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Accountable Care Organizations

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https://www.readbyqxmd.com/read/28730890/the-biopsychosocial-model-of-illness-a-model-whose-time-has-come
#1
Derick T Wade, Peter W Halligan
The biopsychosocial model outlined in Engel's classic Science paper four decades ago emerged from dissatisfaction with the biomedical model of illness, which remains the dominant healthcare model. Engel's call to arms for a biopsychosocial model has been taken up in several healthcare fields, but it has not been accepted in the more economically dominant and politically powerful acute medical and surgical domains. It is widely used in research into complex healthcare interventions, it is the basis of the World Health Organisation's International Classification of Functioning (WHO ICF), it is used clinically, and it is used to structure clinical guidelines...
August 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28730518/the-case-for-enrolling-high-cost-patients-in-an-aco
#2
Abraham Graber, Shane Carter, Asha Bhandary, Matthew Rizzo
Though accountable care organizations (ACOs) are increasingly important to American healthcare, ethical inquiry into ACOs remains in its nascent stages. Several articles have raised the concern that ACOs have an incentive to avoid enrolling high-cost patients and, thereby, have an incentive to deny care to those who need it the most. This concern is borne out by the reports of consultants working with newly formed ACOs. This paper argues that, contra initial appearances, there is no financial incentive for ACOs to avoid enrolling high-cost patients...
July 20, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28724674/mission-health-partners-a-community-based-social-determinants-driven-accountable-care-organization
#3
Robert Fields
Mission Health Partners Accountable Care Organization's population health strategy is based on the idea that improvements in outcomes are best achieved by addressing social determinants gaps for its members. Our network of service providers and a process for referrals and tracking streamlines the limited resources available to meet these needs.
July 2017: North Carolina Medical Journal
https://www.readbyqxmd.com/read/28724671/accountable-care-communities
#4
Marcus Plescia, Michael Dulin
Accountable care communities are a new health model that involves multiple stakeholders working together to improve the health and well-being of their communities by addressing social determinants of health. Stakeholders include health care delivery systems, public health organizations, and community organizations. In an accountable care community, the stakeholders commit to share responsibility, resources, and data to improve community health indicators. Accountable care communities are a promising model to both decrease medical costs and improve health outcomes by placing greater emphasis on addressing social and economic issues that ultimately define health...
July 2017: North Carolina Medical Journal
https://www.readbyqxmd.com/read/28724552/cost-of-injury-care-in-india-cross-sectional-analysis-of-national-sample-survey-2014
#5
J P Tripathy, J Jagnoor, B M Prasad, R Ivers
BACKGROUND: Injuries account for nearly 10% of total deaths in India and this burden is likely to rise. We aimed to estimate the out-of-pocket (OOP) expenditure and catastrophic expenditure due to hospitalisation or outpatient care as a result of any injury and factors associated with incurring catastrophic expenditure. METHODS: Secondary analysis of nationally representative data for India collected by National Sample Survey Organization in 2014, reporting on health service utilisation and healthcare-related OOP expenditure by income quintiles and by type of health facility (public or private)...
July 19, 2017: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/28721958/cost-analysis-of-a-simulation-based-training-for-health-workforce-in-india
#6
Gursimer Jeet, Shankar Prinja, Arun Kumar Aggarwal
BACKGROUND: Training of health-care workforce including doctors, staff nurses, and Auxiliary Nurse Midwives using simulation techniques for skill enhancement have been used in a variety of clinical settings to improve the quality of training. India adopted the skills laboratories model for capacity building of health workers in maternal and child health in Bihar state. OBJECTIVE: Current economic evaluation was performed with the objective of assessing the financial and economic cost of implementing skills laboratories...
April 2017: Indian Journal of Public Health
https://www.readbyqxmd.com/read/28712667/antibiotic-stewardship-in-low-and-middle-income-countries-same-but-different
#7
REVIEW
Janneke A Cox, Erika Vlieghe, Marc Mendelson, Heiman Wertheim, Linus Ndegwa, Maria Virginia Villegas, Ian Gould, Gabriel Levy Hara
BACKGROUND: Antibiotic resistance (ABR) is a quickly worsening problem worldwide, also in low-and middle-income countries (LMICs). Appropriate antibiotic use in humans and animals, i.e. antibiotic stewardship (ABS), is one of the corner stones of the World Health Organization's global action plan for ABR. Many LMICs are in the process of developing stewardship policies and programs. AIMS: We highlight the challenges for ABS initiatives in LMICs, give an outline of the (inter)national recommendations and demonstrate examples of effective, contextualised stewardship interventions...
