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Accountable Care Organizations

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https://www.readbyqxmd.com/read/29777644/closing-the-gap-between-people-and-programs-lessons-from-implementation-of-social-accountability-for-family-planning-and-reproductive-health-in-uganda
#1
Vicky Boydell, Stella Neema, Kelsey Wright, Karen Hardee
Globally, women's access to modern contraception can be attributed to poor service conditions and care. Growing evidence from across the health sector has found that social accountability approaches have the potential to improve the quality of care and therefore the utilization of health services, little of this evidence relates to family planning and reproductive health programs. This paper therefore assessed the results of retrospective implementation research into a five-year social accountability project in Uganda that focused on family planning and reproductive health...
March 2018: African Journal of Reproductive Health
https://www.readbyqxmd.com/read/29771847/review-of-surgeon-participation-in-early-accountable-care-organizations-by-resnick-mj-graves-aj-buntin-mb-richards-mr-penson-df-in-ann-surg-267-401-407-2018
#2
Venkata S Kothamasu, Larry H Hollier
No abstract text is available yet for this article.
May 15, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29771724/early-impact-of-medicare-accountable-care-organizations-on-inpatient-surgical-spending
#3
Hari Nathan, Jyothi R Thumma, Andrew M Ryan, Justin B Dimick
OBJECTIVE: To evaluate whether hospital participation in accountable care organizations (ACOs) is associated with reduced Medicare spending for inpatient surgery. BACKGROUND: ACOs have proliferated rapidly and now cover more than 32 million Americans. Medicare Shared Savings Program (MSSP) ACOs have shown modest success in reducing medical spending. Whether they have reduced surgical spending remains unknown. METHODS: We used 100% Medicare claims from 2010 to 2014 for patients aged 65 to 99 years undergoing 6 common elective surgical procedures [abdominal aortic aneurysm (AAA) repair, colectomy, coronary artery bypass grafting (CABG), hip or knee replacement, or lung resection]...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29771222/structure-of-health-care-dyad-leadership-an-organization-s-experience
#4
Anurag Saxena, Maura Davies, Don Philippon
Purpose This study aims to explore the structural aspects (roles, responsibilities and reporting) of dyad leadership in one health-care organization (HCO). Design/methodology/approach The perceptions of 32 leaders (17 physician leaders and 15 dyad co-leaders) in formal leadership positions (six first-level with formal authority limited to teams or divisions, 23 middle-level with wider departmental or program responsibility and three senior-level with institution-wide authority) were obtained through focus groups and surveys...
May 8, 2018: Leadership in Health Services
https://www.readbyqxmd.com/read/29768401/near-real-time-forecasting-for-cholera-decision-making-in-haiti-after-hurricane-matthew
#5
Damiano Pasetto, Flavio Finger, Anton Camacho, Francesco Grandesso, Sandra Cohuet, Joseph C Lemaitre, Andrew S Azman, Francisco J Luquero, Enrico Bertuzzo, Andrea Rinaldo
Computational models of cholera transmission can provide objective insights into the course of an ongoing epidemic and aid decision making on allocation of health care resources. However, models are typically designed, calibrated and interpreted post-hoc. Here, we report the efforts of a team from academia, field research and humanitarian organizations to model in near real-time the Haitian cholera outbreak after Hurricane Matthew in October 2016, to assess risk and to quantitatively estimate the efficacy of a then ongoing vaccination campaign...
May 16, 2018: PLoS Computational Biology
https://www.readbyqxmd.com/read/29768311/impact-of-provider-participation-in-aco-programs-on-preventive-care-services-patient-experiences-and-health-care-expenditures-in-us-adults-aged-18-64
#6
Young-Rock Hong, Kalyani Sonawane, Samantha Larson, Arch G Mainous, Nicole M Marlow
BACKGROUND: Little is known about the impact of accountable care organization (ACO) on US adults aged 18-64. OBJECTIVES: To examine whether having a usual source of care (USC) provider participating in an ACO affects receipt of preventive care services, patient experiences, and health care expenditures among nonelderly Americans. RESEARCH DESIGN: A cross-sectional analysis of the 2015 Medical Organizations Survey linked with the Medical Expenditure Panel Survey...
