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"Pay for performance"

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https://www.readbyqxmd.com/read/28531317/a-diabetes-pay-for-performance-program-and-the-competing-causes-of-death-among-cancer-survivors-with-type-2-diabetes-in-taiwan
#1
Hui-Min Hsieh, Herng-Chia Chiu, Yi-Ting Lin, Shyi-Jang Shin
Objective: To examine associations between a diabetes pay-for-performance (P4P) program in Taiwan and all-cause of mortality and competing causes of death in cancer survivors with type 2 diabetes. Design: A longitudinal observational intervention and comparison group study design. Setting and participants: Cancer survivors with type 2 diabetes who enrolled in the P4P program compared with survivors who did not participate (non-P4P) under the Taiwan National Health Insurance program...
May 20, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28486670/economic-evaluation-of-a-pre-esrd-pay-for-performance-programme-in-advanced-chronic-kidney-disease-patients
#2
Hui-Min Hsieh, Ming-Yen Lin, Yi-Wen Chiu, Ping-Hsun Wu, Li-Jeng Cheng, Feng-Shiuan Jian, Chih-Cheng Hsu, Shang-Jyh Hwang
Background: The National Health Insurance Administration in Taiwan initiated a nationwide pre-end-stage renal disease (ESRD) pay-for-performance (P4P) programme at the end of 2006 to improve quality of care for chronic kidney disease (CKD) patients. This study aimed to examine this programme's effect on patients' clinical outcomes and its cost-effectiveness among advanced CKD patients. Methods: We conducted a longitudinal observational matched cohort study using two nationwide population-based datasets...
November 10, 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28481976/electronically-available-comorbidities-should-be-used-in-surgical-site-infection-risk-adjustment
#3
Sarah S Jackson, Surbhi Leekha, Laurence S Magder, Lisa Pineles, Deverick J Anderson, William E Trick, Keith F Woeltje, Keith S Kaye, Timothy J Lowe, Anthony D Harris
Background: Healthcare-associated infections such as surgical site infections (SSI) are used by Centers for Medicare and Medicaid Services (CMS) as pay-for-performance metrics. Risk adjustment allows a fairer comparison of SSI rates across hospitals. Until 2016, Centers for Disease Control and Prevention (CDC) risk adjustment models for pay-for-performance SSI did not adjust for patient comorbidities. New 2016 CDC models only adjust for body mass index and diabetes. Methods: We performed a multicenter retrospective cohort study of patients undergoing surgical procedures at 28 US hospitals...
May 6, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28476461/adding-social-determinant-data-changes-children-s-hospitals-readmissions-performance
#4
Marion R Sills, Matthew Hall, Gretchen J Cutler, Jeffrey D Colvin, Laura M Gottlieb, Michelle L Macy, Jessica L Bettenhausen, Rustin B Morse, Evan S Fieldston, Jean L Raphael, Katherine A Auger, Samir S Shah
OBJECTIVES: To determine whether social determinants of health (SDH) risk adjustment changes hospital-level performance on the 30-day Pediatric All-Condition Readmission (PACR) measure and improves fit and accuracy of discharge-level models. STUDY DESIGN: We performed a retrospective cohort study of all hospital discharges meeting criteria for the PACR from 47 hospitals in the Pediatric Health Information database from January to December 2014. We built four nested regression models by sequentially adding risk adjustment factors as follows: chronic condition indicators (CCIs); PACR patient factors (age and sex); electronic health record-derived SDH (race, ethnicity, payer), and zip code-linked SDH (families below poverty level, vacant housing units, adults without a high school diploma, single-parent households, median household income, unemployment rate)...
May 2, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28420558/maternal-medical-complexity-impact-on-prenatal-health-care-spending-among-women-at-low-risk-for-cesarean-section
#5
Shayna D Cunningham, Carolina Herrera, Ifeyinwa E Udo, Katy B Kozhimannil, Eric Barrette, Urania Magriples, Jeannette R Ickovics
BACKGROUND: Obstetric procedures are among the most expensive health care services, yet relatively little is known about health care spending among pregnant women, particularly the commercially-insured. OBJECTIVE: The objective of this study was to examine the association between maternal medical complexity, as a result of having one or more comorbid conditions, and health care spending during the prenatal period among a national sample of 95,663 commercially-insured women at low risk for cesarean delivery...
