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"Value-based payment"

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https://www.readbyqxmd.com/read/28217305/redesigning-care-delivery-with-patient-support-personnel-learning-from-accountable-care-organizations
#1
Ksenia O Gorbenko, Taressa Fraze, Valerie A Lewis
INTRODUCTION: Accountable care organizations (ACOs) are a value-based payment model in the United States rooted in holding groups of healthcare providers financially accountable for the quality and total cost of care of their attributed population. To succeed in reaching their quality and efficiency goals, ACOs implement a variety of care delivery changes, including workforce redesign. Patient support personnel (PSP)-non-physician staff such as care coordinators, community health workers, and others-are critical to restructuring care delivery...
September 2016: Int J Care Coord
https://www.readbyqxmd.com/read/28214149/implementing-primary-care-pharmacist-services-go-upstream-in-the-world-of-value-based-payment-models
#2
Marie A Smith, Henry A Palmer
No abstract text is available yet for this article.
February 9, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28157409/external-factors-that-influence-the-practice-of-radiology-proceedings-of-the-international-society-for-strategic-studies-in-radiology-meeting
#3
Geoffrey D Rubin, Barbara J McNeil, András Palkó, James H Thrall, Gabriel P Krestin, Ada Muellner, Herbert Y Kressel
In both the United States and Europe, efforts to reduce soaring health care costs have led to intense scrutiny of both standard and innovative uses of imaging. Given that the United States spends a larger share of its gross domestic product on health care than any other nation and also has the most varied health care financing and delivery systems in the world, it has become an especially fertile environment for developing and testing approaches to controlling health care costs and value. This report focuses on recent reforms that have had a dampening effect on imaging use in the United States and provides a glimpse of obstacles that imaging practices may soon face or are already facing in other countries...
February 4, 2017: Radiology
https://www.readbyqxmd.com/read/28152833/understanding-total-cost-of-cancer-care-to-determine-strategic-interventions-to-improve-value
#4
Salimah Velji, Kavita Patel, Basit Chaudhry, Sonia Grizzle, Catherine A Lyons, Rogerio Lilenbaum
: 3 Background: Cancer centers across the country are largely unprepared to move toward value-based payment. Total cost of care data is not readily available and centers do not know how much of their patients' care is received at other hospitals, when in the trajectory of illness greatest cost is incurred, or the elements of care that present the greatest opportunity for savings. A previous examination of practice patterns Smilow Cancer Hospital (SCH) demonstrated that our patients had high rates of ED visits, hospital admissions and ICU use in their last month of life...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152738/designing-and-implementing-a-payment-system-to-support-cancer-care-coordination-a-literature-review
#5
Chloe Gerves-Pinquie, Etienne Minvielle
: 40 Background: Demands for new payment systems to better coordinate services along the care continuum are emerging in oncology. Among them, bundling payments for defined episodes of care are considered as a promising payment option. The study objective was to understand how to develop an optimal payment system in order to foster coordination between hospitals and post-acute providers, and to identify potential pitfalls associated with its implementation. METHODS: We conducted a literature review, exploring articles published between 2010 and 2015 in Medline...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152688/a-new-digital-classification-schema-to-detect-treatment-variances-and-enable-value-based-payment-reforms
#6
Eric V Schultz, Kelly Choi, William Kea, Augie Smith, Cindy Kim, Matthew Axelrod, Teresa Fletcher, Matthew Love, Ruth Pe Benito, Samira Daswani, Sukhi Kaur, Kathyrn Tanenbaum, James Schaffer, Ali Hasan, Dilip Raj, Kumar Bharath Prabhu, Kiran Suryadevara, Ryan Callahan, Stuart L Goldberg
: 28 Background: Value based payment reforms which improve the outcome to cost ratio (paying for outcomes not for services) require detailed information on both elements. Although the digitalization of medicine via the EHR may facilitate data collection, the imprecise ICD9 and ICD10 schemas hinder analysis (eg: all breast cancers are ICD9 174.9). A more precise classification schema that accounts for biologic variances to allow analysis (and reduction) of treatment variances is needed...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28144977/changing-landscape-for-peritoneal-dialysis-optimizing-utilization
#7
Martin J Schreiber
The future growth of peritoneal dialysis (PD) will be directly linked to the shift in US healthcare to a value-based payment model due to PD's lower yearly cost, early survival advantage over in-center hemodialysis, and improved quality of life for patients treating their kidney disease in the home. Under this model, nephrology practices will need an increased focus on managing the transition from chronic kidney disease to end-stage renal disease (ESRD), providing patient education with the aim of accomplishing modality selection and access placement ahead of dialysis initiation...
February 1, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28141930/value-based-payment-in-implementing-evidence-based-care-the-mental-health-integration-program-in-washington-state
#8
Yuhua Bao, Thomas G McGuire, Ya-Fen Chan, Ashley A Eggman, Andrew M Ryan, Martha L Bruce, Harold Alan Pincus, Erin Hafer, Jürgen Unützer
OBJECTIVES: To assess the role of value-based payment (VBP) in improving fidelity and patient outcomes in community implementation of an evidence-based mental health intervention, the Collaborative Care Model (CCM). STUDY DESIGN: Retrospective study based on a natural experiment. METHODS: We used the clinical tracking data of 1806 adult patients enrolled in a large implementation of the CCM in community health clinics in Washington state. VBP was initiated in year 2 of the program, creating a natural experiment...
January 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28121611/getting-medical-directors-out-of-the-c-suite-and-closer-to-points-of-care
#9
Michael Schlosser
Physicians, more than anyone else, can influence peers when it comes to talking about evidence-based care, even when it runs counter to customary, but costly, practice patterns. The timing couldn't be better to put physicians in this leadership role because of the growing use of value-based payment models.