May 15, 2018: Medical Care
https://www.readbyqxmd.com/read/29762273/patient-engagement-in-aco-practices-and-patient-reported-outcomes-among-adults-with-co-occurring-chronic-disease-and-mental-health-conditions
#7
Susan L Ivey, Stephen M Shortell, Hector P Rodriguez, Yue Emily Wang
BACKGROUND: Accountable care organizations (ACOs) have increased their use of patient activation and engagement strategies, but it is unknown whether they achieve better outcomes for patients with comorbid chronic physical and mental health conditions. OBJECTIVES: To assess the extent to which practices with patient-centered cultures, greater shared decision-making strategies, and better coordination among team members have better patient-reported outcomes (PROs) for patients with diabetes and/or cardiovascular and comorbid mental health diagnoses...
May 12, 2018: Medical Care
https://www.readbyqxmd.com/read/29754614/quality-measures-in-hernia-surgery
#8
REVIEW
Michael J Rosen
With growing pressures to formulate easily interpreted quality metrics, potential pitfalls exist that deleteriously affect the ultimate outcome of patients. This article defines what quality means in hernia surgery, how it is measured, who measures it, and how it is reported. Key governmental organizations responsible are highlighted. Although striving for high quality seems relatively straightforward, it is a challenge to account for all variables. Most definitions of quality are based on products and derived from minimum standards...
June 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29753700/spectrum-and-prevalence-of-genetic-predisposition-in-medulloblastoma-a-retrospective-genetic-study-and-prospective-validation-in-a-clinical-trial-cohort
#9
Sebastian M Waszak, Paul A Northcott, Ivo Buchhalter, Giles W Robinson, Christian Sutter, Susanne Groebner, Kerstin B Grund, Laurence Brugières, David T W Jones, Kristian W Pajtler, A Sorana Morrissy, Marcel Kool, Dominik Sturm, Lukas Chavez, Aurelie Ernst, Sebastian Brabetz, Michael Hain, Thomas Zichner, Maia Segura-Wang, Joachim Weischenfeldt, Tobias Rausch, Balca R Mardin, Xin Zhou, Cristina Baciu, Christian Lawerenz, Jennifer A Chan, Pascale Varlet, Lea Guerrini-Rousseau, Daniel W Fults, Wiesława Grajkowska, Peter Hauser, Nada Jabado, Young-Shin Ra, Karel Zitterbart, Suyash S Shringarpure, Francisco M De La Vega, Carlos D Bustamante, Ho-Keung Ng, Arie Perry, Tobey J MacDonald, Pablo Hernáiz Driever, Anne E Bendel, Daniel C Bowers, Geoffrey McCowage, Murali M Chintagumpala, Richard Cohn, Timothy Hassall, Gudrun Fleischhack, Tone Eggen, Finn Wesenberg, Maria Feychting, Birgitta Lannering, Joachim Schüz, Christoffer Johansen, Tina V Andersen, Martin Röösli, Claudia E Kuehni, Michael Grotzer, Kristina Kjaerheim, Camelia M Monoranu, Tenley C Archer, Elizabeth Duke, Scott L Pomeroy, Redmond Shelagh, Stephan Frank, David Sumerauer, Wolfram Scheurlen, Marina V Ryzhova, Till Milde, Christian P Kratz, David Samuel, Jinghui Zhang, David A Solomon, Marco Marra, Roland Eils, Claus R Bartram, Katja von Hoff, Stefan Rutkowski, Vijay Ramaswamy, Richard J Gilbertson, Andrey Korshunov, Michael D Taylor, Peter Lichter, David Malkin, Amar Gajjar, Jan O Korbel, Stefan M Pfister
BACKGROUND: Medulloblastoma is associated with rare hereditary cancer predisposition syndromes; however, consensus medulloblastoma predisposition genes have not been defined and screening guidelines for genetic counselling and testing for paediatric patients are not available. We aimed to assess and define these genes to provide evidence for future screening guidelines. METHODS: In this international, multicentre study, we analysed patients with medulloblastoma from retrospective cohorts (International Cancer Genome Consortium [ICGC] PedBrain, Medulloblastoma Advanced Genomics International Consortium [MAGIC], and the CEFALO series) and from prospective cohorts from four clinical studies (SJMB03, SJMB12, SJYC07, and I-HIT-MED)...