April 15, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28407094/pay-for-performance-reduces-healthcare-spending-and-improves-quality-of-care-analysis-of-target-and%C3%A2-non-target-obstetrics-and-gynecology-surgeries
#6
Seung Ju Kim, Kyu-Tae Han, Sun Jung Kim, Eun-Cheol Park
Objective: In Korea, the Value Incentive Program (VIP) was first applied to selected clinical conditions in 2007 to evaluate the performance of medical institutes. We examined whether the condition-specific performance of the VIP resulted in measurable improvement in quality of care and in reduced medical costs. Design: Population-based retrospective observational study. Setting: We used two data set including the results of quality assessment and hospitalization data from National Health Claim data from 2011 to 2014...
April 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28406233/changes-in-prevalence-awareness-treatment-and-control-of-hypertension-in-disadvantaged-french-caribbean-populations-2003-to-2014
#7
P Carrère, N Halbert, S Lamy, J Inamo, A Atallah, T Lang
In 2003, the PHDG (Prevalence of Hypertension among Disadvantaged Guadeloupeans) study highlighted poor management of hypertension in an unemployed French Caribbean population. New processes of health-care coordination and a pay-for-performance system have since been developed. We aimed to assess changes in hypertension characteristics in disadvantaged French Caribbean populations in the last 10 years. Using PHDG 2003 data, in 2014 we undertook a cross-sectional study with identical methods. The source population comprised all Guadeloupeans having undergone periodic heath checks offered by the Social Security insurance at these dates...
April 13, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28405531/will-the-meikirch-model-a-new-framework-for-health-induce-a-paradigm-shift-in-healthcare
#8
REVIEW
Johannes Bircher, Eckhart G Hahn
Over the past decades, scientific medicine has realized tremendous advances. Yet, it is felt that the quality, costs, and equity of medicine and public health have not improved correspondingly and, both inside and outside the USA, may even have changed for the worse. An initiative for improving this situation is value-based healthcare, in which value is defined as health outcomes relative to the cost of achieving them. Value-based healthcare was advocated in order to stimulate competition among healthcare providers and thereby reduce costs...
March 6, 2017: Curēus
https://www.readbyqxmd.com/read/28403477/risk-stratification-for-surgical-site-infections-in-colon-cancer
#9
Ramzi Amri, Anne M Dinaux, Hiroko Kunitake, Liliana G Bordeianou, David L Berger
Importance: Surgical site infections (SSIs) feature prominently in surgical quality improvement and pay-for-performance measures. Multiple approaches are used to prevent or reduce SSIs, prompted by the heavy toll they take on patients and health care budgets. Surgery for colon cancer is not an exception. Objective: To identify a risk stratification score based on baseline and operative characteristics. Design, Setting, and Participants: This retrospective cohort study included all patients treated surgically for colon cancer at Massachusetts General Hospital from 2004 through 2014 (n = 1481)...
April 12, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28395660/incentivised-chronic-disease-management-and-the-inverse-equity-hypothesis-findings-from-a-longitudinal-analysis-of-scottish-primary-care-practice-level-data
#10
Richard Lowrie, Alex McConnachie, Andrea E Williamson, Evangelos Kontopantelis, Marie Forrest, Norman Lannigan, Stewart W Mercer, Frances S Mair
BACKGROUND: The inverse equity hypothesis asserts that new health policies initially widen inequality, then attenuate inequalities over time. Since 2004, the UK's pay-for-performance scheme for chronic disease management (CDM) in primary care general practices (the Quality and Outcomes Framework) has permitted practices to except (exclude) patients from attending annual CDM reviews, without financial penalty. Informed dissent (ID) is one component of exception rates, applied to patients who have not attended due to refusal or non-response to invitations...
