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https://www.readbyqxmd.com/read/27908559/influence-of-a-pay-for-performance-program-on-glycemic-control-in-patients-living-with-diabetes-by-family-physicians-in-a-canadian-province
#1
Emilie LeBlanc, Mathieu Bélanger, Véronique Thibault, Lise Babin, Beverly Greene, Stuart Halpine, Michelina Mancuso
OBJECTIVES: We evaluated the influence of the introduction of a pay-for-performance program implemented in 2010 for family physicians on the glycemic control of patients with diabetes. METHODS: Administrative data for all 583 eligible family physicians and 83,580 adult patients with diabetes in New Brunswick over 10 years were used. We compared the probability of receiving at least 2 tests for glycated hemoglobin (A1C) levels and achieving glycemic control before (2005-2009) and after (2010-2014) the implementation of the program and between patients divided based on whether a physician claimed the incentive or did not...
November 29, 2016: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/27906530/medicare-program-hospital-outpatient-prospective-payment-and-ambulatory-surgical-center-payment-systems-and-quality-reporting-programs-organ-procurement-organization-reporting-and-communication-transplant-outcome-measures-and-documentation-requirements-electronic
#2
(no author information available yet)
This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2017 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system...
November 14, 2016: Federal Register
https://www.readbyqxmd.com/read/27905815/medicare-program-merit-based-incentive-payment-system-mips-and-alternative-payment-model-apm-incentive-under-the-physician-fee-schedule-and-criteria-for-physician-focused-payment-models-final-rule-with-comment-period
#3
(no author information available yet)
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repeals the Medicare sustainable growth rate (SGR) methodology for updates to the physician fee schedule (PFS) and replaces it with a new approach to payment called the Quality Payment Program that rewards the delivery of high-quality patient care through two avenues: Advanced Alternative Payment Models (Advanced APMs) and the Merit-based Incentive Payment System (MIPS) for eligible clinicians or groups under the PFS. This final rule with comment period establishes incentives for participation in certain alternative payment models (APMs) and includes the criteria for use by the Physician-Focused Payment Model Technical Advisory Committee (PTAC) in making comments and recommendations on physician-focused payment models (PFPMs)...
November 4, 2016: Federal Register
https://www.readbyqxmd.com/read/27903559/randomised-controlled-trial-of-alternative-messages-to-increase-enrolment-in-a-healthy-food-programme-among-individuals-with-diabetes
#4
A Gopalan, J Paramanund, P A Shaw, D Patel, J Friedman, C Brophy, A M Buttenheim, A B Troxel, D A Asch, K G Volpp
OBJECTIVES: We compared the effectiveness of diabetes-focused messaging strategies at increasing enrolment in a healthy food programme among adults with diabetes. METHODS: Vitality is a multifaceted wellness benefit available to members of Discovery Health, a South Africa-based health insurer. One of the largest Vitality programmes is HealthyFood (HF), an incentive-based programme designed to encourage healthier diets by providing up to 25% cashback on healthy food purchases...
November 30, 2016: BMJ Open
https://www.readbyqxmd.com/read/27893954/does-primary-care-model-effect-healthcare-at-the-end-of-life-a-population-based-retrospective-cohort-study
#5
Michelle Howard, Mathieu Chalifoux, Peter Tanuseputro
BACKGROUND: Comprehensive primary care may enhance patient experience at end of life. OBJECTIVE: To examine whether belonging to different models of primary care is associated with end-of-life healthcare use and outcomes. DESIGN: Retrospective population cohort study, using health administrative databases to describe health services and costs in the last six months of life across three primary care models: enrolled to a physician remunerated mainly by capitation, with incentives for comprehensive care and access in some to allied health practitioners (Capitation); remunerated mainly from fee-for-service (FFS) with smaller incentives for comprehensive care (Enhanced FFS); and not enrolled, seeing physicians remunerated solely through FFS (Traditional FFS)...
November 28, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27893012/surgeons-and-trauma-care-physicians-perception-of-the-impact-of-the-globalization-of-medical-education-on-quality-of-care-in-lima-peru
#6
Lacey N LaGrone, Leah N Isquith-Dicker, Eduardo Huaman Egoavil, Manuel J A Rodriguez Castro, Alfredo Allagual, Fernando Revoredo, Charles N Mock
Importance: The globalization of medical education-the process by which trainees in any region gain access to international training (electronic or in-person)-is a growing trend. More data are needed to inform next steps in the responsible stewardship of this process, from the perspective of trainees and institutions at all income levels, and for use by national and international policymakers. Objective: To describe the impact of the globalization of medical education on surgical care in Peru from the perspective of Peruvian surgeons who received international training...