May 9, 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29749302/integrated-accountable-care-for-medicaid-expansion-enrollees-a-comparative-evaluation-of-hennepin-health
#10
Katherine D Vickery, Nathan D Shippee, Jeremiah Menk, Ross Owen, David M Vock, Peter Bodurtha, Dana Soderlund, Rodney A Hayward, Matthew M Davis, John Connett, Mark Linzer
Hennepin Health, a Medicaid accountable care organization, began serving early expansion enrollees (very low-income childless adults) in 2012. It uses an integrated care model to address social and behavioral needs. We compared health care utilization in Hennepin Health with other Medicaid managed care in the same area from 2012 to 2014, controlling for demographics, chronic conditions, and enrollment patterns. Homelessness and substance use were higher in Hennepin Health. Overall adjusted results showed Hennepin Health had 52% more emergency department visits and 11% more primary care visits than comparators...
May 1, 2018: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29749288/changes-in-quality-of-life-among-enrollees-in-hennepin-health-a-medicaid-expansion-aco
#11
Katherine D Vickery, Nathan D Shippee, Laura M Guzman-Corrales, Cindy Cain, Sarah Turcotte Manser, Tom Walton, Jessica Richards, Mark Linzer
Despite limited program evaluations of Medicaid accountable care organizations (ACOs), no studies have examined if cost-saving goals negatively affect quality of life and health care experiences of low-income enrollees. The Hennepin Health ACO uses an integrated care model to address the physical, behavioral, and social needs of Medicaid expansion enrollees. As part of a larger evaluation, we conducted semistructured interviews with 35 primary care using Hennepin Health members enrolled for 2 or more years...
May 1, 2018: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29748810/analyzing-the-uncertainty-of-diffusive-gel-based-passive-samplers-as-tools-for-evaluating-the-averaged-contamination-of-surface-water-by-organic-pollutants
#12
Angel Belles, Claire Alary, Nellaïdeve Laguerre, Christine Franke
Agarose gel-based passive samplers are nowadays one of the most effective sampling devices able to provide a quantitative evaluation of water contamination level for a broad range of organic contaminants. These devices show significant improvements in comparison to the previous passive samplers dedicated to hydrophilic compounds because they tend to reduce the effect of hydrodynamic flow conditions on the uptake rate of compounds and thus subsequently to improve their accuracy. However, albeit their effects minimized, hydrodynamic water flow and temperature are reported as variables likely to change the uptake rate of compounds that may lead to some inaccuracy if they are not adequately taken into account...
May 11, 2018: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/29743939/review-of-attacks-on-health-care-facilities-in-six-conflicts-of-the-past-three-decades
#13
REVIEW
Carolyn Briody, Leonard Rubenstein, Les Roberts, Eamon Penney, William Keenan, Jeffrey Horbar
Background: In the ongoing conflicts of Syria and Yemen, there have been widespread reports of attacks on health care facilities and personnel. Tabulated evidence does suggest hospital bombings in Syria and Yemen are far higher than reported in other conflicts but it is unclear if this is a reporting artefact. Objective: This article examines attacks on health care facilities in conflicts in six middle- to high- income countries that have occurred over the past three decades to try and determine if attacks have become more common, and to assess the different methods used to collect data on attacks...
2018: Conflict and Health
https://www.readbyqxmd.com/read/29741403/radiotherapeutic-implications-of-the-updated-icrp-thresholds-for-tissue-reactions-related-to-cataracts-and-circulatory-diseases
#14
L T Dauer, E Yorke, M Williamson, Y Gao, Z L Dauer, D L Miller, E Vañó
Radiation therapy of cancer patients involves a trade-off between a sufficient tumour dose for a high probability of local control and dose to organs at risk that is low enough to lead to a clinically acceptable probability of toxicity. The International Commission on Radiological Protection (ICRP) reviewed epidemiological evidence and provided updated estimates of 'practical' threshold doses for tissue injury, as defined at the level of 1% incidence, in ICRP Publication 118. Particular attention was paid to cataracts and circulatory diseases...