July 13, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28712357/medicare-accountable-care-organizations-and-antidepressant-use-by-patients-with-depression
#8
Alisa B Busch, Haiden A Huskamp, Amanda R Kreider, J Michael McWilliams
OBJECTIVE: This study examined whether Medicare accountable care organization (ACO) programs were associated with early changes in antidepressant use or adherence among beneficiaries with depression. METHODS: A difference-in-difference design was used to compare claims from Medicare fee-for-service beneficiaries (2009-2013) and ACO patients with those from local control groups. Outcome measures were total antidepressant days supplied, filling one or more antidepressant prescriptions, and proportion of days covered (PDC) by supply among antidepressant users (adherence)...
July 17, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28709413/who-wants-to-be-involved-in-health-care-decisions-comparing-preferences-for-individual-and-collective-involvement-in-england-and-sweden
#9
Mio Fredriksson, Max Eriksson, Jonathan Tritter
BACKGROUND: Patient and public involvement (PPI) is framed as positive for individuals, the health system, public health, as well as for communities and society as a whole. We investigated whether preferences for PPI differed between two countries with Beveridge type health systems-Sweden and England. We measured willingness to be involved in individual treatment decisions and in decisions about the organization and provision of local health and social care services. METHODS: This was a comparative cross-sectional study of the general population's preferences...
July 14, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28702862/oregon-s-coordinated-care-organizations-and-their-effect-on-prenatal-care-utilization-among-medicaid-enrollees
#10
Lisa P Oakley, S Marie Harvey, Jangho Yoon, Jeff Luck
Introduction Previous studies indicate that inadequate prenatal care is more common among women covered by Medicaid compared with private insurance. Increasing the proportion of pregnant women who receive early and adequate prenatal care is a Healthy People 2020 goal. We examined the impact of the implementation of Oregon's accountable care organizations, Coordinated Care Organizations (CCOs), for Medicaid enrollees, on prenatal care utilization among Oregon women of reproductive age enrolled in Medicaid. Methods Using Medicaid eligibility data linked to unique birth records for 2011-2013, we used a pre-posttest treatment-control design that compared prenatal care utilization for women on Medicaid before and after CCO implementation to women never enrolled in Medicaid...
July 12, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28701232/the-three-paradoxes-of-patient-flow-an-explanatory-case-study
#11
Sara A Kreindler
BACKGROUND: Health systems in many jurisdictions struggle to reduce Emergency Department congestion and improve patient flow across the continuum of care. Flow is often described as a systemic issue requiring a "system approach"; however, the implications of this idea remain poorly understood. Focusing on a Canadian regional health system whose flow problems have been particularly intractable, this study sought to determine what system-level flaws impede healthcare organizations from improving flow...
July 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28700790/association-of-changes-in-medication-use-and-adherence-with-accountable-care-organization-exposure-in-patients-with-cardiovascular-disease-or-diabetes
#12
J Michael McWilliams, Mehdi Najafzadeh, William H Shrank, Jennifer M Polinski
Importance: Many of the quality measures used to assess accountable care organization (ACO) performance in the Medicare Shared Savings Program (MSSP) focus on disease control and medication use among patients with cardiovascular disease and diabetes. To date, the association between participation in the MSSP by provider organizations and medication use or adherence among their patients with cardiovascular disease or diabetes has not been described. Objective: To assess the association between exposure to the MSSP and changes in the use of and adherence to common antihypertensive, lipid-lowering, and hypoglycemic medications...
July 12, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28700775/improving-care-in-an-accountable-care-organization-so-many-choices-so-little-time
#13
William B Borden
No abstract text is available yet for this article.
July 12, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28700504/silent-presentation-of-multiple-metastasis-burkitt-lymphoma-in-a-child-a-case-report-and-review-of-the-literature
#14
Ingrith Miron, Lucian Miron, Vasile Valeriu Lupu, Ancuta Ignat
RATIONALE: The Burkitt lymphoma (BL) is a very aggressive B-cell non-Hodgkin's lymphoma. It accounts for 34% of lymphoma cases in children. PATIENT CONCERNS: We present the case of a 6-year-old boy diagnosed with BL, who presented multiple contrasting elements of the disease: silent symptomatology, without involvement of the bone marrow at first, but with multiorgan infiltration and a fast evolution, despite starting the treatment shortly after the symptoms appeared...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28700294/accountable-care-organizations-payments-to-physicians-patients-should-have-the-right-to-know
#15
Mayce Mansour, Nathan Favini, Michael A Carome, Sidney Wolfe, Steffie Woolhandler, David U Himmelstein
No abstract text is available yet for this article.
