keyword
MENU ▼
Read by QxMD icon Read
search

Medicare for All

keyword
https://www.readbyqxmd.com/read/28109347/how-is-physician-work-valued
#1
Jeffrey P Jacobs, Stephen J Lahey, Francis C Nichols, James M Levett, George Gilbert Johnston, Richard K Freeman, James D St Louis, Julie Painter, Courtney Yohe, Cameron D Wright, Kirk R Kanter, John E Mayer, Keith S Naunheim, Jeffrey B Rich, Joseph E Bavaria
Strategies to value physician work continue to evolve. The Society of Thoracic Surgeons and The Society of Thoracic Surgeons National Database have an increasingly important role in this evolution. An understanding of the Current Procedural Terminology (CPT) system (American Medical Association [AMA], Chicago, IL) and the Relative Value Scale Update Committee (RUC) is necessary to comprehend how physician work is valued. In 1965, with the dawn of increasingly complex medical care, immense innovation, and the rollout of Medicare, the need for a common language describing medical services and procedures was recognized as being of critical importance...
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28108823/which-clinical-and-patient-factors-influence-the-national-economic-burden-of-hospital-readmissions-after-total-joint-arthroplasty
#2
Steven M Kurtz, Edmund C Lau, Kevin L Ong, Edward M Adler, Frank R Kolisek, Michael T Manley
BACKGROUND: The Affordable Care Act of 2010 advanced the economic model of bundled payments for total joint arthroplasty (TJA), in which hospitals will be financially responsible for readmissions, typically at 90 days after surgery. However, little is known about the financial burden of readmissions and what patient, clinical, and hospital factors drive readmission costs. QUESTIONS/PURPOSES: (1) What is the incidence, payer mix, and demographics of THA and TKA readmissions in the United States? (2) What patient, clinical, and hospital factors are associated with the cost of 30- and 90-day readmissions after primary THA and TKA? (3) Are there any differences in the economic burden of THA and TKA readmissions between payers? (4) What types of THA and TKA readmissions are most costly to the US hospital system? METHODS: The recently developed Nationwide Readmissions Database from the Healthcare Cost and Utilization Project (2006 hospitals from 21 states) was used to identify 719,394 primary TJAs and 62,493 90-day readmissions in the first 9 months of 2013 based on International Classification of Diseases, 9th Revision, Clinical Modification codes...
January 20, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28108639/prevalence-of-epilepsy-seizures-as-a-comorbidity-of-neurologic-disorders-in-nursing-homes
#3
Angela K Birnbaum, Ilo E Leppik, Kenneth Svensden, Lynn E Eberly
OBJECTIVE: To determine the prevalence of epilepsy/seizure (epi/sz) comorbid with other neurologic disorders in elderly nursing home residents and to examine demographic and regional variability and associations with clinical characteristics. METHODS: We studied 5 cross-sectional cohorts of all residents in any Medicare/Medicaid-certified nursing home in the United States on July 15 of each year from 2003 to 2007. Epi/sz was identified by ICD-9 codes (345.xx or 780...
January 20, 2017: Neurology
https://www.readbyqxmd.com/read/28108154/collaborative-design-of-a-health-care-experience-survey-for-persons-with-disability
#4
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/28106518/a-case-report-cornerstone-health-care-reduced-the-total-cost-of-care-through-population-segmentation-and-care-model-redesign
#5
Dale E Green, Bruce H Hamory, Grace E Terrell, Jasmine O'Connell
Over the course of a single year, Cornerstone Health Care, a multispecialty group practice in North Carolina, redesigned the underlying care models for 5 of its highest-risk populations-late-stage congestive heart failure, oncology, Medicare-Medicaid dual eligibles, those with 5 or more chronic conditions, and the most complex patients with multiple late-stage chronic conditions. At the 1-year mark, the results of the program were analyzed. Overall costs for the patients studied were reduced by 12.7% compared to the year before enrollment...
January 20, 2017: Population Health Management
https://www.readbyqxmd.com/read/28103923/risk-adjustment-methods-for-all-payer-comparative-performance-reporting-in-vermont
#6
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/28103123/disease-burden-of-patients-with-asthma-copd-overlap-in-a-us-claims-database-impact-of-icd-9-coding-based-definitions
#7
Keele E Wurst, Samantha St Laurent, David Hinds, Kourtney J Davis
The inclusion of an asthma/chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) population in the 2015 Global Initiative for Chronic Obstructive Lung Disease strategic documents has raised questions about the profile of these patients in clinical practice, as they are mostly excluded from asthma and COPD clinical trials. We estimated the disease burden, co-morbidities, and respiratory treatments of patients with asthma/COPD overlap, utilizing the Truven MarketScan commercial and Medicare databases...
