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https://www.readbyqxmd.com/read/28805415/actualizing-culture-change-the-promoting-excellent-alternatives-in-kansas-nursing-homes-peak-2-0-program
#1
Gayle A Doll, Laci J Cornelison, Heath Rath, Maggie L Syme
Nursing homes have been challenged in their attempts to achieve deep, organizational change (i.e., culture change) aimed at providing quality of care and quality of life for nursing home residents through person-centered care. To attain deep change, 2 well-defined components must be in place: a shared understanding of (a) the what, or content goals, and (b) the how, or process of change. However, there are few examples of this at a macro or micro level in long-term care. In an effort to enact true culture change in nursing homes statewide, the Kansas Department for Aging and Disability Services implemented the Promoting Excellent Alternatives in Kansas Nursing Homes program...
August 2017: Psychological Services
https://www.readbyqxmd.com/read/28802466/in-pursuit-of-the-fourth-aim-in-health-care-the-joy-of-practice
#2
REVIEW
Katherine A Gergen Barnett
In today's health care system where there are increased demands for health care provider productivity, increased pay for performance metrics, decreased reimbursements, and ever-increasing demands of electronic medical records, providers are at risk for high rates of burnout. Indeed, recent studies have indicated that more than 50% of US physicians are now experiencing burnout and that burnout is rising dramatically faster among physicians than in any other US professional field. These high rates of burnout have many downstream consequences, for both the providers and for the patients they serve...
September 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28763549/association-of-practice-level-social-and-medical-risk-with-performance-in-the-medicare-physician-value-based-payment-modifier-program
#3
Lena M Chen, Arnold M Epstein, E John Orav, Clara E Filice, Lok Wong Samson, Karen E Joynt Maddox
Importance: Medicare recently launched the Physician Value-Based Payment Modifier (PVBM) Program, a mandatory pay-for-performance program for physician practices. Little is known about performance by practices that serve socially or medically high-risk patients. Objective: To compare performance in the PVBM Program by practice characteristics. Design, Setting, and Participants: Cross-sectional observational study using PVBM Program data for payments made in 2015 based on performance of large US physician practices caring for fee-for-service Medicare beneficiaries in 2013...
August 1, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28754790/the-medicare-access-and-chip-reauthorization-act-implications-for-nephrology
#4
Eugene Lin, Thomas MaCurdy, Jay Bhattacharya
In response to rising Medicare costs, Congress passed the Medicare Access and Children's Health Insurance Program Reauthorization Act in 2015. The law fundamentally changes the way that health care providers are reimbursed by implementing a pay for performance system that rewards providers for high-value health care. As of the beginning of 2017, providers will be evaluated on quality and in later years, cost as well. High-quality, cost-efficient providers will receive bonuses in reimbursement, and low-quality, expensive providers will be penalized financially...
July 28, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28754517/does-person-centered-care-improve-residents-satisfaction-with-nursing-home-quality
#5
Judith L Poey, Linda Hermer, Laci Cornelison, Migette L Kaup, Patrick Drake, Robyn I Stone, Gayle Doll
OBJECTIVE: Person-centered care (PCC) is meant to enhance nursing home residents' quality of life (QOL). Including residents' perspectives is critical to determining whether PCC is meeting residents' needs and desires. This study examines whether PCC practices promote satisfaction with QOL and quality of care and services (QOC and QOS) among nursing home residents. DESIGN: A longitudinal, retrospective cohort study using an in-person survey. SETTING: Three hundred twenty nursing homes in Kansas enrolled or not enrolled in a pay-for-performance program, Promoting Excellent Alternatives in Kansas (PEAK 2...
July 25, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28749727/practice-innovation-health-care-utilization-and-costs-in-a-network-of-federally-qualified-health-centers-and-hospitals-for-medicaid-enrollees
#6
Tricia J Johnson, Art Jones, Cheryl Lulias, Anthony Perry
State Medicaid programs need cost-effective strategies to provide high-quality care that is accessible to individuals with low incomes and limited resources. Integrated delivery systems have been formed to provide care across the continuum, but creating a shared vision for improving community health can be challenging. Medical Home Network was created as a network of primary care providers and hospital systems providing care to Medicaid enrollees, guided by the principles of egalitarian governance, practice-level care coordination, real-time electronic alerts, and pay-for-performance incentives...
July 27, 2017: Population Health Management
https://www.readbyqxmd.com/read/28742710/using-confidential-clinical-data-registries-for-public-reporting-and-pay-for-performance
#7
Melissa A Hornor, Mark E Cohen, Bruce L Hall, Clifford Y Ko
No abstract text is available yet for this article.
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28738821/quality-improvement-implementation-and-dissemination-strategies-to-improve-mental-health-care-for-children-and-adolescents-a-systematic-review
#8
REVIEW
Valerie L Forman-Hoffman, Jennifer Cook Middleton, Joni L McKeeman, Leyla F Stambaugh, Robert B Christian, Bradley N Gaynes, Heather Lynne Kane, Leila C Kahwati, Kathleen N Lohr, Meera Viswanathan
BACKGROUND: Some outcomes for children with mental health problems remain suboptimal because of poor access to care and the failure of systems and providers to adopt established quality improvement strategies and interventions with proven effectiveness. This review had three goals: (1) assess the effectiveness of quality improvement, implementation, and dissemination strategies intended to improve the mental health care of children and adolescents; (2) examine harms associated with these strategies; and (3) determine whether effectiveness or harms differ for subgroups based on system, organizational, practitioner, or patient characteristics...
July 24, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28730746/management-and-prevalence-of-long-term-conditions-in-primary-health-care-for-adults-with-intellectual-disabilities-compared-with-the-general-population-a-population-based-cohort-study
#9
Sally-Ann Cooper, Laura Hughes-McCormack, Nicola Greenlaw, Alex McConnachie, Linda Allan, Marion Baltzer, Laura McArthur, Angela Henderson, Craig Melville, Paula McSkimming, Jill Morrison
BACKGROUND: In the UK, general practitioners/family physicians receive pay for performance on management of long-term conditions, according to best-practice indicators. METHOD: Management of long-term conditions was compared between 721 adults with intellectual disabilities and the general population (n = 764,672). Prevalence of long-term conditions was determined, and associated factors were investigated via logistic regression analyses. RESULTS: Adults with intellectual disabilities received significantly poorer management of all long-term conditions on 38/57 (66...
July 20, 2017: Journal of Applied Research in Intellectual Disabilities: JARID
https://www.readbyqxmd.com/read/28708749/effectiveness-of-pay-for-performance-for-chronic-kidney-disease-patients-on-hemodialysis-a-systematic-review-protocol
#10
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
#11
Lina Maria Ellegård, 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
#12
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
#13
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
#14
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 moving away from a volume-based payment system to a quality- and value-based system. Medicare, the largest insurer and payer of health care, has accelerated the movement toward value-based care with the development and implementation of myriad alternate 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 that these patients account for a disproportionate amount of health care 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
#15
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
#16
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
#17
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
#18
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...
September 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
#19
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
#20
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
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