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"Value-based payment"

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https://www.readbyqxmd.com/read/27918757/outcome-measurement-in-value-based-payments
#1
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/27916711/implementation-of-a-surgeon-level-comparative-quality-performance-review-to-improve-positive-surgical-margin-rates-during-radical-prostatectomy
#2
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/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/27898132/community-models-of-care-a-scoping-review
#4
Lindsay Mullins, Lisa E Skemp, Meridean L Maas
Nurse preparation and role in community models of care for older adults is not well documented. The purpose of the current structured scoping literature review was to identify nurse-led or nurse-involved community models of care for older adults, articulate the nurse's role and preparation in the model, and identify Triple Aim policy implications. Literature from 2008 through 2014 yielded 34 models identified in 51 articles. Twenty-one of 34 models were evaluated and none clearly articulated the full impact of a nurse role...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27893519/effects-of-hospital-systems-on-medical-home-transformation-in-primary-care-residency-training-practices
#5
Kyle Knierim, Tristen Hall, Douglas Fernald, Thomas J Staff, Emilie Buscaj, Jessica Cornett Allen, Mary Onysko, W Perry Dickinson
Most primary care residency training practices have close financial and administrative relationships with teaching hospitals and health systems. Many residency practices have begun integrating the core principles of the patient-centered medical home (PCMH) into clinical workflows and educational experiences. Little is known about how the relationships with hospitals and health systems affect these transformation efforts. Data from the Colorado Residency PCMH Project were analyzed. Results show that teaching hospitals and health systems have significant opportunities to influence residency practices' transformation, particularly in the areas of supporting team-based care, value-based payment reforms, and health information technology...
November 23, 2016: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27874914/surgical-cost-disclosure-may-reduce-operating-room-expenditures
#6
Luke S Austin, Fotios P Tjoumakaris, Alvin C Ong, Nicholas J Lombardi, Charles D Wowkanech, Michael J Mehnert
Health care expenditures are rising in the United States. Recent policy changes are attempting to reduce spending through the development of value-based payment systems that rely heavily on cost transparency. This study was conducted to investigate whether cost disclosure influences surgeons to reduce operating room expenditures. Beginning in 2012, surgeon scorecards were distributed at a regional health care system. The scorecard reported the actual direct supply cost per case for a specific procedure and compared each surgeon's data with those of other surgeons in the same subspecialty...
November 22, 2016: Orthopedics
https://www.readbyqxmd.com/read/27858564/preparing-for-value-based-payment-a-stepwise-approach-for-cancer-centers
#7
Kerin B Adelson, Salimah Velji, Kavita Patel, Basit Chaudhry, Catherine Lyons, Rogerio Lilenbaum
Most cancer centers are ill-equipped to pursue value-based payment (VBP) because of limited information on their population's cost of care. Herein, we outline the stepwise approach used by Smilow Cancer Hospital at Yale-New Haven in our pursuit of better value care. First, we addressed institutional barriers. A move toward value required demonstration to Yale-New Haven Health System leadership that OCM would improve patient care, fund new infrastructure, and provide the opportunity to gain experience with VBP without a major threat to the financial stability of the health system...
October 2016: Journal of Oncology Practice
https://www.readbyqxmd.com/read/27849349/health-systems-tackling-social-determinants-of-health-promises-pitfalls-and-opportunities-of-current-policies
#8
Krisda H Chaiyachati, David T Grande, Jaya Aysola
Although improving the quality and delivery of clinical care is a critical mission for health systems, they are increasingly being tasked with improving the overall health of patients. This new directive is reflected in the growing number of health sector efforts in population health-a concept intertwined with social forces that impact patient care and health outcomes: the social determinants of health. Three policies that have the potential to help health systems intervene on social determinants of health are: 1) the Internal Revenue Service-mandated Community Health Needs Assessment for nonprofit hospitals, 2) value-based payment reform, and 3) CMS' Accountable Health Communities program...