April 11, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28389971/pay-for-performance-in-orthopedics-how-we-got-here-and-where-we-are-going
#11
REVIEW
Ashton H Goldman, Stephen Kates
PURPOSE OF THE REVIEW: Recent health laws have shifted from the traditional fee-for-service model toward a pay-for-performance model. In this changing climate, it is imperative that a provider understands these changes and recognizes the importance of health services research on medicine. RECENT FINDINGS: Increasing the value of care by improving quality and decreasing cost has been the focus of several projects. Preventing complications may be an effective way to increase value...
April 7, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28376461/increased-health-information-technology-adoption-and-use-among-small-primary-care-physician-practices-over-time-a-national-cohort-study
#12
Diane R Rittenhouse, Patricia P Ramsay, Lawrence P Casalino, Sean McClellan, Zosha K Kandel, Stephen M Shortell
PURPOSE: Implementation and meaningful use of health information technology (HIT) has been shown to facilitate delivery system transformation, yet implementation is far from universal. This study examined correlates of greater HIT implementation over time among a national cohort of small primary care practices in the United States. METHODS: We used data from a 40-minute telephone panel survey of 566 small primary care practices having 8 or fewer physicians to investigate adoption and use of HIT in 2007-2010 and 2012-2013...
January 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28375496/a-review-and-survey-of-neurosurgeon-hospital-relationships-evolution-and-options
#13
Dong H Kim, Bernard Duco, Daniel Wolterman, Charles Stokes, Rod Brace, Robert A Solomon, Nicholas Barbaro, Richard Westmark, David MacDougall, James Bean, Joanna O'Leary, Nicole Moayeri, Ralph G Dacey, Mitchel S Berger, Robert Harbaugh
As healthcare delivery shifts from fee-for-service, episodic care to pay for performance and population health, both hospitals and physicians are looking for new forms of integration. A number of regulations and restrictions govern physician relationships with hospitals. In this paper, we review the legal basis for such relationships and the options available. We also survey neurosurgeons and hospital executives to gain their perspective on the current situation and likely future. Two series of structured interviews were conducted with 10 neurosurgeons who work in a range of situations in diverse markets, and with Memorial Hermann Healthcare System senior executive leadership...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28375495/quality-programs-in-neurosurgery-the-memorial-hermann-university-of-texas-experience
#14
Dong H Kim, Miriam Morales, Rahil Tai, Georgene Hergenroeder, Chirag Shah, Joanna O'Leary, Nicole Harrison, Gabrielle Edquilang, Emily Paisley, Enedra Allen-McBride, Allison Murphy, Justin Smith, William Gormley, Amanda Spielman
The importance of outcome measures is steadily increasing due to the rise of "pay for performance" and the advent of population health. In 2007, a quality initiative was started due to poor performance on rankings such as the University Health Consortium (UHC) report card. Inherent to all such efforts are common challenges: how to engage the providers; how to gather and ensure the accuracy of the data; how to attribute results to individuals; how to ensure permanent improvements. After analysis, a strategy was developed that included an initial focus on 3 metrics (mortality, infection rates, and complications), leadership from practicing neurosurgeons, protocol development and adherence, and subspecialization...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28373270/patient-provider-communication-and-health-outcomes-among-individuals-with-atherosclerotic-cardiovascular-disease-in-the-united-states-medical-expenditure-panel-survey-2010-to-2013
#15
Victor Okunrintemi, Erica S Spatz, Paul Di Capua, Joseph A Salami, Javier Valero-Elizondo, Haider Warraich, Salim S Virani, Michael J Blaha, Ron Blankstein, Adeel A Butt, William B Borden, Kumar Dharmarajan, Henry Ting, Harlan M Krumholz, Khurram Nasir
BACKGROUND: Consumer-reported patient-provider communication (PPC) assessed by Consumer Assessment of Health Plans Survey in ambulatory settings is incorporated as a complementary value metric for patient-centered care of chronic conditions in pay-for-performance programs. In this study, we examine the relationship of PPC with select indicators of patient-centered care in a nationally representative US adult population with established atherosclerotic cardiovascular disease. METHODS AND RESULTS: The study population consisted of a nationally representative sample of 6810 individuals (aged ≥18 years), representing 18...
