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https://www.readbyqxmd.com/read/28339427/a-critical-analysis-of-obamacare-affordable-care-or-insurance-for-many-and-coverage-for-few
#1
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
The Affordable Care Act (ACA), of 2010, or Obamacare, was the most monumental change in US health care policy since the passage of Medicaid and Medicare in 1965. Since its enactment, numerous claims have been made on both sides of the aisle regarding the ACA's success or failure; these views often colored by political persuasion. The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care. One point often lost in the discussion is the distinction between affordability and access...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339426/evolution-of-us-health-care-reform
#2
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
Major health policy creation or changes, including governmental and private policies affecting health care delivery are based on health care reform(s). Health care reform has been a global issue over the years and the United States has seen proposals for multiple reforms over the years. A successful, health care proposal in the United States with involvement of the federal government was the short-lived establishment of the first system of national medical care in the South. In the 20th century, the United States was influenced by progressivism leading to the initiation of efforts to achieve universal coverage, supported by a Republican presidential candidate, Theodore Roosevelt...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28333869/macra-a-new-age-for-physician-payments
#3
Kent Kwasind Huston
The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 introduced a new system of physician payments in the United States. This legislation and the complex rules written to enact the law intend to force a shift away from volume-based payments and into so called value-based payments. Physicians and other clinicians will be graded via quality and cost metrics and payments will be adjusted based on performance. Robust use of certified electronic health records is required under MACRA. Physicians will follow one of two payment reform tracks known as the Merit-Based Incentive Payment System (MIPS) and the Alternative Payment Model (APM) pathways...
April 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28332943/effects-of-different-models-of-dialysis-care-on-patient-important-outcomes-a-systematic-review-and-meta-analysis
#4
Priya Ramar, Ahmed T Ahmed, Zhen Wang, Sagar S Chawla, Maria Lourdes Gonzalez Suarez, LaTonya J Hickson, Ann Farrell, Amy W Williams, Nilay D Shah, M Hassan Murad, Bjorg Thorsteinsdottir
Ongoing payment reform in dialysis necessitates better patient outcomes and lower costs. Suggested improvements to processes of care for maintenance dialysis patients are abundant; however, their impact on patient-important outcomes is unclear. This systematic review included comparative randomized controlled trials or observational studies with no restriction on language, published from 2000 to 2014, involving at least 5 adult dialysis patients who received a minimum of 6 months of follow-up. The effect size was pooled and stratified by intervention strategy (multidisciplinary care [MDC], home dialysis, alternate dialysis settings, and electronic health record implementation)...
March 23, 2017: Population Health Management
https://www.readbyqxmd.com/read/28332223/change-management-in-an-environment-of-ongoing-primary-health-care-system-reform-a-case-study-of-australian-primary-health-care-services
#5
Sara Javanparast, Janny Maddern, Fran Baum, Toby Freeman, Angela Lawless, Ronald Labonté, David Sanders
INTRODUCTION/BACKGROUND: Globally, health reforms continue to be high on the health policy agenda to respond to the increasing health care costs and managing the emerging complex health conditions. Many countries have emphasised PHC to prevent high cost of hospital care and improve population health and equity. The existing tension in PHC philosophies and complexity of PHC setting make the implementation and management of these changes more difficult. This paper presents an Australian case study of PHC restructuring and how these changes have been managed from the viewpoint of practitioners and middle managers...
March 22, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28331120/color-functionality-used-in-visual-display-for-occupational-and-environmental-safety-and-managing-color-vision-deficiency
#6
Nobuhisa Ochiai, Hiroyuki Kondo
The effects of color perception are utilized in visual displays for the purpose of safety in the workplace and in daily life. These effects, generally known as color functionality, are divided into four classifications: visibility, legibility, conspicuity and discriminability. This article focuses on the relationship between the color functionality of color schemes used in visual displays for occupational and environmental safety and color vision deficiency (particularly congenital red-green color deficiency), a critical issue in ophthalmology, and examines the effects of color functionality on the perception of the color red in individuals with protan defects...
2017: Journal of UOEH
https://www.readbyqxmd.com/read/28329466/healthcare-reform-literacy-among-academic-dermatologists-what-we-know-and-don-t-know-about-the-affordable-care-act
#7
Brian A Raphael, Suephy Chen, Benjamin Stoff
IMPORTANCE: There have been no attempts to determinethe understanding of the Affordable Care Act (ACA)among dermatologists. OBJECTIVE: Assess knowledgeof the ACA among academic dermatologists. DESIGN: A 21-item survey was administered to membersof the Association of Professors of Dermatology(APD). The items assessed knowledge and opinionsof the ACA, and demographics of the participants.Multivariate regressions were conducted todetermine associations between variables...
