions in reimbursement lead to differential changes in treatment intensity and provider costs depending on the level of competition in a market...
December 30, 2016: Journal of Health Economics
https://www.readbyqxmd.com/read/28072793/merit-based-incentive-payment-system-meaningful-changes-in-the-final-rule-brings-cautious-optimism
#15
Laxmaiah Manchikanti, Standiford Helm Ii, Aaron K Calodney, Joshua A Hirsch
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) eliminated the flawed Sustainable Growth Rate (SGR) act formula - a longstanding crucial issue of concern for health care providers and Medicare beneficiaries. MACRA also included a quality improvement program entitled, "The Merit-Based Incentive Payment System, or MIPS." The proposed rule of MIPS sought to streamline existing federal quality efforts and therefore linked 4 distinct programs into one. Three existing programs, meaningful use (MU), Physician Quality Reporting System (PQRS), value-based payment (VBP) system were merged with the addition of Clinical Improvement Activity category...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28072508/repealing-federal-health-reform-economic-and-employment-consequences-for-states
#16
Leighton Ku, Erika Steinmetz, Erin Brantley, Brian Bruen
Issue: The incoming Trump administration and Republicans in Congress are seeking to repeal the Affordable Care Act (ACA), likely beginning with the law’s insurance premium tax credits and expansion of Medicaid eligibility. Research shows that the loss of these two provisions would lead to a doubling of the number of uninsured, higher uncompensated care costs for providers, and higher taxes for low-income Americans. Goal: To determine the state-by-state effect of repeal on employment and economic activity...
2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28071841/attending-to-power-differentials-how-np-led-group-medical-visits-can-influence-the-management-of-chronic-conditions
#17
Laura Housden, Annette J Browne, Sabrina T Wong, Martin Dawes
OBJECTIVE: In Canada, primary care reform has encouraged innovations, including nurse practitioners (NPs) and group medical visits (GMVs). NP-led GMVs provide an opportunity to examine barriers and enablers to implementing this innovation in primary care. DESIGN: An instrumental case study design (n=3): two cases where NPs were using GMVs and one case where NPs were not using GMVs, was completed. In-depth interviews with patients and providers (N=24) and 10 hours of direct observation were completed...
January 10, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28069855/prevalence-and-spending-associated-with-patients-who-have-a-behavioral-health-disorder-and-other-conditions
#18
Ken Thorpe, Sanjula Jain, Peter Joski
: People with multiple medical conditions are a growing and increasingly costly segment of the U.S. POPULATION: Despite the co-occurrence of physical and behavioral health comorbidities, the US health care system tends to treat these conditions separately rather than holistically. To identify opportunities for population health improvement, we examined the treated prevalence of and health care spending on behavioral health disorders, by the number of coexisting physical disorders, among noninstitutionalized adults...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069851/less-intense-postacute-care-better-outcomes-for-enrollees-in-medicare-advantage-than-those-in-fee-for-service
#19
Peter J Huckfeldt, José J Escarce, Brendan Rabideau, Pinar Karaca-Mandic, Neeraj Sood
Traditional fee-for-service (FFS) Medicare's prospective payment systems for postacute care provide little incentive to coordinate care or control costs. In contrast, Medicare Advantage plans pay for postacute care out of monthly capitated payments and thus have stronger incentives to use it efficiently. We compared the use of postacute care in skilled nursing and inpatient rehabilitation facilities by enrollees in Medicare Advantage and FFS Medicare after hospital discharge for three high-volume conditions: lower extremity joint replacement, stroke, and heart failure...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069001/has-equity-in-government-subsidy-on-healthcare-improved-in-china-evidence-from-the-china-s-national-health-services-survey
#20
Lei Si, Mingsheng Chen, Andrew J Palmer
BACKGROUND: Monitoring the equity of government healthcare subsidies (GHS) is critical for evaluating the performance of health policy decisions. China's low-income population encounters barriers in accessing benefits from GHS. This paper focuses on the distribution of China's healthcare subsidies among different socio-economic populations and the factors that affect their equitable distribution. It examines the characteristics of equitable access to benefits in a province of northeastern China, comparing the equity performance between urban and rural areas...
January 10, 2017: International Journal for Equity in Health
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