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https://www.readbyqxmd.com/read/28323670/prevention-of-respiratory-complications-of-the-surgical-patient-actionable-plan-for-continued-process-improvement
#1
Katarina J Ruscic, Stephanie D Grabitz, Maíra I Rudolph, Matthias Eikermann
PURPOSE OF REVIEW: Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common. RECENT FINDINGS: Results of recent quantitative effectiveness studies and clinical trials provide a framework that helps develop center-specific treatment guidelines, tailored to minimize the risk of PRCs. The implementation of those protocols should be guided by a local, respected, and visible facilitator who leads proper implementation while inviting center-specific input from surgeons, anesthesiologists, and other perioperative stakeholders...
March 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28319968/four-strategies-for-succeeding-with-bundled-payments
#2
James J Pizzo, Debra L Ryan
No abstract text is available yet for this article.
September 2016: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28318861/medical-comorbidities-impact-the-episode-of-care-reimbursements-of-total-hip-arthroplasty
#3
Samuel Rosas, Karim G Sabeh, Leonard T Buller, Tsun Yee Law, Martin W Roche, Victor H Hernandez
BACKGROUND: Total hip arthroplasty (THA) costs are a source of great interest in the currently evolving health care market. The initiation of a bundled payment system has led to further research into costs drivers of this commonly performed procedure. One aspect that has not been well studied is the effect of comorbidities on the reimbursements of THA. The purpose of this study was to determine if common medical comorbidities affect these reimbursements. METHODS: A retrospective, level of evidence III study was performed using the PearlDiver supercomputer to identify patients who underwent primary THA between 2007 and 2015...
February 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28314695/a-systematic-review-of-cost-effective-treatment-of-postoperative-rotator-cuff-repairs
#4
REVIEW
Rebecca N Dickinson, John E Kuhn, Jamie L Bergner, Katherine H Rizzone
OBJECTIVE: The Bundled Payments for Care Improvement initiative combines payment of multiple services for episodes of care into 1 bundle. Rotator cuff repair is a likely candidate for future inclusion. The objective of this study was to determine cost-effective, high-quality postoperative rehabilitation dosing and cryotherapy for patients undergoing rotator cuff repair based on systematic review of the literature. METHODS: Systematic review of level I and level II articles was performed in PubMed, Cochrane Databases, and PEDro...
March 15, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28292629/the-5-clinical-pillars-of-value-for-total-joint-arthroplasty-in-a-bundled-payment-paradigm
#5
Kelvin Kim, Richard Iorio
BACKGROUND: Our large, urban, tertiary, university-based institution reflects on its 4-year experience with Bundled Payments for Care Improvement. We will describe the importance of 5 clinical pillars that have contributed to the early success of our bundled payment initiative. We are convinced that value-based care delivered through bundled payment initiatives is the best method to optimize patient outcomes while rewarding surgeons and hospitals for adapting to the evolving healthcare reforms...
February 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28291598/identifying-radiology-s-place-in-the-expanding-landscape-of-episode-payment%C3%A2-models
#6
Andrew B Rosenkrantz, Joshua A Hirsch, Bibb Allen, H Benjamin Harvey, Gregory N Nicola
The current fee-for-service system for health care reimbursement in the United Stated is argued to encourage fragmented care delivery and a lack of accountability that predisposes to insufficient focus on quality as well as unnecessary or duplicative resource utilization. Episode payment models (EPMs) seek to improve coordination by linking payments for all services related to a patient's condition or procedure, thereby improving quality and efficiency of care. The CMS Innovation Center has implemented a broadening array of EPMs...
March 10, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28277258/continuous-versus-single-shot-brachial-plexus-block-and-their-relationship-to-discharge-barriers-and-length-of-stay
#7
Matthew Thompson, Robert Simonds, Bryce Clinger, Kristen Kobulnicky, Adam P Sima, Laura Lahaye, N Douglas Boardman
BACKGROUND: Brachial plexus block has been associated with improved pain control and decreased length of stay in patients undergoing upper extremity arthroplasty. Continuous delivery is associated with a shorter length of stay; however, comparisons to single-shot delivery in this setting are scarce. As the paradigm shifts to outpatient arthroplasty in the era of bundled payments, there exists a strong impetus to identify the most effective mode of analgesia associated with the least risk to patients...
October 26, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28263698/population-health-research-early-description-of-the-organizational-shift-toward-population-health-management-and-defining-a-vision-for-leadership
#8
Kristi L Caldararo, David B Nash
As health care delivery systems adapt to the changing marketplace, many struggle to define a clear strategy that will prove successful in managing the health of entire populations. The federal government continues to put increasing pressure on organizations to shift away from the traditional way of delivering episodic care and move toward managing populations as a whole-before, during, and after a patient presents in a health care facility. Private payers have begun to follow suit as risk-based payer contracts and bundled payment models become increasingly popular...
March 6, 2017: Population Health Management
https://www.readbyqxmd.com/read/28239220/incentivizing-cost-effective-reductions-in-hospital-readmission-rates
#9
James C Cox, Vjollca Sadiraj, Kurt E Schnier, John F Sweeney
The recent regulatory changes enacted by the Centers for Medicare and Medicaid Services (CMS) have identified hospital readmission rates as a critical healthcare quality metric. This research focuses on the utilization of pay-for-performance (P4P) mechanisms to cost effectively reduce hospital readmission rates and meet the regulatory standards set by CMS. Using the experimental economics laboratory we find that both of the P4P mechanisms researched, bonus and bundled payments, cost-effectively meet the performance criteria set forth by CMS...
