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https://www.readbyqxmd.com/read/29451464/bundled-payment-for-bundles-of-joy
#1
Lola Butcher
Episode payments for maternity care, however, are particularly challenging for many reasons, including the fact that a full course of care starts with one patient and usually ends with at least two. Something needs to be done, because pregnancy, labor, and birth account for seven of the top 20 most expensive hospitalized conditions.
February 2018: Managed Care
https://www.readbyqxmd.com/read/29442297/a-single-center-cost-analysis-of-treating-primary-and-metastatic-brain-cancers-with-either-brain-laser-interstitial-thermal-therapy-litt-or-craniotomy
#2
Eric C Leuthardt, Jeff Voigt, Albert H Kim, Pete Sylvester
BACKGROUND: Brain laser interstitial thermal therapy (LITT) under magnetic resonance imaging (MRI) guidance has recently gained US clinical approval for the ablation of soft, neurological tissue. LITT is a minimally invasive alternative to craniotomy. OBJECTIVE: While safety and efficacy are the focus of most current LITT studies, it is unclear how acute care costs (inpatient care ± aftercare) of LITT compare to craniotomy in an academic medical center. Therefore, the purpose of this analysis is to examine these costs of using brain LITT under MRI guidance compared to craniotomy in complex anatomies...
March 2017: PharmacoEconomics Open
https://www.readbyqxmd.com/read/29419821/the-use-of-individual-provider-performance-reports-by-us-hospitals
#3
Joshua A Rolnick, Kira L Ryskina
Medicare reimbursement for hospitals is increasingly tied to performance. The use of individual provider performance reports offers the potential to improve clinical outcomes through social comparison, and isolated cases of clinical dashboard uses at specific institutions have been previously reported. However, little is known about overall trends in how hospitals use the electronic health record to track and provide feedback on provider performance. We used data from 2013 to 2015 from the American Hospital Association (AHA) Annual Survey Information Technology Supplement, which asked hospitals if they have used electronic data to create performance profiles...
February 7, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29403570/prospective-bundled-payments-in-a-changing-environment-the-experience-of-a-self-funded-state-sponsored-plan
#4
Frank H Lawler, Frank R Wilson, G Keith Smith, Lynn V Mitchell
Background: Healthcare reimbursement, which has traditionally been based on the quantity of services delivered, is currently moving toward value-based reimbursement-a system that addresses the quantity, quality, and cost of services. One such arrangement has been the evolution of bundled payments for a specific procedure or for an episode of care, paid prospectively or through post-hoc reconciliation. Objective: To evaluate the impact of instituting bundled payments that incorporate facility charges, physician fees, and all ancillary charges by the State of Oklahoma HealthChoice public employee insurance plan...
December 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/29398036/what-matters-after-sleeve-gastrectomy-patient-characteristics-or-surgical-technique
#5
Vikrom K Dhar, Dennis J Hanseman, Brad M Watkins, Ian M Paquette, Shimul A Shah, Jonathan R Thompson
BACKGROUND: The impact of operative technique on outcomes in laparoscopic sleeve gastrectomy has been explored previously; however, the relative importance of patient characteristics remains unknown. Our aim was to characterize national variability in operative technique for laparoscopic sleeve gastrectomy and determine whether patient-specific factors are more critical to predicting outcomes. METHODS: We queried the database of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program for laparoscopic sleeve gastrostomies performed in 2015 (n = 88,845)...
February 2, 2018: Surgery
https://www.readbyqxmd.com/read/29395312/society-of-gynecologic-oncology-clinical-outcomes-registry-from-small-beginnings-come-great-things
#6
REVIEW
Summer B Dewdney, Amy C Dancisak, Jason A Lachance, Edward C Grendys, Sean C Dowdy, Matthew Powell, John O Schorge
OBJECTIVE: Clinical registries within medical societies have demonstrated the capacity to promote quality improvement. Opportunities for well-designed data repositories could yield reliable national standards for informing reimbursement, determining adherence to care guidelines, maintaining board certification, and developing bundled payment models. Looking to the future, we set out to develop a gynecologic cancer registry serving the members of the Society of Gynecologic Oncology (SGO)...