August 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28697685/interruptions-and-multitasking-in-surgery-a-multicentre-observational-study-of-the-daily-work-patterns-of-doctors-and-nurses
#16
Tommaso Bellandi, Alessandro Cerri, Giulia Carreras, Scott Walter, Cipriana Mengozzi, Sara Albolino, Eleonora Mastrominico, Fernando Renzetti, Riccardo Tartaglia, Johanna Westbrook
The aim of this study was to obtain baseline data on doctors' and nurses' work activities and rates of interruptions and multi-tasking to improve work organization and processes. Data were collected in six surgical units with the WOMBAT (Work Observation Method by Activity Timing) tool. Results show that doctors and nurses received approximately 13 interruptions per hour, or one interruption every 4.5 minutes. Compared to doctors, nurses were more prone to interruptions in most activities, while doctors performed multitasking (33...
July 12, 2017: Ergonomics
https://www.readbyqxmd.com/read/28696597/-sepsis-particularities-in-the-elderly-patients
#17
Xavier Roux, Benedikt Huttner, Jérôme Pugin, Virginie Prendki, Jean-Luc Reny
Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to an infection. The clinical presentation of sepsis in the elderly is very variable and sepsis is therefore challenging to diagnose in this population. The new sepsis definitions published in 2016, which are based on objective clinical and biological scores, should lead to earlier recognition and diagnosis. Treatment should start as soon as possible because the specific pathophysiological changes of aging increase the risk of a sudden deterioration to septic shock...
November 9, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28696250/american-heart-association-s-call-to-action-for-payment-and-delivery-system-reform
#18
REVIEW
Vincent J Bufalino, Scott A Berkowitz, Timothy J Gardner, Ileana L Piña, Madeleine Konig
The healthcare system is undergoing a transition from paying for volume to paying for value. Clinicians, as well as public and private payers, are beginning to implement alternative delivery and payment models, such as the patient-centered medical home, accountable care organizations, and bundled payment arrangements. Implementation of these new models will necessitate delivery system transformation and will actively involve all fields of medical care, in particular medicine and surgery. This call to action, on behalf of the American Heart Association's Expert Panel on Payment and Delivery System Reform, serves to offer support and direction for further involvement by the American Heart Association...
July 10, 2017: Circulation
https://www.readbyqxmd.com/read/28696077/legionnaires-disease-in-transplant-recipients-a-15-year-retrospective-study-in-a-tertiary-referral-center
#19
Shobini Sivagnanam, Sara Podczervinski, Susan M Butler-Wu, Vivian Hawkins, Zach Stednick, Lois A Helbert, William A Glover, Estella Whimbey, Jeffrey Duchin, Guang-Shing Cheng, Steven A Pergam
Legionnaires' disease (LD) can be fatal among high-risk transplant recipients. To understand the epidemiology of LD, we reviewed 15-year, longitudinal data from a center in Seattle, Washington that cares for both solid organ transplant (SOT) and hematopoietic cell transplant (HCT) recipients. We identified all laboratory-confirmed LD and extracted data on species, diagnostic modalities, clinical presentation, management, and outcomes from medical records. Among 32 patients with LD, transplant recipients made up the majority of diagnoses (22, 69%; SOT 10, HCT 12)...
July 11, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28695714/evaluation-of-specialist-referrals-at-a-rural-health-care-clinic
#20
Mary Ellen Biggerstaff, Nancy Short
PURPOSE: Transition to a value-based care system involves reducing costs improving population health and enhancing the patient experience. Many rural hospitals must rely on specialist referrals because of a lack of an internal system of specialists on staff. This evaluation of the existing specialist referrals from primary care was conducted to better understand and improve the referral process and address costs, population health, and the patient experience. DATA SOURCES: A 6-month retrospective chart review was conducted to evaluate quality and outcomes of specialty referrals submitted by 10 primary care providers...
July 2017: Journal of the American Association of Nurse Practitioners
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