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https://www.readbyqxmd.com/read/27923155/user-preferences-and-willingness-to-pay-for-safe-drinking-water-experimental-evidence-from-rural-tanzania
#1
Zachary Burt, Robert M Njee, Yolanda Mbatia, Veritas Msimbe, Joe Brown, Thomas F Clasen, Hamisi M Malebo, Isha Ray
Almost half of all deaths from drinking microbiologically unsafe water occur in Sub-Saharan Africa. Household water treatment and safe storage (HWTS) systems, when consistently used, can provide safer drinking water and improve health. Social marketing to increase adoption and use of HWTS depends both on the prices of and preferences for these systems. This study included 556 households from rural Tanzania across two low-income districts with low-quality water sources. Over 9 months in 2012 and 2013, we experimentally evaluated consumer preferences for six "low-cost" HWTS options, including boiling, through an ordinal ranking protocol...
November 25, 2016: Social Science & Medicine
https://www.readbyqxmd.com/read/27922506/coding-in-muscle-disease
#2
Lyell K Jones, John P Ney
Accurate coding is critically important for clinical practice and research. Ongoing changes to diagnostic and billing codes require the clinician to stay abreast of coding updates. Payment for health care services, data sets for health services research, and reporting for medical quality improvement all require accurate administrative coding. This article provides an overview of administrative coding for patients with muscle disease and includes a case-based review of diagnostic and Evaluation and Management (E/M) coding principles in patients with myopathy...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27920540/treatment-cost-of-narcolepsy-with-cataplexy-in-central-europe
#3
Petra Maresova, Michal Novotny, Blanka Klímová, Kamil Kuča
BACKGROUND: Narcolepsy is a lifelong, rare neurological sleep disorder characterized by chronic, excessive attacks of daytime sleepiness. This disease is often extremely incapacitating, interfering with every aspect of life, in work and social settings. OBJECTIVE: The purpose of this study is to specify the treatment costs of patients in Central Europe (Czech Republic), while the attention is mainly paid to the drugs that were fully or partially covered by public health insurance...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27920317/contrary-to-popular-belief-medicaid-hospital-admissions-are-often-profitable-because-of-additional-medicare-payments
#4
Jeffrey Stensland, Zachary R Gaumer, Mark E Miller
It is generally believed that most hospitals lose money on Medicaid admissions. The data suggest otherwise. Medicaid admissions are often profitable for hospitals because of payments from both the Medicaid program and the Medicare program, including payments for uncompensated care and from the Medicare disproportionate-share hospital program. On average, adding a single Medicaid patient day in fiscal year 2017 will increase most hospitals' Medicare payments by more than $300. When added to Medicaid payments, these payments often cause Medicaid patients to be profitable for hospitals...
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27920316/for-disproportionate-share-hospitals-taxes-and-fees-curtail-medicaid-payments
#5
Robert Nelb, James Teisl, Allen Dobson, Joan E DaVanzo, Lane Koenig
After accounting for supplemental payments, we found that in 2011, disproportionate-share hospitals, on average, received gross Medicaid payments that totaled 108 percent of their costs for treating Medicaid patients but only 89 percent of their costs for Medicaid and uninsured patients combined. However, these payments were reduced by approximately 4-11 percent after we accounted for provider taxes and local government contributions that are used to help finance Medicaid payments.
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27919450/development-and-validation-of-a-prediction-model-for-patients-discharged-to-post-acute-care-after-colorectal-cancer-surgery
#6
Elizabeth A Bailey, Rebecca L Hoffman, Christopher Wirtalla, Giorgos Karakousis, Rachel R Kelz
BACKGROUND: As payment shifts toward bundled reimbursement, decreasing unnecessary inpatient care may provide cost savings. This study examines the association between discharge status, hospital duration of stay, and cost for colorectal operation patients without complications and uses risk factors to predict the need for post-acute care. METHODS: We used the New York Statewide Planning and Research Cooperative System and the California Healthcare Cost and Utilization Project State Inpatient Databases to identify all patients who underwent operative resection for colorectal cancer in 2009-2010 and were discharged to home or post-acute care...