January 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/28327143/the-imperative-for-systems-thinking-to-promote-access-to-medicines-efficient-delivery-and-cost-effectiveness-when-implementing-health-financing-reforms-a-qualitative-study
#8
Tom Achoki, Abaleng Lesego
BACKGROUND: Health systems across Africa are faced with a multitude of competing priorities amidst pressing resource constraints. Expansion of health insurance coverage offers promise in the quest for sustainable healthcare financing for many of the health systems in the region. However, the broader policy implications of expanding health insurance coverage have not been fully investigated and contextualized to many African health systems. METHODS: We interviewed 37 key informants drawn from public, private and civil society organizations involved in health service delivery in Botswana...
March 21, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28325241/radiation-oncology-in-the-developing-economies-of-central-and-eastern-europe
#9
REVIEW
Natia Esiashvili
Eastern Europe is represented by 22 countries of significant variability in population density and degree of economic development. They have been affected by past geopolitical isolation due to their association with the "Soviet Block." Currently, all Eastern European countries except Slovenia are low- or middle-income level and 10 of them are part of European Union. Health care systems in Central and Eastern Europe have been influenced by the legacy of centralized soviet-era governance; however, most countries, particularly in European Union zone, have gone through health care reforms directed toward modernizing infrastructure and staffing...
April 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28323603/how-medicine-may-save-the-life-of-us-immigration-policy-from-clinical-and-educational-encounters-to-ethical-public-policy
#10
Mark G Kuczewski
Medicine has a conceptual contribution to make to the immigration debate. Our nation has been unable to move forward with meaningful immigration reform because many citizens seem to assume that immigrants are in the United States to access benefits to which they are not entitled. In contrast, when medicine encounters undocumented immigrants in the health care or medical education setting, it is obvious that their contributions to our health care system are denied by exclusionary laws. When the system is amended to be inclusive, immigrants become contributors to the systems that they access...
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28323579/who-experiences-seclusion-an-examination-of-demographics-and-duration-in-a-public-acute-inpatient-mental-health-service
#11
Jacinta Chavulak, Melissa Petrakis
Restrictive interventions such as seclusion may occur during an acute mental health crisis. Such interventions are experienced by people as traumatic and counter to recovery. The current study aimed to investigate the use of seclusion and who was secluded amongst patients presenting with psychotic symptomology. All acute inpatient admissions were examined across a 12-month period January-December 2013. Electronic and paper records were accessed and audited for all 655 admissions. There were 91 admissions that included a seclusion and 200 seclusion events...
March 21, 2017: Social Work in Health Care
https://www.readbyqxmd.com/read/28321291/re-thinking-barriers-to-organizational-change-in-public-hospitals
#12
Nigel Edwards, Richard B Saltman
Public hospitals are well known to be difficult to reform. This paper provides a comprehensive six-part analytic framework that can help policymakers and managers better shape their organizational and institutional behavior. The paper first describes three separate structural characteristics which, together, inhibit effective problem description and policy design for public hospitals. These three structural constraints are i) the dysfunctional characteristics found in most organizations, ii) the particular dysfunctions of professional health sector organizations, and iii) the additional dysfunctional dimensions of politically managed organizations...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28319907/the-impact-of-welfare-reform-on-the-health-insurance-coverage-utilization-and-health-of-low-education-single-mothers
#13
Kimberly Narain, Marianne Bitler, Ninez Ponce, Gerald Kominski, Susan Ettner
The Personal Responsibility Work Opportunity and Reconciliation Act (PRWORA) of 1996 imposed time limits on the receipt of welfare cash benefits and mandated cash benefit sanctions for failure to meet work requirements. Many studies examining the health implications of PRWORA have found associated declines in health insurance coverage and healthcare utilization among single mothers but no impact of PRWORA on health outcomes. A limitation of this literature is that most studies cover a time period before time limits were implemented in all states and also before individuals began actually timing out...