January 1, 2018: Annals of the ICRP
https://www.readbyqxmd.com/read/29737573/organizational-attributes-associated-with-medicare-aco-quality-performance
#15
Xi Zhu, Keith Mueller, Huang Huang, Fred Ullrich, Thomas Vaughn, A Clinton MacKinney
PURPOSE: To evaluate associations between geographic, structural, and service-provision attributes of Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) and the ACOs' quality performance. METHODOLOGY: We conducted cross-sectional and longitudinal analyses of ACO quality performance using data from the Centers for Medicare and Medicaid Services and additional sources. The sample included 322 and 385 MSSP ACOs that had successfully reported quality measures in 2014 and 2015, respectively...
May 8, 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/29737556/time-discounting-and-protected-area-priorities
#16
Paul R Armsworth
Should conservation organizations focus on protecting habitats that are at imminent risk of being converted but are expensive or more remote areas that are less immediately threatened but where a large amount of land can be set aside? Variants of this trade-off commonly arise in spatial planning. We examined this trade-off using models of land use change near a deforestation frontier. The optimal choice of where to protect was determined by how decisions taken today accounted for ecological benefits and economic costs of conservation actions that would occur sometime in the future...
May 8, 2018: Conservation Biology: the Journal of the Society for Conservation Biology
https://www.readbyqxmd.com/read/29736980/face-to-face-interventions-for-informing-or-educating-parents-about-early-childhood-vaccination
#17
REVIEW
Jessica Kaufman, Rebecca Ryan, Louisa Walsh, Dell Horey, Julie Leask, Priscilla Robinson, Sophie Hill
BACKGROUND: Early childhood vaccination is an essential global public health practice that saves two to three million lives each year, but many children do not receive all the recommended vaccines. To achieve and maintain appropriate coverage rates, vaccination programmes rely on people having sufficient awareness and acceptance of vaccines.Face-to-face information or educational interventions are widely used to help parents understand why vaccines are important; explain where, how and when to access services; and address hesitancy and concerns about vaccine safety or efficacy...
May 8, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29736617/insiders-insight-discrimination-against-indigenous-peoples-through-the-eyes-of-health-care-professionals
#18
Lloy Wylie, Stephanie McConkey
Discrimination in the health care system has a direct negative impact on health and wellbeing. Experiences of discrimination are considered a root cause for the health inequalities that exist among Indigenous peoples. Experiences of discrimination are commonplace, with patients noting abusive treatment, stereotyping, and a lack of quality in the care provided, which discourage Indigenous people from accessing care. This research project examined the perspectives of health care providers and decision-makers to identify what challenges they see facing Indigenous patients and families when accessing health services in a large city in southern Ontario...
May 7, 2018: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/29732457/a-computable-definition-of-sepsis-facilitates-screening-and-performance-improvement-tracking
#19
Lauren J Alessi, Holly R Warmus, Erin K Schaffner, Sajel Kantawala, Joseph Carcillo, Johanna Rosen, Christopher M Horvat
Background: Sepsis kills almost 5,000 children annually, accounting for 16% of pediatric health care spending in the United States. Objectives: We sought to identify sepsis within the Electronic Health Record (EHR) of a quaternary children's hospital to characterize disease incidence, improve recognition and response, and track performance metrics. Methods: Methods are organized in a plan-do-study-act cycle. During the "plan" phase, electronic definitions of sepsis (blood culture and antibiotic within 24 hours) and septic shock (sepsis plus vasoactive medication) were created to establish benchmark data and track progress with statistical process control...
March 2018: Pediatric Quality & Safety
https://www.readbyqxmd.com/read/29731672/what-does-it-mean-to-be-youth-friendly-results-from-qualitative-interviews-with-health-care-providers-and-clinic-staff-serving-youth-and-young-adults-living-with-hiv
#20
Parya Saberi, Kristin Ming, Carol Dawson-Rose
Purpose: Given the consistent associations between younger age and numerous suboptimal clinical outcomes, there is a critical need for more research in youth living with human immunodeficiency virus (YLWH) and tailoring of health care delivery to the unique and complex needs of this population. The objective of this study was to examine the facilitators of and barriers to engagement in care among YLHW at the system and provider/staff level, as well as the barriers to using technology-based forms of communication with YLWH to improve retention and engagement in care...
2018: Adolescent Health, Medicine and Therapeutics
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