November 1, 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27825770/estimating-longitudinal-risks-and-benefits-from-cardiovascular-preventive-therapies-among-medicare-patients-the-million-hearts-longitudinal-ascvd-risk-assessment-tool
#9
Donald M Lloyd-Jones, Mark D Huffman, Kunal N Karmali, Darshak M Sanghavi, Janet S Wright, Colleen Pelser, Martha Gulati, Frederick A Masoudi, David C Goff
The Million Hearts Initiative has a goal of preventing 1 million heart attacks and strokes-the leading causes of mortality-through several public health and healthcare strategies by 2017. The American Heart Association and American College of Cardiology support the program. The Cardiovascular Risk Reduction Model was developed by Million Hearts and the Center for Medicare & Medicaid Services as a strategy to asses a value-based payment approach toward reduction in 10-year predicted risk of atherosclerotic cardiovascular disease (ASCVD) by implementing cardiovascular preventive strategies to manage the "ABCS" (aspirin therapy in appropriate patients, blood pressure control, cholesterol management, and smoking cessation)...
October 28, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27815375/estimating-longitudinal-risks-and-benefits-from-cardiovascular-preventive-therapies-among-medicare-patients-the-million-hearts-longitudinal-ascvd-risk-assessment-tool-a-special-report-from-the-american-heart-association-and-american-college-of-cardiology
#10
Donald M Lloyd-Jones, Mark D Huffman, Kunal N Karmali, Darshak M Sanghavi, Janet S Wright, Colleen Pelser, Martha Gulati, Frederick A Masoudi, David C Goff
The Million Hearts Initiative has a goal of preventing 1 million heart attacks and strokes-the leading causes of mortality-through several public health and healthcare strategies by 2017. The American Heart Association and American College of Cardiology support the program. The Cardiovascular Risk Reduction Model was developed by Million Hearts and the Center for Medicare & Medicaid Services as a strategy to asses a value-based payment approach toward reduction in 10-year predicted risk of atherosclerotic cardiovascular disease (ASCVD) by implementing cardiovascular preventive strategies to manage the "ABCS" (aspirin therapy in appropriate patients, blood pressure control, cholesterol management, and smoking cessation)...
November 4, 2016: Circulation
https://www.readbyqxmd.com/read/27806385/reimbursement-based-on-value-in-knee-surgery-what-you-need-to-know-about-the-medicare-access-and-children-s-health-insurance-program-reauthorization-act-of-2015
#11
Khaled J Saleh, Zain Sayeed, Afshin A Anoushiravani, Hussein F Darwiche, Bryan Little, Todd James Frush, Mouhanad M El-Othmani
Health care cost is consuming a large portion of the nation's gross domestic product while placing added economic burdens on physicians and their patients. With total joint replacement being one of the early-targeted procedures in the evolving health care environment, knee surgeons will benefit from developing a critical knowledge on health care reforms and their financial implications. The Medicare Access and Children's Health Insurance Program Reauthorization Act represents a cohesive movement toward value-based payment reform and contains several unchartered rulings that require detailed attention by knee surgeons...
November 2, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27753557/capitation-as-an-incentive-for-transitioning-to-patient-centered-medical-homes-in-the-united-states-army-a-brief-report
#12
Richard G Malish
The Army transitioned to a Patient-Centered Medical Home concept for primary care beginning in 2011. In spite of organizational commitment to the paradigm, the transition has not been without pitfalls. This performance improvement project operated under the hypothesis that focusing on the market-based incentives of a capitated system would result in a quantum leap toward the Patient-Centered Medical Home ideal. Utilizing a simple teaching device to repetitively highlight clinic and provider behaviors incentivized in a value-based payment system, a single clinic achieved significant improvements in enrollment, patient satisfaction, and measures associated with prevention while assuming an identity as a "virtual clinic"...
October 2016: Military Medicine
https://www.readbyqxmd.com/read/27697316/time-driven-activity-based-costing-to-identify-opportunities-for-cost-reduction-in-pediatric-appendectomy
#13
Yangyang R Yu, Paulette I Abbas, Carolyn M Smith, Kathleen E Carberry, Hui Ren, Binita Patel, Jed G Nuchtern, Monica E Lopez
PURPOSE: As reimbursement programs shift to value-based payment models emphasizing quality and efficient healthcare delivery, there exists a need to better understand process management to unearth true costs of patient care. We sought to identify cost-reduction opportunities in simple appendicitis management by applying a time-driven activity-based costing (TDABC) methodology to this high-volume surgical condition. METHODS: Process maps were created using medical record time stamps...