November 2016: Managed Care
https://www.readbyqxmd.com/read/28110618/expanding-ambulatory-care-pharmacy-residency-education-through-a-multisite-university-affiliated-model
#10
Sarah K Schweiss, Sarah M Westberg, Jean Y Moon, Todd D Sorensen
INTRODUCTION: As the health-care system evolves and shifts to value-based payment systems, there is a recognized need to increase the number of ambulatory care trained pharmacists. OBJECTIVE: The objective of this article is to describe the administrative structure of the University of Minnesota Postgraduate Year 1 (PGY1) Pharmacy Residency program and to encourage adoption of similar models nationally in order to expand ambulatory care residency training opportunities and meet the demand for pharmacist practitioners...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28103923/risk-adjustment-methods-for-all-payer-comparative-performance-reporting-in-vermont
#11
Karl Finison, MaryKate Mohlman, Craig Jones, Melanie Pinette, David Jorgenson, Amy Kinner, Tim Tremblay, Daniel Gottlieb
BACKGROUND: As the emphasis in health reform shifts to value-based payments, especially through multi-payer initiatives supported by the U.S. Center for Medicare & Medicaid Innovation, and with the increasing availability of statewide all-payer claims databases, the need for an all-payer, "whole-population" approach to facilitate the reporting of utilization, cost, and quality measures has grown. However, given the disparities between the different populations served by Medicare, Medicaid, and commercial payers, risk-adjustment methods for addressing these differences in a single measure have been a challenge...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28099106/costing-in-radiology-and-health-care-rationale-relativity-rudiments-and-realities
#12
Geoffrey D Rubin
Costs direct decisions that influence the effectiveness of radiology in the care of patients on a daily basis. Yet many radiologists struggle to harness the power of cost measurement and cost management as a critical path toward establishing their value in patient care. When radiologists cannot articulate their value, they risk losing control over how imaging is delivered and supported. In the United States, recent payment trends directing value-based payments for bundles of care advance the imperative for radiology providers to articulate their value...
February 2017: Radiology
https://www.readbyqxmd.com/read/28099059/family-physician-readiness-for-value-based-payments-does-ownership-status-matter
#13
Heidy Robertson-Cooper, Bradley Neaderhiser, Laura E Happe, Roy A Beveridge
Value-based payments are rapidly replacing fee-for-service arrangements, necessitating advancements in physician practice capabilities and functions. The objective of this study was to examine potential differences among family physicians who are owners versus employed with respect to their readiness for value-based payment models. The authors surveyed more than 550 family physicians from the American Academy of Family Physician's membership; nearly 75% had made changes to participate in value-based payments...
January 18, 2017: Population Health Management
https://www.readbyqxmd.com/read/28075077/making-sense-of-macra-part-2-value-based-payment-and-your-future
#14
Amy Mullins
No abstract text is available yet for this article.
January 2017: Family Practice Management
https://www.readbyqxmd.com/read/28072894/macra-easing-the-pain
#15
Amy Lynn Sorrel
Medicare's final MACRA regulations acquiesce to medicine's call for more flexibility for small practices in the first year but moves full speed ahead with the transition to value-based payment.
January 1, 2017: Texas Medicine
https://www.readbyqxmd.com/read/28072793/merit-based-incentive-payment-system-meaningful-changes-in-the-final-rule-brings-cautious-optimism
#16
Laxmaiah Manchikanti, Standiford Helm Ii, Aaron K Calodney, Joshua A Hirsch
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) eliminated the flawed Sustainable Growth Rate (SGR) act formula - a longstanding crucial issue of concern for health care providers and Medicare beneficiaries. MACRA also included a quality improvement program entitled, "The Merit-Based Incentive Payment System, or MIPS." The proposed rule of MIPS sought to streamline existing federal quality efforts and therefore linked 4 distinct programs into one. Three existing programs, meaningful use (MU), Physician Quality Reporting System (PQRS), value-based payment (VBP) system were merged with the addition of Clinical Improvement Activity category...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28069856/patient-hospital-experience-improved-modestly-but-no-evidence-medicare-incentives-promoted-meaningful-gains
#17
Irene Papanicolas, José F Figueroa, E John Orav, Ashish K Jha
The Centers for Medicare and Medicaid Services (CMS) has played a leading role in efforts to improve patients' experiences with hospital care. Yet little is known about how much patient experience has changed over the past decade, and even less is known about the impact of CMS's most recent strategy: tying payments to performance under the Value-Based Purchasing (VBP) program. We examined trends in multiple measures of patient satisfaction in the period 2008-14. We found that patient experience has improved modestly at US hospitals-both those participating in the VBP program and others-with the majority of improvement concentrated in the period before the program was implemented...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28061965/report-of-the-acr-s-economics-committee-on-value-based-payment-models
#18
Giles W Boland, Lucille Glenn, Shlomit Goldberg-Stein, Saurabh Jha, Mark Mangano, Samir Patel, Kurt A Schoppe, David Seidenwurm, John Lohnes, Ezequiel Silva, Richard Abramson, Daniel J Durand, Laura Pattie, Pamela Kassing, Richard E Heller
A major outcome of the current health care reform process is the move away from unrestricted fee-for-service payment models toward those that are based on the delivery of better patient value and outcomes. The authors' purpose, therefore, is to critically evaluate and define those components of the overall imaging enterprise that deliver meaningful value to both patients and referrers and to determine how these components might be measured and quantified. These metrics might then be used to lobby providers and payers for sustainable payment solutions for radiologists and radiology services...
January 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27918757/outcome-measurement-in-value-based-payments
#19
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
#20
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
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