December 2, 2016: Surgery
https://www.readbyqxmd.com/read/27918757/outcome-measurement-in-value-based-payments
#7
Samyukta Mullangi, Stephen Schleicher, Thomas W Feeley
No abstract text is available yet for this article.
December 1, 2016: JAMA Oncology
https://www.readbyqxmd.com/read/27917479/hospital-postacute-care-referral-networks-is-referral-concentration-associated-with-medicare-style-bundled-payments
#8
Ramandeep Kaur, Jennifer N Perloff, Christopher Tompkins, Christine E Bishop
OBJECTIVE: To evaluate whether Medicare-style bundled payments are lower or higher for beneficiaries discharged from hospitals with postacute care (PAC) referrals concentrated among fewer PAC providers. DATA SOURCE: Medicare Part A and Part B claim (2008-2012) for all beneficiaries residing in any of 17 market areas: the Provider of Service file, the Healthcare Cost Report Information System, and the Dartmouth Atlas. STUDY DESIGN: An observational study in which hospitals were distinguished according to PAC referral concentration, which is the tendency to utilize fewer rather than more PAC providers...
December 5, 2016: Health Services Research
https://www.readbyqxmd.com/read/27916711/implementation-of-a-surgeon-level-comparative-quality-performance-review-to-improve-positive-surgical-margin-rates-during-radical-prostatectomy
#9
Richard S Matulewicz, Jeffrey J Tosoian, C J Stimson, Ashley E Ross, Meera Chappidi, Tamara L Lotan, Elizabeth Humphreys, Alan W Partin, Edward M Schaeffer
PURPOSE: Success in the era of value-based payment will depend on the capacity of health systems to improve quality while controlling costs. Comparative quality performance review (CQPR) can be used to drive improvements in surgical outcomes and thereby reduce costs. We sought to determine the efficacy of CQPR to improve a surgeon-level measure of surgical oncologic quality: positive surgical margin (PSM) rate at the time of radical prostatectomy (RP). METHODS: Between 1-1-2015 and 12-31-15, eight surgeons performing consecutive RP at a single high-volume institution were included...
December 1, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27916434/competition-policy-for-health-care-provision-in-norway
#10
Kurt R Brekke, Odd Rune Straume
Competition policy has played a very limited role for health care provision in Norway. The main reason is that Norway has a National Health Service (NHS) with extensive public provision and a wide set of sector-specific regulations that limit the scope for competition. However, the last two decades, several reforms have deregulated health care provision and opened up for provider competition along some dimensions. For specialised care, the government has introduced patient choice and (partly) activity (DRG) based funding, but also corporatised public hospitals and allowed for more private provision...
November 23, 2016: Health Policy
https://www.readbyqxmd.com/read/27911921/what-is-the-economic-burden-of-subsidized-hiv-aids-treatment-services-on-patients-in-nigeria-and-is-this-burden-catastrophic-to-households
#11
Enyi Etiaba, Obinna Onwujekwe, Kwasi Torpey, Benjamin Uzochukwu, Robert Chiegil
BACKGROUND: A gap in knowledge exists regarding the economic burden on households of subsidized anti-retroviral treatment (ART) programs in Nigeria. This is because patients also incur non-ART drug costs, which may constrain the delivery and utilisation of subsidized services. METHODS: An exit survey of adults (18+years) attending health facilities for HIV/AIDS treatment was conducted in three states in Nigeria (Adamawa, Akwa Ibom and Anambra). In the states, ART was fully subsidized but there were different payment modalities for other costs of treatment...
2016: PloS One
https://www.readbyqxmd.com/read/27909581/expansion-of-health-insurance-in-moldova-and-associated-improvements-in-access-and-reductions-in-direct-payments
#12
Thomas Hone, Jarno Habicht, Silviu Domente, Rifat Atun
BACKGROUND: Moldova is the poorest country in Europe. Economic constraints mean that Moldova faces challenges in protecting individuals from excessive costs, improving population health and securing health system sustainability. The Moldovan government has introduced a state benefit package and expanded health insurance coverage to reduce the burden of health care costs for citizens. This study examines the effects of expanded health insurance by examining factors associated with health insurance coverage, likelihood of incurring out-of-pocket (OOP) payments for medicines or services, and the likelihood of forgoing health care when unwell...
