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"Pay for performance"

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https://www.readbyqxmd.com/read/29304527/is-there-a-preferred-stroke-prevention-strategy-for-diabetic-patients-with-non-valvular-atrial-fibrillation-comparing-warfarin-dabigatran-and-rivaroxaban
#1
Chih-Cheng Hsu, Pai-Feng Hsu, Shih-Hsien Sung, Shih-Te Tu, Ben-Hui Yu, Chi-Jung Huang, Hao-Min Cheng
BACKGROUND:  The prevalence of diabetes is growing, and diabetes is an independent risk factor for both atrial fibrillation (AF) and stroke. However, the relative effectiveness and safety of different oral anticoagulants for diabetic patients with non-valvular AF remain unclear. We aimed to compare thromboembolic events, bleeding and mortality in diabetic AF patients treated with rivaroxaban, dabigatran and warfarin. METHODS AND RESULTS:  Diabetic AF patients taking dabigatran (n = 322), rivaroxaban (n = 320) or warfarin (n = 1,899) were identified from the nationwide diabetes pay-for-performance program (n = 814,465) in Taiwan...
January 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29302881/could-pay-for-performance-worsen-health-disparities
#2
Mubeen Shakir, Katrina Armstrong, Jason H Wasfy
Pay-for-performance (P4P) has become a prominent component of health care funding in the Affordable Care Act (ACA) era. Although the ACA's future remains unclear, these programs receive bipartisan support and will likely continue to be a part of payment policies. At the same time, racial and class disparities remain among the most pressing of the many challenges facing the US health system. We review evidence of the effects of P4P on disparities at the population and individual levels. Providers caring for predominantly minority patients or those with lower socioeconomic status are known to have poorer quality metrics...
January 4, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29299473/economic-evaluation-of-different-suture-closure-methods-barbed-versus-traditional-interrupted-sutures
#3
REVIEW
Randa K Elmallah, Anton Khlopas, Mhamad Faour, Morad Chughtai, Arthur L Malkani, Peter M Bonutti, Martin Roche, Steven F Harwin, Michael A Mont
Healthcare systems are receiving increasing pressures from payers, such as the Centers for Medicare and Medicaid (CMS), to reduce the costs associated with procedures, and with the implementation of the Affordable Care Act, high costs are addressed through pay-for-performance programs. Thus, multiple areas of total knee arthroplasty (TKA) surgery are under scrutiny, including surgical times, material costs, and the costs of associated complications and readmissions. Suture type has been determined to be a factor that may influence closure times, as well as direct material costs...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29298765/impact-of-financial-incentives-on-early-and-late-adopters-among-us-hospitals-observational-study
#4
Igna Bonfrer, Jose F Figueroa, Jie Zheng, E John Orav, Ashish K Jha
OBJECTIVE: To examine how hospitals that volunteered to be under financial incentives for more than a decade as part of the Premier Hospital Quality Incentive Demonstration (early adopters) compared with similar hospitals where these incentives were implemented later under the Hospital Value-Based Purchasing program (late adopters). DESIGN: Observational study. SETTING: 1189 hospitals in the USA (214 early adopters and 975 matched late adopters), using Hospital Compare data from 2003 through 2013...
January 3, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29280687/evaluation-of-the-value-of-team-based-psychiatric-consultation-in-a-general-hospital-setting
#5
Catherine Orsak, Abey Thomas, Paul Bush, E Sherwood Brown
Background With the increase use of pay for performance in healthcare, 30-day readmissions after discharges are critically important. Objective A team-based psychiatric consultation approach was tested in an inpatient hospital setting. This is the first study that examines 30-day readmission rate with this approach. Methods In this quality improvement study, 164 patients received a team-based psychiatric consultation that included daily meetings during the weekdays between psychiatrists and hospitalists and 436 received care of treatment-as-usual or traditional consultation-liaison services...
January 1, 2017: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/29277423/engaging-nurses-in-smoking-cessation-challenges-and-opportunities-in-turkey
#6
Mimi Nichter, Aslı Çarkoğlu, Mark Nichter, Şeyda Özcan, M Atilla Uysal
This paper discusses the training of nurses in smoking cessation as part of routine patient care in Turkey. Formative research was carried out prior to training to identify challenges faced by smokers when trying to quit. Site visits to government hospitals and cessation clinics were conducted to observe health care provider-patient interactions involving behavior change. Four culturally sensitive cessation training workshops for nurses (n = 54) were conducted in Istanbul. Following training, nurses were debriefed on their experiences delivering cessation advice...
