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"Pay for performance"

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https://www.readbyqxmd.com/read/28708749/effectiveness-of-pay-for-performance-for-chronic-kidney-disease-patients-on-hemodialysis-a-systematic-review-protocol
#1
Jo Ann A Otts, Patricia F Pearce, Cynthia A Langford
The objective of this review is to assess the evidence on the effectiveness of implementation of a pay-for-performance program on clinical outcomes in the adult chronic kidney disease (CKD) patient receiving hemodialysis.The review question is: What is the effectiveness of implementation of a pay-for-performance program on clinical outcomes in the adult CKD patient receiving hemodialysis, as compared to the period immediately before implementation of the program?More specifically, the objectives are to identify...
July 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28685902/can-pay-for-performance-to-primary-care-providers-stimulate-appropriate-use-of-antibiotics
#2
Lina Maria EllegÄrd, Jens Dietrichson, Anders Anell
Antibiotic resistance is a major threat to public health worldwide. As the healthcare sector's use of antibiotics is an important contributor to the development of resistance, it is crucial that physicians only prescribe antibiotics when needed and that they choose narrow-spectrum antibiotics, which act on fewer bacteria types, when possible. Inappropriate use of antibiotics is nonetheless widespread, not least for respiratory tract infections (RTI), a common reason for antibiotics prescriptions. We examine if pay-for-performance (P4P) presents a way to influence primary care physicians' choice of antibiotics...
July 7, 2017: Health Economics
https://www.readbyqxmd.com/read/28685850/return-on-investment-roi-analyses-of-an-inpatient-lay-health-worker-model-on-30-day-readmission-rates-in-a-rural-community-hospital
#3
Roberto Cardarelli, Gregory Bausch, Joan Murdock, Michelle Renee Chyatte
PURPOSE: The purpose of the study was to assess the return-on-investment (ROI) of an inpatient lay health worker (LHW) model in a rural Appalachian community hospital impacting 30-day readmission rates. METHODS: The Bridges to Home (BTH) study completed an evaluation in 2015 of an inpatient LHW model in a rural Kentucky hospital that demonstrated a reduction in 30-day readmission rates by 47.7% compared to a baseline period. Using the hospital's utilization and financial data, a validated ROI calculator specific to care transition programs was used to assess the ROI of the BTH model comparing 3 types of payment models including Diagnosis Related Group (DRG)-only payments, pay-for-performance (P4P) contracts, and accountable care organizations (ACOs)...
July 7, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28650679/establishing-maximal-medical-improvement-after-arthroscopic-rotator-cuff-repair
#4
William A Zuke, Timothy S Leroux, Bonnie P Gregory, Austin Black, Brian Forsythe, Anthony A Romeo, Nikhil N Verma
BACKGROUND: As health care transitions from a pay-for-service to a pay-for-performance infrastructure, the value of orthopaedic care must be defined accurately. Significant efforts have been made in defining quality and cost in arthroplasty; however, there remains a lag in ambulatory orthopaedic care. PURPOSE: Two-year follow-up has been a general requirement for reporting outcomes after rotator cuff repair. However, this time requirement has not been established scientifically and is of increasing importance in the era of value-based health care...
June 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28647442/the-impact-of-the-transition-from-volume-to-value-on-heart-failure-care-implications-of-novel-payment-models-and-quality-improvement-initiatives
#5
REVIEW
Dushyanth Srinivasan, Nihar R Desai
In response to wide variation in quality and outcomes as well as escalating health care costs, the U.S. health care system is transitioning away from a volume based payment system to a quality- and value-based system. Medicare, the largest insurer and payer of healthcare, has accelerated the movement towards value-based care with the development and implementation of myriad alternative payment models and pay for performance programs as part of the Affordable Care Act. Given that heart failure affects a significant number of Medicare patients and these patients account for a disproportionate amount of healthcare utilization and spending, heart failure has become a focal point for these initiatives...
June 21, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28637590/evaluation-of-readmissions-due-to-surgical-site-infections-a-potential-target-for-quality-improvement
#6
Romil Shah, Emily Pavey, Mila Ju, Ryan Merkow, Ravi Rajaram, Michael W Wandling, Mark E Cohen, Allison Dahlke, Anthony Yang, Karl Bilimoria
INTRODUCTION: Readmissions have become a focus of pay-for-performance programs. Surgical site infections (SSI) are the reason for most readmissions. Readmissions for SSI could be a unique target for quality improvement. METHODS: Readmission risk for SSI were evaluated for patients undergoing colectomies from 2013 to 2014. Hazard models were developed to examine factors associated with and hospital-level variation in risk-adjusted rates of readmission for SSI. RESULTS: Among 59,088 patients at 525 hospitals, the rate of readmissions for SSI ranged from 1...
June 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28610840/measuring-and-managing-health-system-performance-an-update-from-new-zealand
#7
Linda Maree Chalmers, Toni Ashton, Tim Tenbensel
In July 2016, New Zealand introduced a new approach to measuring and monitoring health system performance. This 'Systems Level Measure Framework' (SLMF) has evolved from the Integrated Performance and Incentive Framework (IPIF) previously reported in this journal. The SLMF is designed to stimulate a 'whole of system' approach that requires inter-organisational collaboration. Local 'Alliances' between government and non-government health sector organisations are responsible for planning and achieving improved health system outcomes such as reducing ambulatory sensitive hospitalisation for young children, and reducing acute hospital bed days...