January 30, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29369155/distribution-and-determinants-of-90-day-payments-for-multilevel-posterior-lumbar-fusion-a-medicare-analysis
#7
Nikhil Jain, Frank M Phillips, Safdar N Khan
STUDY DESIGN: A retrospective, economic analysis. OBJECTIVE: The objective of this article is to analyze the distribution of 90-day payments, sources of variation, and reimbursement for complications and readmissions for primary ≥3-level posterior lumbar fusion (PLF) from Medicare data. A secondary objective was to identify risk factors for complications. SUMMARY OF BACKGROUND DATA: Bundled payments represent a single payment system to cover all costs associated with a single episode of care, typically over 90 days...
January 23, 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29364553/assessing-relative-cost-of-complications-following-orthotopic-liver-transplant
#8
Neal Bhutiani, Christopher M Jones, Robert M Cannon, David Wei, Laura Goldstein, Sanjoy Roy, Prejesh Philips, Charles R Scoggins, Kelly M McMasters, Robert Cg Martin
INTRODUCTION: Peri-operative complications impose both a clinical and financial burden on patients and the healthcare system. This study sought to identify the frequency and economic impact of complications following orthotopic liver transplantation (OLT). METHODS: The Premier Perspective® Hospital Database was queried for patients undergoing OLT between 2008 and 2015. Complications were identified by ICD-9 code and grouped by complication type. Complication frequency as well as impact on clinical and economic outcomes was calculated...
January 24, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29357548/re-medicare-s-acute-care-episode-demonstration-effects-of-bundled-payments-on-costs-and-quality-of-surgical-care
#9
David F Penson
No abstract text is available yet for this article.
February 2018: Journal of Urology
https://www.readbyqxmd.com/read/29327034/the-rise-and-fall-of-mandatory-cardiac-bundled-payments
#10
Rishi K Wadhera, Robert W Yeh, Karen E Joynt Maddox
No abstract text is available yet for this article.
January 11, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29325725/who-goes-to-inpatient-rehabilitation-or-skilled-nursing-facilities-unexpectedly-following-total-knee-arthroplasty
#11
Alexander J Rondon, Timothy L Tan, Max R Greenky, Karan Goswami, Noam Shohat, Jessica L Phillips, James J Purtill
BACKGROUND: Inpatient rehabilitation facilities (IRFs) and skilled nursing facilities (SNFs) represent a significant portion of post-operative expenses of bundled payments for total knee arthroplasty (TKA). Although many surgeons no longer routinely send patients to IRFs or SNFs, some patients are unable to be discharged directly home. This study identified patient factors for discharge to post-acute care facilities with an institutional protocol of discharging TKA patients home. METHODS: A retrospective review of patients undergoing primary unilateral TKA at a single institution from 2012 to 2017 was performed...
December 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29318267/participation-and-dropout-in-the-bundled-payments-for-care-improvement-initiative
#12
Karen E Joynt Maddox, E John Orav, Jie Zheng, Arnold M Epstein
No abstract text is available yet for this article.
January 9, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29299473/economic-evaluation-of-different-suture-closure-methods-barbed-versus-traditional-interrupted-sutures
#13
REVIEW
Randa K Elmallah, Anton Khlopas, Mhamad Faour, Morad Chughtai, Arthur L Malkani, Peter M Bonutti, Martin Roche, Steven F Harwin, Michael A Mont
Healthcare systems are receiving increasing pressures from payers, such as the Centers for Medicare and Medicaid (CMS), to reduce the costs associated with procedures, and with the implementation of the Affordable Care Act, high costs are addressed through pay-for-performance programs. Thus, multiple areas of total knee arthroplasty (TKA) surgery are under scrutiny, including surgical times, material costs, and the costs of associated complications and readmissions. Suture type has been determined to be a factor that may influence closure times, as well as direct material costs...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29295772/differences-in-post-operative-outcome-between-conversion-and-primary-total-hip-arthroplasty
#14
Charles D Qin, Mia M Helfrich, David W Fitz, Mark A Oyer, Kevin D Hardt, David W Manning
BACKGROUND: The demand for conversion of prior hip surgery to total hip arthroplasty (conversion THA) is likely to increase as a function of increasing US hip fracture burden in addition to its application in managing other conditions. Thus, outcome analysis is warranted to better inform value-based reimbursement schemes in the era of bundled payments. METHODS: Via Current Procedural Terminology codes, the National Surgical Quality Improvement Project data files were queried for all patients who underwent primary THA and conversion of previous hip surgery to THA from 2005 to 2014...