March 11, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28319813/the-clinical-implications-of-legalizing-marijuana-are-physician-and-non-physician-providers-prepared
#14
Elizabeth Brooks, Doris C Gundersen, Erin Flynn, Ashley Brooks-Russell, Sheana Bull
INTRODUCTION: Passage of voter-driven marijuana reform laws signals a shift in public attitudes for marijuana use. For providers, legalization may necessitate practice modifications, particularly regarding patient-provider conversations about use and risk. We examined healthcare providers' knowledge of marijuana laws and health implications, professional practice behaviors, and attitudes about training. MATERIALS AND METHODS: We surveyed 114 Colorado-based providers who care for children, adolescents, pregnant and breastfeeding women using a Venue-Day-Time survey methodology throughout Colorado...
March 10, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28317168/the-health-policy-pendulum-cost-control-vs-activity-growth
#15
Trond Tjerbo, Terje P Hagen
BACKGROUND: Cost containment is a major policy challenge and one of the key drivers of health care reform. In this article, we focus on the role cost control has played as a reform driver in the Norwegian hospital sector between 1980 and 2014. METHODS: We use data on aggregate expenditure as well as on activity changes from year to year. We also use qualitative data for illustrative purposes. RESULTS: We identify 4 phases in the period 1980 to 2014: two where activity increases have dominated the agenda and 2 where cost control has been emphasized...
March 20, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28316557/achieving-prudent-dementia-care-palliare-an-international-policy-and-practice-imperative
#16
Debbie Tolson, Anne Fleming, Elizabeth Hanson, Wilson de Abreu, Manuel Lillo Crespo, Rhoda Macrae, Graham Jackson, Simona Hvalič-Touzery, Iva Holmerová, Pirkko Routasalo
This paper examines the provision of integrated advanced dementia care within seven European countries and critically reviews the potential contribution of the Prudent Healthcare perspective as a starting point for reform. Progressive efforts to innovate, promote quality and integrate care are tempered with the reality of resource constraints. Some policy makers in Europe and North America have turned their attention to the principles of Prudent Healthcare as a potential mechanism to maximise benefits for patients within available resources...
December 31, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28316039/public-health-data-in-action-an-analysis-of-using-louisiana-vital-statistics-for-quality-improvement-and-payment-reform
#17
Valery A Danilack, Rebekah E Gee, Danielle P Berthelot, Rebecca Gurvich, Janet H Muri
Introduction In 2012, the Louisiana (LA) Department of Health and Hospitals revised the LA birth certificate to include medical reasons for births before 39 completed weeks' gestation. We compared the completeness and validity of these data with hospital discharge records. Methods For births occurring 4/1/2012-9/30/2012 at Woman's Hospital of Baton Rouge, we linked maternal delivery and newborn birth data collected through the National Perinatal Information Center with LA birth certificates. Among early term births (37-38 completed weeks' gestation), we quantified the reasons for early delivery listed on the birth certificate and compared them with ICD-9-CM codes from Woman's discharge data...
March 18, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28302682/gp-training-in-mental-health-needs-urgent-reform
#18
EDITORIAL
Elizabeth England, Vicki Nash, Kamila Hawthorne
No abstract text is available yet for this article.
March 16, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28302597/mhealth-interventions-for-health-system-strengthening-in-china-a-systematic-review
#19
Maoyi Tian, Jing Zhang, Rong Luo, Shi Chen, Djordje Petrovic, Julie Redfern, Dong Roman Xu, Anushka Patel
BACKGROUND: With rapidly expanding infrastructure in China, mobile technology has been deemed to have the potential to revolutionize health care delivery. There is particular promise for mobile health (mHealth) to positively influence health system reform and confront the new challenges of chronic diseases. OBJECTIVE: The aim of this study was to systematically review existing mHealth initiatives in China, characterize them, and examine the extent to which mHealth contributes toward the health system strengthening in China...
March 16, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28301705/reprioritizing-research-activity-for-the-post-antibiotic-era-ethical-legal-and-social-considerations
#20
Spencer Phillips Hey, Aaron S Kesselheim
Many hold that the so-called golden era of antibiotic discovery has passed, leaving only a limited clinical pipeline for new antibiotics. A logical conclusion of such arguments is that we need to reform the current system of antibiotic drug research-including clinical trials and regulatory requirements-to spur activity in discovery and development. The United States Congress in the past few years has debated a number of bills to address this crisis, including the 2012 Generating Antibiotic Incentives Now Act and the 2016 21st Century Cures Act...
March 2017: Hastings Center Report
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