September 15, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27687748/use-of-twitter-polls-to-determine-public-opinion-regarding-content-presented-at-a-major-national-specialty-society-meeting
#14
Andrew B Rosenkrantz, C Matthew Hawkins
PURPOSE: The aim of this study was to evaluate the feasibility of using Twitter polls to assess public opinion regarding session content at a national specialty society meeting. METHODS: Twitter polls allow users to embed multiple-choice questions within tweets and automatically aggregate responses. Two radiologists attending the 2016 annual meeting of the ACR posted a Twitter poll containing the hashtag #ACR2016 during 10 meeting sessions addressing socioeconomics/advocacy, patient experience, and social media/informatics (20 polls total)...
September 24, 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27676686/merit-based-incentive-payment-system-mips-harsh-choices-for-interventional-pain-management-physicians
#15
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
UNLABELLED: The Merit-based Incentive Payment System (MIPS) was created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) to improve the health of all Americans by providing incentives and policies to improve patient health outcomes. MIPS combines 3 existing programs, Meaningful Use (MU), now called Advancing Care Information (ACI), contributing 25% of the composite score; Physician Quality Reporting System (PQRS), changed to Quality, contributing 50% of the composite score; and Value-based Payment (VBP) system to Resource Use or cost, contributing 10% of the composite score...
September 2016: Pain Physician
https://www.readbyqxmd.com/read/27668560/the-central-role-of-physician-leadership-for-driving-change-in-value-based-care-environments
#16
Adam Lustig, Michael Ogden, Robert W Brenner, Jerry Penso, Kimberly D Westrich, Robert W Dubois
BACKGROUND: In 2013, it was reported that about 1 of every 3 U.S. adults has hypertension. Of these 70 million individuals, approximately 50% have their blood pressure under control. Achieving hypertension control, especially in at-risk populations, requires a multipronged approach that includes lifestyle modifications and pharmacological treatment. As provider groups, hospital systems, and integrated delivery networks optimize their care processes to promote population health activities in support of the accountable care organization (ACO) model of care, managing hypertension and other chronic diseases will be essential to their success...
October 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27659194/pqrs-and-the-macra-value-based-payments-have-moved-from-concept-to-reality
#17
J A Hirsch, T M Leslie-Mazwi, G N Nicola, M Bhargavan-Chatfield, D J Seidenwurm, E Silva, L Manchikanti
No abstract text is available yet for this article.
September 22, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27601968/are-independent-urology-practices-embracing-business-and-clinical-integration-to-prepare-for-the-coming-era-of-value-based-payment
#18
Gary M Kirsh
No abstract text is available yet for this article.
2016: Reviews in Urology
https://www.readbyqxmd.com/read/27599395/the-physician-insurer-dynamic-must-shift-to-successfully-implement-value-based-payments
#19
Roy A Beveridge, Laura E Happe, Mike Funk
Decades of practice under a system that set the financial interests of physicians and insurers at odds, has resulted in physician distrust of insurers being cited a key obstacle to value-based arrangements. Insurers must work to shift the insurer-provider relationship from one that's transactional to a partnership built on trust. Even when physicians and insurers agree philosophically on quality over quantity, there are practical challenges. Insurers can provide the data, systems and analytical insights that help inform the physician's care strategy...
September 2, 2016: Healthcare
https://www.readbyqxmd.com/read/27599092/making-value-a-priority-how-this-paradigm-shift-is-changing-the-landscape-in-health-care
#20
John Kimberly, Imran Cronk
The world of health care is changing dramatically, as reflected in the number, magnitude, and scope of innovative new approaches-to how illness is treated and how better health is promoted-that are being implemented around the globe. The changes triggered by these initiatives affect both how care is organized, managed, and paid for and the kinds of approaches that are being developed to keep people healthy. Underlying these changes is a more fundamental paradigm shift, a shift in the priority given to "value" in the formulation of policy and management practice...
September 6, 2016: Annals of the New York Academy of Sciences
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