November 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29275113/alternative-payment-models-should-risk-adjust-for-conversion-total-hip-arthroplasty-a-propensity-score-matched-study
#15
Alexander S McLawhorn, William W Schairer, Ran Schwarzkopf, David A Halsey, Richard Iorio, Douglas E Padgett
BACKGROUND: For Medicare beneficiaries, hospital reimbursement for nonrevision hip arthroplasty is anchored to either diagnosis-related group code 469 or 470. Under alternative payment models, reimbursement for care episodes is not further risk-adjusted. This study's purpose was to compare outcomes of primary total hip arthroplasty (THA) vs conversion THA to explore the rationale for risk adjustment for conversion procedures. METHODS: All primary and conversion THAs from 2007 to 2014, excluding acute hip fractures and cancer patients, were identified in the National Surgical Quality Improvement Program database...
December 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29273289/inpatient-consults-and-complications-during-primary-total-joint-arthroplasty-in-a-bundled-care-model
#16
Billy T Baumgartner, Vasili Karas, Beau J Kildow, Daniel J Cunningham, Mitchell R Klement, Cindy L Green, David E Attarian, Thorsten M Seyler
BACKGROUND: The Centers for Medicare and Medicaid Services (CMS) are implementing changes in hospital reimbursement models for total joint arthroplasty (TJA), moving to value-based bundled payments from the fee-for-service model. The purpose of this study is to identify consults and complications during the perioperative period that increase financial burden. METHODS: We combined CMS payment data for inpatient, professional, and postoperative with retrospective review of patients undergoing primary TJA and developed profiles of patients included in the Comprehensive Care for Joint Replacement bundle undergoing TJA...
November 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29223321/is-there-value-in-retrospective-90-day-bundle-payment-models-for-shoulder-arthroplasty-procedures
#17
Susan M Odum, Nady Hamid, Bryce A Van Doren, Leo R Spector
BACKGROUND: The Centers for Medicare & Medicaid Services Bundled Payments for Care Improvement (BPCI) initiative was implemented as part of the Affordable Care Act. We implemented a retrospective payment model 2 for a 90-day total shoulder arthroplasty (TSA) episode to assess the value of TSA BPCI at our private practice. METHODS: Expenditures and postacute event rates of 132 fee-for-service (FFS) patients who underwent a TSA operation between 2009 and 2012 were compared with 333 BPCI patients who had a TSA operation in 2015...
December 7, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29200351/risk-adjustment-may-lessen-penalties-on-hospitals-treating-complex-cardiac-patients-under-medicare-s-bundled-payments
#18
Adam A Markovitz, Chandy Ellimoottil, Devraj Sukul, Samyukta Mullangi, Lena M Chen, Brahmajee K Nallamothu, Andrew M Ryan
To reduce variation in spending, Medicare has considered implementing a cardiac bundled payment program for acute myocardial infarction and coronary artery bypass graft. Because the proposed program does not account for patient risk factors when calculating hospital penalties or rewards ("reconciliation payments"), it might unfairly penalize certain hospitals. We estimated the impact of adjusting for patients' medical complexity and social risk on reconciliation payments for Medicare beneficiaries hospitalized for the two conditions in the period 2011-13...
December 2017: Health Affairs
https://www.readbyqxmd.com/read/29194494/impact-of-bundled-payments-on-hip-fracture-outcomes-a-nationwide-population-based-study
#19
Yu-Chi Tung, Hsien-Yen Chang, Guann-Ming Chang
Objective: Establishing one price for all bundled services for a particular illness, which has become the key to healthcare reform efforts, is designed to encourage health professionals to coordinate their care for patients. Limited information is available, however, concerning whether bundled payments are associated with changes in patient outcomes. Nationwide longitudinal population-based data were used to examine the effect of bundled payments on hip fracture outcomes. Design: An interrupted time series design with a comparison group...
November 29, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29180193/defining-payments-associated-with-the-treatment-of-colorectal-cancer
#20
Faiz Gani, Marcelo Cerullo, Joseph K Canner, Alison Conca-Cheng, Alan E Harzman, Syed G Husain, William C Cirocco, Mark W Arnold, Amber Traugott, Fabian M Johnston, Timothy M Pawlik
BACKGROUND: While bundled payments aim to reduce variations in health care spending across the continuum of care, data reporting on variations in payments for privately insured patients undergoing treatment for colon cancer (CC) are lacking. The current study sought to characterize variations in payments received for the treatment of CC using a cohort of commercially insured patients. METHODS: Patients who underwent a colectomy for CC were identified using the MarketScan Database for 2010-2014...
December 2017: Journal of Surgical Research
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