April 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28371024/discharge-disposition-as-an-independent-predictor-of-readmission-among-patients-hospitalised-for-community-acquired-pneumonia
#16
Tien Dong, John F Cursio, Samira Qadir, Peter K Lindenauer, Gregory W Ruhnke
BACKGROUND: Community-acquired pneumonia (CAP) is the most common non-obstetrical reason for hospital admission, the leading infectious cause of death, and a target for public reporting. CAP has thus become a target of quality improvement and pay-for-performance efforts. However, the relationship between discharge disposition and readmission risk has not been investigated. METHODS: We studied CAP patients admitted to the University of Chicago from 11/2011 to 04/2015...
March 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28337732/medicare-reimbursement-and-orthopedic-surgery-past-present-and-future
#17
REVIEW
R Carter Clement, Suneel B Bhat, Meredith E Clement, James C Krieg
PURPOSE OF REVIEW: This paper reviews the history and structure of Medicare reimbursement with a focus on aspects relevant to the field of orthopedic surgery. Namely, this includes Parts A and B, with particular attention paid to the origins of Diagnosis Related Groups (DRG) and the physician fee schedule, respectively. We then review newer policies affecting orthopedic surgeons. RECENT FINDINGS: Recent Medicare reforms relevant to our field include readmission penalties, the evolution of bundled payments including the mandatory Comprehensive Care for Joint Replacement (CJR) and Surgical Hip and Femur Fracture Treatment (SHFFT) programs, and the new mandatory Merit-based Incentive Payment System (MIPS) pay-for-performance program...
March 23, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28332939/pediatric-asthma-hospitalizations-among-urban-minority-children-and-the-continuity-of-primary-care
#18
Levon H Utidjian, Alexander G Fiks, A Russell Localio, Lihai Song, Mark J Ramos, Ron Keren, Louis M Bell, Robert W Grundmeier
OBJECTIVE: To examine the effect of ambulatory health care processes on asthma hospitalizations. METHODS: A retrospective cohort study using electronic health records was completed. Patients aged 2-18 years receiving health care from 1 of 5 urban practices between Jan 1, 2004 and Dec 31, 2008 with asthma documented on their problem list were included. Independent variables were modifiable health care processes in the primary care setting: (1) use of asthma controller medications; (2) regular assessment of asthma symptoms; (3) use of spirometry; (4) provision of individualized asthma care plans; (5) timely influenza vaccination; (6) access to primary healthcare; and (7) use of pay for performance physician incentives...
February 25, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28322095/therapeutic-inertia-and-intensified-treatment-in-diabetes-mellitus-prescription-patterns-a-nationwide-population-based-study-in-taiwan
#19
Li-Ying Huang, Hseng-Long Yeh, Ming-Chin Yang, Wen-Yi Shau, Syi Su, Mei-Shu Lai
Objective To measure therapeutic inertia by characterizing prescription patterns using secondary data obtained from the nationwide diabetes mellitus pay-for-performance (DM-P4P) programme in Taiwan. Methods Using reimbursement claims from Taiwan's National Health Insurance Research Database, a nationwide retrospective cohort study was undertaken of patients with diabetes mellitus who participated in the DM-P4P programme from 2006-2008. Glycosylated haemoglobin results were used to evaluate modifications in therapy in response to poor diabetes control...
December 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/28300990/analysis-of-the-attributes-of-primary-health-care-using-the-electronic-medical-records-in-the-city-of-rio-de-janeiro
#20
Daniel Soranz, Luiz Felipe Pinto, Luiz Antonio Bastos Camacho
Epidemiology plays a strategic role at this stage of the policy cycle, contributing to goal setting, resource allocation and use of information systems. In 2009, the Municipal Health Secretariat of Rio de Janeiro initiated a reform of the health care model under the main influence the Primary Health Care concept. This study evaluates the trend of selected pay-for-performance indicators that measure the health care process in the city's PHC. This a study on repeated panels, from the administrative and clinical records of electronic medical records in the period from 2012 to 2016...
March 2017: Ciência & Saúde Coletiva
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