December 2016: Journal of Global Health
https://www.readbyqxmd.com/read/27909073/accuracy-of-outpatient-service-data-for-activity-based-funding-in-new-south-wales-australia
#13
Esther N Munyisia, David Reid, Ping Yu
BACKGROUND: Despite increasing research on activity-based funding (ABF), there is no empirical evidence on the accuracy of outpatient service data for payment. OBJECTIVE: This study aimed to identify data entry errors affecting ABF in two drug and alcohol outpatient clinic services in Australia. METHODS: An audit was carried out on healthcare workers' (doctors, nurses, psychologists, social workers, counsellors, and aboriginal health education officers) data entry errors in an outpatient electronic documentation system...
December 1, 2016: HIM Journal
https://www.readbyqxmd.com/read/27906531/medicare-program-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other-revisions-to-part-b-for-cy-2017-medicare-advantage-bid-pricing-data-release-medicare-advantage-and-part-d-medical-loss-ratio-data-release-medicare-advantage-provider-network
#14
(no author information available yet)
This major final rule addresses changes to the physician fee schedule and other Medicare Part B payment policies, such as changes to the Value Modifier, to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. This final rule also includes changes related to the Medicare Shared Savings Program, requirements for Medicare Advantage Provider Networks, and provides for the release of certain pricing data from Medicare Advantage bids and of data from medical loss ratio reports submitted by Medicare health and drug plans...
November 15, 2016: Federal Register
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
#15
(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/27905941/financing-strategies-to-improve-essential-public-health-equalization-and-its-effects-in-china
#16
Li Yang, Li Sun, Liankui Wen, Huyang Zhang, Chenyang Li, Kara Hanson, Hai Fang
BACKGROUND: In 2009, China launched a health reform to promote the equalization of national essential public health services package (NEPHSP). The present study aimed to describe the financing strategies and mechanisms to improve access to public health for all, identify the strengths and weaknesses of the different approaches, and showed evidence on equity improvement among different regions. METHODS: We reviewed the relevant literatures and identified 208 articles after screening and quality assessment and conducted six key informants' interviews...
December 1, 2016: International Journal for Equity in Health
https://www.readbyqxmd.com/read/27905888/medicare-program-end-stage-renal-disease-prospective-payment-system-coverage-and-payment-for-renal-dialysis-services-furnished-to-individuals-with-acute-kidney-injury-end-stage-renal-disease-quality-incentive-program-durable-medical-equipment-prosthetics-orthotics
#17
(no author information available yet)
This rule updates and makes revisions to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year 2017. It also finalizes policies for coverage and payment for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury. This rule also sets forth requirements for the ESRD Quality Incentive Program, including the inclusion of new quality measures beginning with payment year (PY) 2020 and provides updates to programmatic policies for the PY 2018 and PY 2019 ESRD QIP...
November 4, 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
#18
(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/27905814/medicare-and-medicaid-programs-cy-2017-home-health-prospective-payment-system-rate-update-home-health-value-based-purchasing-model-and-home-health-quality-reporting-requirements-final-rule
#19
(no author information available yet)
This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP)...
November 3, 2016: Federal Register
https://www.readbyqxmd.com/read/27905652/-conflicts-of-interest-in-nephrology
#20
Sofía P Salas, Antonio Vukusich, María Isabel Catoni, Andrés Valdivieso, Emilio Roessler
Since doctors disposed of effective tools to serve their patients, they had to worry about the proper management of available resources and how to deal with the relationship with the industry that provides such resources. In this relation-ship, health professionals may be involved in conflicts of interest that they need to acknowledge and learn how to handle. This article discusses the conflicts of interest in nephrology. Its objectives are to identify those areas where such conflicts could occur; to help to solve them, always considering the best interest of patients; and to help health workers to keep in mind that they have to preserve their autonomy and professional integrity...
August 2016: Revista Médica de Chile
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