June 2, 2017: Health Policy
https://www.readbyqxmd.com/read/28602394/reputational-concerns-with-altruistic-providers
#8
Pau Olivella, Luigi Siciliani
We study a model of reputational concerns when doctors differ in their degree of altruism and they can signal their altruism by their (observable) quality. When reputational concerns are high, following the introduction or enhancement of public reporting, the less altruistic (bad) doctor mimics the more altruistic (good) doctor. Otherwise, either a separating or a semi-separating equilibrium arises: the bad doctor mimics the good doctor with probability less than one. Pay-for-performance incentive schemes are unlikely to induce crowding out, unless some dimensions of quality are unobservable...
June 1, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28594696/quality-measures-in-gastrointestinal-endoscopy-the-current-state
#9
Megan A Adams, Sameer D Saini, John I Allen
PURPOSE OF REVIEW: The purpose of this review is to summarize the current state of endoscopic quality measurement and use of measures in enhancing the value of endoscopic services. RECENT FINDINGS: Initially, quality measurement of endoscopic procedures was claims based or included small unit or practice-specific efforts. Now we have a mature national registry and large electronic medical or procedural records that are designed to yield valuable data relevant to quality measurement...
June 7, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28591072/the-incremental-hospital-cost-and-length-of-stay-associated-with-treating-adverse-events-among-medicare-beneficiaries-undergoing-cervical-spinal-fusion-during-fiscal-year-2013-and-2014
#10
Steven D Culler, Kevin J McGuire, Kenneth M Little, David Jevsevar, Kevin Shea, Michael Schlosser, Karen E Ambrose, April W Simon
STUDY DESIGN: A retrospective study. OBJECTIVES: To report the incremental hospital resources consumed with treating adverse events experienced by Medicare beneficiaries undergoing a two or three vertebrae level cervical spinal fusion. SUMMARY OF BACKGROUND DATA: Hospitals are increasingly at financial risk for patients experiencing adverse events due "pay for performance". Little is known about incremental resources consumed when treating patients who experienced an adverse event following cervical spinal fusions...
June 6, 2017: Spine
https://www.readbyqxmd.com/read/28583973/solving-disparities-through-payment-and-delivery-system-reform-a-program-to-achieve-health-equity
#11
Rachel H DeMeester, Lucy J Xu, Robert S Nocon, Scott C Cook, Andrea M Ducas, Marshall H Chin
Payment systems generally do not directly encourage or support the reduction of health disparities. In 2013 the Finding Answers: Solving Disparities through Payment and Delivery System Reform program of the Robert Wood Johnson Foundation sought to understand how alternative payment models might intentionally incorporate a disparities-reduction component to promote health equity. A qualitative analysis of forty proposals to the program revealed that applicants generally did not link payment reform tightly to disparities reduction...
June 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28583141/characterization-and-effectiveness-of-pay-for-performance-in-ophthalmology-a-systematic-review
#12
Tim Herbst, Martin Emmert
BACKGROUND: To identify, characterize and compare existing pay-for-performance approaches and their impact on the quality of care and efficiency in ophthalmology. METHODS: A systematic evidence-based review was conducted. English, French and German written literature published between 2000 and 2015 were searched in the following databases: Medline (via PubMed), NCBI web site, Scopus, Web of Knowledge, Econlit and the Cochrane Library. Empirical as well as descriptive articles were included...
June 5, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28568245/quality-metrics-and-systems-transformation-are-we-advancing-alcohol-and-drug-screening-in-primary-care
#13
Traci Rieckmann, Stephanie Renfro, Dennis McCarty, Robin Baker, K John McConnell
OBJECTIVE: To examine the influence of Oregon's coordinated care organizations (CCOs) and pay-for-performance incentive model on completion of screening and brief intervention (SBI) and utilization of substance use disorder (SUD) treatment services. DATA SOURCES/STUDY SETTING: Secondary analysis of Medicaid encounter data from 2012 to 2015 and semiannual qualitative interviews with stakeholders in CCOs. STUDY DESIGN: Longitudinal mixed-methods design with simultaneous data collection with equal importance...
May 31, 2017: Health Services Research
https://www.readbyqxmd.com/read/28562307/the-eye-of-the-beholder-a-discussion-of-value-and-quality-from-the-perspective-of-families-of-children-and-youth-with-special-health-care-needs
#14
Betsy Anderson, Julie Beckett, Nora Wells, Meg Comeau
There is broad agreement that increasing the cost-effectiveness and quality of health care services, thereby achieving greater value, is imperative given this country's current spiraling costs and poor health outcomes. However, how individuals or stakeholder groups define value may differ significantly. Discussion of value in the context of health care, in particular value-based purchasing and value-based insurance design, must acknowledge that there is no universal consensus definition as to what constitutes value...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28536769/an-honest-day-s-work-pay-for-performance-in-a-pediatric-radiology-department
#15
REVIEW
George S Bisset
Compensation models in radiology take a variety of forms, but regardless of practice type, successful models must reward productivity, be simple, and epitomize fairness. The ideal model should also be flexible enough to transition, based upon the changing strategic goals of a department. The plan should be constructed around rewarding the behaviors that the organization values. In this minisymposium article the author presents the value of different types of compensation plans and discusses advantages and disadvantages...
June 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28536768/quality-measures-and-pediatric-radiology-suggestions-for-the-transition-to-value-based-payment
#16
REVIEW
Richard E Heller, Brian D Coley, Stephen F Simoneaux, Daniel J Podberesky, Marta Hernanz-Schulman, Richard L Robertson, Lane F Donnelly
Recent political and economic factors have contributed to a meaningful change in the way that quality in health care, and by extension value, are viewed. While quality is often evaluated on the basis of subjective criteria, pay-for-performance programs that link reimbursement to various measures of quality require use of objective and quantifiable measures. This evolution to value-based payment was accelerated by the 2015 passage of the Medicare Access and CHIP (Children's Health Insurance Program) Reauthorization Act (MACRA)...
June 2017: Pediatric Radiology
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
#17
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
#18
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
#19
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
#20
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
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