November 23, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27888948/web-applications-for-patient-communication
#7
Kristopher Lewis, Murray A Reicher
Communication between imaging professionals and patients can help achieve many goals, including improved patient understanding of imaging-related diagnostic and treatment options, better compliance with appropriate imaging screening procedures, and improved efficiency of service. The explosive growth of out-of-pocket consumer spending on health care has heightened health care shopping, thus making patient communication an important goal of any imaging practice or health care organization. Furthermore, the Merit-Based Incentive Payment System introduced by CMS will publicly disclose physicians' quality ratings, which are in part dependent on patient engagement...
December 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27887676/trauma-patients-i-can-t-get-no-patient-satisfaction
#8
Karalyn Bentley-Kumar, Theresa Jackson, Danny Holland, Brian LeBlanc, Vaidehi Agrawal, Michael S Truitt
BACKGROUND: The Centers for Medicare and Medicaid Services (CMS) provides financial incentives to hospitals based on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction survey. This data is made publicly available on their website to be utilized by patients and insurers. Hospitals are profoundly interested in identifying patient populations that negatively contribute to overall patient satisfaction scores. Hospitals consider trauma patients "high risk" from a HCAHPS perspective, but there is no data to inform this opinion...
October 20, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27884928/macra-2-0-are-you-ready-for-mips
#9
REVIEW
Joshua A Hirsch, Andrew B Rosenkrantz, Sameer A Ansari, Laxmaiah Manchikanti, Gregory N Nicola
The annual cost of healthcare delivery in the USA now exceeds US$3 trillion. Fee for service methodology is often implicated as a cause of this exceedingly high figure. The Affordable Care Act created the Center for Medicare and Medicaid Innovation (CMMI) to pilot test value based alternative payments for reimbursing physician services. In 2015, the Medicare Access and CHIP Reauthorization Act (MACRA) was passed into law. MACRA has dramatic implications for all US based healthcare providers. MACRA permanently repealed the Medicare Sustainable Growth Rate so as to stabilize physician part B Medicare payments, consolidated pre-existing federal performance programs into the Merit based Incentive Payments System (MIPS), and legislatively mandated new approaches to paying clinicians...
November 24, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27878712/much-ado-about-nothing-the-financial-impact-of-physician-owned-specialty-hospitals
#10
Sujoy Chakravarty
The U.S. hospital industry has recently witnessed a number of policy changes aimed at aligning hospital payments to costs and these can be traced to significant concerns regarding selection of profitable patients and procedures by physician-owned specialty hospitals. The policy responses to specialty hospitals have alternated between payment system reforms and outright moratoriums on hospital operations including one in the recently enacted Affordable Care Act. A key issue is whether physician-owned specialty hospitals pose financial strain on the larger group of general hospitals through cream-skimming of profitable patients, yet there is no study that conducts a systematic analysis relating such selection behavior by physician-owners to financial impacts within hospital markets...
June 2016: Int J Health Econ Manag
https://www.readbyqxmd.com/read/27878710/the-differential-effect-of-compensation-structures-on-the-likelihood-that-firms-accept-new-patients-by-insurance-type
#11
Justin B Bullock, W David Bradford
Adequate access to primary care is not universally achieved in many countries, including the United States, particularly for vulnerable populations. In this paper we use multiple years of the U.S.-based Community Tracking Survey to examine whether a variety of physician compensation structures chosen by practices influence the likelihood that the practice takes new patients from a variety of different types of insurance. Specifically, we examine the roles of customer satisfaction and quality measures on the one hand, and individual physician productivity measures on the other hand, in determining whether or not firms are more likely to accept patients who have private insurance, Medicare, or Medicaid...
March 2016: Int J Health Econ Manag
https://www.readbyqxmd.com/read/27878675/supplementing-gatekeeping-with-a-revenue-scheme-for-secondary-care-providers
#12
Tor Iversen, Anastasia Mokienko
We study implications of a change in the payment scheme for radiology providers in Norway that was implemented in 2008. The change implies reduced fee-for-service and increased fixed budget for a contracted volume of services. A consequence of the change is that private providers have less incentive to conduct examinations beyond the contracted volume. Different from the situation observed before the change in 2008, the volume is no longer determined by the demand side, and a rationing of the supply occurs...
September 2016: Int J Health Econ Manag
https://www.readbyqxmd.com/read/27878674/dispensing-physicians-asymmetric-information-supplier-induced-demand-evidence-from-the-swiss-health-survey
#13
Stefan Meyer
In this paper, we apply a two-part model to estimate the effect of health literacy on the demand for physician visits under different institutional settings. Using a constructed measure of health information, we find evidence for supplier-induced demand in some parts of Switzerland. While the level of health information is uncorrelated with the likelihood of visiting a physician (contact decision), the conditional number of visits (frequency decision) depends on the individual's information status and the regulation of physician drug dispensing...