December 20, 2017: Health Policy
https://www.readbyqxmd.com/read/29274520/managing-imperfect-competition-by-pay-for-performance-and-reference-pricing
#7
Henry Y Mak
I study a managed health service market where differentiated providers compete for consumers by choosing multiple service qualities, and where copayments that consumers pay and payments that providers receive for services are set by a payer. The optimal regulation scheme is two-sided. On the demand side, it justifies and clarifies value-based reference pricing. On the supply side, it prescribes pay for performance when consumers misperceive service benefits or providers have intrinsic quality incentives. The optimal bonuses are expressed in terms of demand elasticities, service technology, and provider characteristics...
November 5, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/29248159/an-effort-to-improve-the-accuracy-of-documented-surgical-wound-classifications
#8
Ryan E Chupp, Elango Edhayan
BACKGROUND: Discordance between circulating nurse- and surgeon diagnosis-based wound classifications may lead to erroneous risk-adjusted rates of surgical site infections with effects on inter-hospital rating, reimbursement, and public perceptions regarding quality of care. METHODS: After an initial two-month audit, we placed a wound class reference algorithm in each operating room and educated staff. An audit was repeated for a two-month period after this intervention...
December 2, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29229101/the-prevalence-of-copd-in-england-an-ontological-approach-to-case-detection-in-primary-care
#9
L Rayner, J Sherlock, B Creagh-Brown, J Williams, S deLusignan
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a significant cause of morbidity and mortality in England, however estimates of its prevalence vary considerably. Routinely collected and coded primary care data can be used to monitor disease prevalence, however reliance upon diagnostic codes alone is likely to miss cases. METHODS: We devised an ontological approach to COPD case detection and implemented it in a large primary care database to identify definite and probable cases of COPD...
November 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/29217445/factors-that-predict-failure-to-meet-mips-quality-measures-for-asymptomatic-carotid-endarterectomy
#10
Anahita Dua, Steven Koprowski, Fadwa Ali, Sapan S Desai
INTRODUCTION: The Physician Quality Reporting System (PQRS) created by the Centers for Medicare and Medicaid Services (CMS) financially penalizes providers who fail to meet expected quality of care measures. The purpose of this study is to evaluate the factors that predict failure to meet PQRS measures for carotid endarterectomy (CEA). METHODS: PQRS measures 260 (discharge by postoperative day 2 following CEA in asymptomatic patients) and 346 (rate of postoperative stroke or death following CEA in asymptomatic patients) were evaluated using hospital records from the state of Florida from 2008-2012...
December 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29216894/early-winners-and-losers-in-dialysis-center-pay-for-performance
#11
Milda R Saunders, Haena Lee, Marshall H Chin
BACKGROUND: We examined the association of dialysis facility characteristics with payment reductions and change in clinical performance measures during the first year of the United States Centers for Medicare & Medicaid Services (CMS) End Stage Renal Disease Quality Incentive Plan (ESRD QIP) to determine its potential impact on quality and disparities in dialysis care. METHODS: We linked the 2012 ESRD QIP Facility Performance File to the 2007-2011 American Community Survey by zip code and dichotomized the QIP total performance scores-derived from percent of patients with urea reduction rate > 65, hemoglobin < 10 g/dL, and hemoglobin > 12 g/dL-as 'any' versus 'no' payment reduction...