January 19, 2017: COPD
https://www.readbyqxmd.com/read/28102893/the-evolving-health-policy-landscape-and-suggested-geriatric-tenets-to-guide-future-responses
#8
Robert L Kane, Debra Saliba, Peter Hollmann
Speculation is rampant about what the new leadership in the White House and continued Republican leadership of both houses of Congress will do about health care. The concordance in party affiliation between President Trump and the congressional majority makes revisions in policy that is relevant to the health of older adults a virtual certainty. Past Republican legislative proposals and the current appointments to lead Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) presage several potential areas of change...
January 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28093663/large-prospective-analysis-of-the-reasons-patients-do-not-pursue-brca-genetic-testing-following-genetic-counseling
#9
Sommer Hayden, Sarah Mange, Debra Duquette, Nancie Petrucelli, Victoria M Raymond
Genetic counseling (GC) and genetic testing (GT) identifies high-risk individuals who benefit from enhanced medical management. Not all individuals undergo GT following GC and understanding the reasons why can impact clinical efficiency, reduce GT costs through appropriate identification of high-risk individuals, and demonstrate the value of pre-GT GC. A collaborative project sponsored by the Michigan Department of Health and Human Services prospectively collects anonymous data on BRCA-related GC visits performed by providers in Michigan, including demographics, patient/family cancer history, GT results, and reasons for declining GT...
January 16, 2017: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/28089185/joint-replacement-volume-positively-correlates-with-improved-hospital-performance-on-centers-for-medicare-and-medicaid-services-quality-metrics
#10
Rachel A Sibley, Vanessa Charubhumi, Lorraine H Hutzler, Albit R Paoli, Joseph A Bosco
BACKGROUND: The Center for Medicare and Medicaid Services (CMS) is transitioning Medicare from a fee-for-service program into a value-based pay-for-performance program. In order to accomplish this goal, CMS initiated 3 programs that attempt to define quality and seek to reward high-performing hospitals and penalize poor-performing hospitals. These programs include (1) penalties for hospital-acquired conditions (HACs), (2) penalties for excess readmissions for certain conditions, and (3) performance on value-based purchasing (VBP)...
December 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28079616/evaluation-of-an-outpatient-rehabilitative-program-to-address-mobility-limitations-among-older-adults
#11
Lorna G Brown, Meng Ni, Catherine T Schmidt, Jonathan F Bean
Live Long Walk Strong is a clinical demonstration program for community-dwelling older patients. It was designed to be consistent with current fall prevention guidelines and reimbursed under the Medicare model. Patients were screened within primary care and referred to a physiatrist followed by systematic assessment and treatment within an outpatient rehabilitative care setting. The treatment included behavioral modification, fall prevention education, community/home exercise integration, and exercise targeting strength, power, flexibility, balance, and endurance...
January 11, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28079266/risk-of-mortality-in-elderly-nursing-home-patients-with-depression-using-paroxetine
#12
Vishal Bali, Satabdi Chatterjee, Michael L Johnson, Hua Chen, Ryan M Carnahan, Rajender R Aparasu
OBJECTIVE: Among selective serotonin reuptake inhibitors (SSRIs), paroxetine is strongly anticholinergic and might lead to higher risk of adverse outcomes such as mortality. This study examined the risk of mortality in depressed elderly nursing home patients using paroxetine and other SSRIs. METHODS: This study used 2007-2010 Minimum Data Set - linked Medicare data and propensity score-matched retrospective cohort study design to achieve the study objective. New users of paroxetine and other SSRIs were followed until they reached the end of the follow-up period (one year), switched to a different antidepressant class, used psychotherapy, or had a gap of more than 15 days in the use of index antidepressant class, whichever occurred earlier...
January 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28077453/state-regulatory-approaches-for-dementia-care-in-residential-care-and-assisted-living
#13
Paula C Carder
PURPOSE: This policy study analyzed states' residential care and assisted living (RC/AL) regulations for dementia care requirements. Estimates suggest that at least half of RC/AL residents have dementia, and 22% of settings provide or specialize in dementia care. Residents with dementia might benefit from regulations that account for specific behaviors and needs associated with dementia, making states' RC/AL regulations address dementia care an important policy topic. DESIGN AND METHODS: This study examined RC/AL regulations in all 50 states and the District of Columbia for regulatory requirements on five topics important to the quality of life of RC/AL residents with dementia: pre-admission assessment, consumer disclosure, staffing types and levels, administrator training, and physical environment...