September 2016: Int J Health Econ Manag
https://www.readbyqxmd.com/read/27876522/relative-value-unit-based-compensation-incentivization-in-an-academic-vascular-practice-improves-productivity-with-no-early-adverse-impact-on-quality
#14
Nadia Awad, Francis J Caputo, Jeffrey P Carpenter, James B Alexander, José L Trani, Joseph V Lombardi
OBJECTIVE: Given the increased pressure from governmental programs to restructure reimbursements to reflect quality metrics achieved by physicians, review of current reimbursement schemes is necessary to ensure sustainability of the physician's performance while maintaining and ultimately improving patient outcomes. This study reviewed the impact of reimbursement incentives on evidence-based care outcomes within a vascular surgical program at an academic tertiary care center. METHODS: Data for patients with a confirmed 30-day follow-up for the vascular surgery subset of our institution's National Surgical Quality Improvement Program submission for the years 2013 and 2014 were reviewed...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27873408/number-needed-to-eat-pizza-and-resident-conference-attendance
#15
Michael J Cosimini, Liza Mackintosh, Todd P Chang
The didactic conference is a common part of the resident education curriculum. Given the demands of clinical responsibilities and restrictions on duty hours, maximising education is a challenge faced by all residency programmes. To date, little research exists with respect to how the provision of complimentary food affects physician and resident conference attendance. The objective of this study was to determine whether complimentary food improves resident arrival times and attendance at educational conferences and, furthermore, to test whether this provision is a potentially cost-effective tool for improving education...
December 2016: Medical Education
https://www.readbyqxmd.com/read/27871296/work-hours-and-turnover-intention-among-hospital-physicians-in-taiwan-does-income-matter
#16
Yu-Hsuan Tsai, Nicole Huang, Li-Yin Chien, Jen-Huai Chiang, Shu-Ti Chiou
BACKGROUND: Physician shortage has become an urgent and critical challenge to many countries. According to the workforce dynamic model, long work hours may be one major pressure point to the attrition of physicians. Financial incentive is a common tool to human power retention. Therefore, this large-scale physician study investigated how pay satisfaction may influence the relationship between work hours and hospital physician's turnover intention. METHODS: Data were obtained from a nationwide survey of full-time hospital staff members working at 100 hospitals in Taiwan...
November 21, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27870675/comanagement-and-gainsharing-opportunities-for-independent-physicians
#17
Chris McBride, Peter L Althausen
Gainsharing and comanagament programs are both successful means of achieving physician buy-in for all cost containment programs in Orthopaedic Trauma. Under comanagement agreements, physicians are reimbursed for their time and intellectual efforts in program and algorithm creation. The cost is minimal for the hospital in return for the millions of dollars in savings they achieve. Gainsharing models can incentivize physicians to quickly adopt cost-effective implant choices, care plans, and program development...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27870670/operating-room-supply-costs-in-orthopaedic-trauma-cost-containment-opportunities
#18
Taylor P Gurnea, Wesley P Frye, Peter L Althausen
In the current health care environment, cost containment is more important than ever. Most physicians currently are unaware of the cost of operating room supplies. A large amount of waste occurs secondary to lack of knowledge and absence of physician incentives for cost saving. Many of the decisions for supply use can be based on good scientific evidence, which supports specific cost saving measures. Careful attention to blood utilization and use of tranexamic acid has the potential to save millions in the hip fracture treatment and arthroplasty treatments...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27864243/determinants-of-the-sustained-employment-of-physician-assistants-in-hospitals-a-qualitative-study
#19
Marijke J C Timmermans, Anneke J A H van Vught, Irma T H M Maassen, Lisette Draaijer, Anton G M Hoofwijk, Marcel Spanier, Wijnand van Unen, Michel Wensing, Miranda G H Laurant
OBJECTIVES: To identify determinants of the initial employment of physician assistants (PAs) for inpatient care as well as of the sustainability of their employment. DESIGN: We conducted a qualitative study with semistructured interviews with care providers. Interviews continued until data saturation was achieved. All interviews were transcribed verbatim. A framework approach was used for data analysis. Codes were sorted by the themes, bringing similar concepts together...
November 18, 2016: BMJ Open
https://www.readbyqxmd.com/read/27815451/financial-incentives-to-encourage-value-based-health-care
#20
REVIEW
Anthony Scott, Miao Liu, Jongsay Yong
This article reviews the literature on the use of financial incentives to improve the provision of value-based health care. Eighty studies of 44 schemes from 10 countries were reviewed. The proportion of positive and statistically significant outcomes was close to .5. Stronger study designs were associated with a lower proportion of positive effects. There were no differences between studies conducted in the United States compared with other countries; between schemes that targeted hospitals or primary care; or between schemes combining pay for performance with rewards for reducing costs, relative to pay for performance schemes alone...
November 3, 2016: Medical Care Research and Review: MCRR
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