December 8, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29214123/pay-for-performance-motivation-to-succeed-in-advanced-trauma-life-support-courses-a-question-of-background-or-funding
#12
Roman Klein, Wolfgang Armbruster, Martin Grotz, Bernd Höner, Matthias Münzberg, Paul Alfred Grützner, Christoph Georg Wölfl
Objective: To correlate students' performance with their professional background and motivation to take part in Advanced Trauma Life Support (ATLS) courses. We base our analysis on the self-determination theory that differentiates intrinsic (ambition to perform by individual itself) from extrinsic motivation (incentive by external stimuli). Design: We present a non-blinded, monocentric, non-randomized descriptive study of 376 students taking part in an ATLS course at one course site in Germany. Part of a two-day ATLS course are two written tests; we correlate test scores with background information provided by the students in a questionnaire of 13 items (age, sex, adress, board certification, specialty, subspecialty, position, hospital level of care, hospital operator and hospital participation in trauma network, motivation, funding source, condition of funding)...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
https://www.readbyqxmd.com/read/29200334/performance-and-participation-of-physicians-in-year-one-of-medicare-s-value-based-payment-modifier-program
#13
Karen E Joynt Maddox, Arnold M Epstein, Lok Wong Samson, Lena M Chen
In 2015 Medicare launched the Physician Value-Based Payment Modifier program, the largest US ambulatory care pay-for-performance program to date and a precursor to the forthcoming Merit-based Incentive Payment System. In its first year, the program included practices with a hundred or more clinicians. We found that 1,010 practices met this criterion, 899 of which had at least one attributed beneficiary. Of these latter practices, 263 (29.3 percent) failed to report performance data and received a 1 percent reporting-based penalty...
December 2017: Health Affairs
https://www.readbyqxmd.com/read/29188395/ema-priority-medicines-scheme-prime-will-more-paying-for-performance-agreements-be-needed-due-to-immature-data
#14
EDITORIAL
F Antoñanzas, C A Juárez-Castelló, R Rodríguez-Ibeas
No abstract text is available yet for this article.
November 29, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/29181535/face-the-facts-we-need-to-change-the-way-we-do-pay-for-performance
#15
Austin B Frakt, Ashish K Jha
No abstract text is available yet for this article.
November 28, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29181511/the-value-based-payment-modifier-program-outcomes-and-implications-for-disparities
#16
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
https://www.readbyqxmd.com/read/29175263/missing-data-and-chance-variation-in-public-reporting-of-cancer-stage-at-diagnosis-cross-sectional-analysis-of-population-based-data-in-england
#17
Matthew E Barclay, Georgios Lyratzopoulos, David C Greenberg, Gary A Abel
BACKGROUND: The percentage of cancer patients diagnosed at an early stage is reported publicly for geographically-defined populations corresponding to healthcare commissioning organisations in England, and linked to pay-for-performance targets. Given that stage is incompletely recorded, we investigated the extent to which this indicator reflects underlying organisational differences rather than differences in stage completeness and chance variation. METHODS: We used population-based data on patients diagnosed with one of ten cancer sites in 2013 (bladder, breast, colorectal, endometrial, lung, ovarian, prostate, renal, NHL, and melanoma)...
November 23, 2017: Cancer Epidemiology
https://www.readbyqxmd.com/read/29173288/improving-the-quality-of-data-for-inpatient-claims-based-measures-used-in-public-reporting-and-pay-for-performance-programs
#18
Hazel Crews, Peter J Pronovost, Paul R Helft, J Matthew Austin
No abstract text is available yet for this article.
December 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29159756/patient-provider-communication-and-health-outcomes-among-individuals-with-hepato-pancreato-biliary-disease-in-the-usa
#19
Qinyu Chen, Eliza W Beal, Eric B Schneider, Victor Okunrintemi, Xu-Feng Zhang, Timothy M Pawlik
BACKGROUND: Patient-provider communication (PPC) is utilized as a value-based metric in pay-for-performance programs. We sought to evaluate the association of PPC with patient-reported health outcomes, as well as healthcare resource utilization among a nationally representative cohort of patients with hepato-pancreato-biliary (HPB) diagnoses. METHODS: Patients with HPB diseases were identified from the 2008-2014 Medical Expenditure Panel Survey cohort. A weighted PPC composite score was categorized using the responses from the CAHPS (Consumer Assessment of Healthcare Providers and Systems) survey as optimal, average, or poor...
November 20, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29091531/measuring-patient-centeredness-of-care-for-seriously-ill-individuals-challenges-and-opportunities-for-accountability-initiatives
#20
Rebecca Anhang Price, Marc N Elliott
Patient- and family-centeredness of care is particularly important for individuals with serious illness. In this article, we describe methodological challenges of using measures of patient- and family-centeredness in accountability initiatives such as public reporting and pay for performance. We begin with background on measuring patient- and family-centered care using standardized surveys, describe evidence of the use of these measures for quality improvement, and highlight methodological challenges in the development and implementation of these measures for use in accountability...
November 1, 2017: Journal of Palliative Medicine
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