January 10, 2017: Gerontologist
https://www.readbyqxmd.com/read/28074756/risk-factors-and-effects-of-care-management-on-hospital-readmissions-among-high-users-at-an-academic-medical-center
#14
Quang H Pham, Sara X Li, Brent C Williams
Few studies have examined predictors of hospital readmission among high-using patients enrolled in a behaviorally oriented intensive care management program. The purpose of this case control study was to describe risk factors and the effectiveness of a complex care management program for hospital readmission among vulnerable patients at a large academic medical center. One hundred sixty-three patients enrolled in the University of Michigan Complex Care Management Program (UM CCMP) were hospitalized between January 2014 and March 2015...
September 1, 2016: Care Management Journals: Journal of Case Management ; the Journal of Long Term Home Health Care
https://www.readbyqxmd.com/read/28073850/characterization-of-mineralocorticoid-receptor-antagonist-therapy-initiation-in-high-risk-patients-with-heart-failure
#15
Lauren B Cooper, Bradley G Hammill, Eric D Peterson, Bertram Pitt, Matthew L Maciejewski, Lesley H Curtis, Adrian F Hernandez
BACKGROUND: Heart failure guidelines recommend routine monitoring of serum potassium, and renal function in patients treated with a mineralocorticoid receptor antagonist (MRA). How these recommendations are implemented in high-risk patients or according to setting of drug initiation is poorly characterized. METHODS AND RESULTS: We conducted a retrospective cohort study of Medicare beneficiaries linked to laboratory data in 10 states with prevalent heart failure as of July 1, 2011, and incident MRA use between May 1 and September 30, 2011...
January 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28073146/value-based-care-in-hepatology
#16
REVIEW
Mario Strazzabosco, John I Allen, Elizabeth O Teisberg
The migration from legacy fee-for-service reimbursement to payments linked to high value health care is accelerating in the United States because of new legislation and re-design of payments from the Centers for Medicare and Medicaid Services (CMS). Since patients with chronic diseases account for substantial use of health care resources, payers and health systems are focusing on maximizing the value of care for these patients. Since chronic liver diseases impose a major health burden worldwide affecting the health and lives of many individuals and families as well as substantial costs for individuals and payers, hepatologists must understand how they can improve their practices ...
January 10, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28072922/the-relationship-between-parenteral-nutrition-and-central-line-associated-bloodstream-infections
#17
Gabriela Fonseca, Marissa Burgermaster, Elaine Larson, David S Seres
BACKGROUND: Parenteral nutrition (PN) administered via central venous catheter has been identified as an independent risk factor for central line-associated bloodstream infections (CLABSIs). The aim of this study was to provide an updated description of the relationship between PN and CLABSI and assess temporal trends in CLABSI rates for individuals who received PN from 2009-2014, after the Centers for Medicare & Medicaid declared CLABSI a "never event." METHODS: Using data obtained from all adult patient discharges between January 1, 2009, and December 31, 2014, from 2 affiliated hospitals in a large health system in New York City, univariate and multivariate analyses were performed to examine the relationship between PN and CLABSIs as well as temporal trends...
January 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28071874/medicare-program-advancing-care-coordination-through-episode-payment-models-epms-cardiac-rehabilitation-incentive-payment-model-and-changes-to-the-comprehensive-care-for-joint-replacement-model-cjr-final-rule
#18
(no author information available yet)
This final rule implements three new Medicare Parts A and B episode payment models, a Cardiac Rehabilitation (CR) Incentive Payment model and modifications to the existing Comprehensive Care for Joint Replacement model under section 1115A of the Social Security Act. Acute care hospitals in certain selected geographic areas will participate in retrospective episode payment models targeting care for Medicare fee-forservice beneficiaries receiving services during acute myocardial infarction, coronary artery bypass graft, and surgical hip/femur fracture treatment episodes...
3, 2017: Federal Register
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/28069848/aco-affiliated-hospitals-reduced-rehospitalizations-from-skilled-nursing-facilities-faster-than-other-hospitals
#20
Ulrika Winblad, Vincent Mor, John P McHugh, Momotazur Rahman
Medicare's more than 420 accountable care organizations (ACOs) provide care for a considerable percentage of the elderly in the United States. One goal of ACOs is to improve care coordination and thereby decrease rates of rehospitalization. We examined whether ACO-affiliated hospitals were more effective than other hospitals in reducing rehospitalizations from skilled nursing facilities. We found a general reduction in rehospitalizations from 2007 to 2013, which suggests that all hospitals made efforts to reduce rehospitalizations...
January 1, 2017: Health Affairs
keyword
keyword
49200
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"