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"Value-based payment"

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https://www.readbyqxmd.com/read/28099106/costing-in-radiology-and-health-care-rationale-relativity-rudiments-and-realities
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#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/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
#10
(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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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...
January 2017: 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
#19
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
#20
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...
December 2016: Journal of Pediatric Surgery
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