November 2016: Journal of Economic Behavior & Organization
https://www.readbyqxmd.com/read/28224191/predicting-the-post-operative-length-of-stay-for-the-orthopaedic-trauma-patient
#10
Deepak Chona, Nikita Lakomkin, Catherine Bulka, Idine Mousavi, Parth Kothari, Ashley C Dodd, Michelle S Shen, William T Obremskey, Manish K Sethi
PURPOSE: Length of stay (LOS) is a major driver of cost and quality of care. A bundled payment system makes it essential for orthopaedic surgeons to understand factors that increase a patient's LOS. Yet, minimal data regarding predictors of LOS currently exist. Using the ACS-NSQIP database, this is the first study to identify risk factors for increased LOS for orthopaedic trauma patients and create a personalized LOS calculator. METHODS: All orthopaedic trauma surgery between 2006 and 2013 were identified from the ACS-NSQIP database using CPT codes...
February 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28214255/clinical-outcomes-and-90-day-costs-following-hemiarthroplasty-or-total-hip-arthroplasty-for-hip-fracture
#11
Christine I Nichols, Joshua G Vose, Ryan M Nunley
BACKGROUND: In the era of bundled payments, many hospitals are responsible for costs from admission through 90 days postdischarge. Although bundled episodes for hip fracture will have a separate target price for the bundle, little is known about the 90-day resource use burden for this patient population. METHODS: Using Medicare 100% Standard Analytic Files (2010-2014), we identified patients undergoing hemiarthroplasty or total hip arthroplasty (THA). Patients were aged 65 and older with admitting diagnosis of closed hip fracture, no concurrent fractures of the lower limb, and no history of hip surgery in the prior 12 months baseline...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28212250/economic-impact-of-nonmodifiable-risk-factors-in-orthopaedic-fracture-care-is-bundled-payment-feasible
#12
Siddharth A Mahure, Lorraine Hutzler, Richard S Yoon, Joseph A Bosco
OBJECTIVES: To determine whether bundled payments are feasible in the orthopaedic fracture setting, and the potential economic implications of this reimbursement structure. DESIGN: Prospective. SETTING: Multicenter. PATIENTS/PARTICIPANTS: Between 2004 and 2014, a total of 23,643 operatively treated patients with fracture and 544,067 patients with total joint arthroplasty (TJA) were identified using the New York State Statewide Planning and Research Cooperative System database...
March 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28199248/four-strategies-for-succeeding-with-bundled-payments
#13
James J Pizzo, Debra L Ryan
No abstract text is available yet for this article.
September 2016: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28152947/measuring-value-in-bundled-payments-for-head-and-neck-cancer
#14
Tracy E Spinks, Alexis B Guzman, Randal S Weber, Ehab Y Hanna, Amy Clark Hessel, Beth Michelle Beadle, Kate A Hutcheson, James Incalcaterra, Nancy M Wood, Delrose Jones, Thomas W Feeley
11 Background: Value, defined as outcomes relative to costs, cannot be improved without rigorous long-term measurement. To assess value within a bundled payment pilot for head and neck cancer, we aim to generate timely, patient-centered outcomes and robust, near-real time financial tracking (Porter and Teisberg, Redefining health care. Creating value-based competition on results; Harvard Business School Press, 2006). METHODS: Clinical and quality experts created an outcome measure set for head and neck cancer, using a three-tiered outcomes hierarchy from Michael Porter of Harvard Business School as a framework...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152834/assessing-the-quality-of-chemotherapy-in-an-episode-based-funding-model-in-ontario
#15
Vicky Simanovski, Huma Tariq, Carlin Lalonde, Irene Blais, William K Evans
1 Background: On April 1, 2014, the delivery of systemic treatment in Ontario transitioned to an episode-based funding model, which provides bundled payments for a full course of therapy delivered with adjuvant/curative intent and a monthly bundled payment for palliative intent. Disease Site Teams have defined treatment options and "best practice" for each funded adjuvant/curative regimen. METHODS: The utilization of treatment according to disease and intent was analyzed for 35 systemic treatment facilities in Ontario, comparing actual practice (AP) with "best practice" (BP) (dose/schedule/cycle number), for common adjuvant/curative regimens...
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
#16
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/28121537/cms-wants-to-remodel-cancer-payment-care
#17
Thomas Reinke
CMS' Oncology Care Model program is bringing bundled payments to cancer care. With drug costs so high and hard to control, the 195 participating practices will have to figure out other ways to control costs if they want to beat financial benchmarks and earn bonuses.
October 2016: Managed Care
https://www.readbyqxmd.com/read/28111178/risk-factors-for-and-timing-of-adverse-events-after-total-shoulder-arthroplasty
#18
Andrew J Lovy, Aakash Keswani, Christina Beck, James E Dowdell, Bradford O Parsons
BACKGROUND: Total shoulder arthroplasty (TSA) is a likely target for future bundled payment initiatives, necessitating accurate preoperative risk stratification. The purpose of this study was to identify risk factors for unplanned readmission and severe adverse events, to risk stratify TSA patients based on these risk factors, and to assess timing of complications after TSA. METHODS: Data were collected from patients undergoing TSA from 2009 to 2014 in the American College of Surgeons National Surgical Quality Improvement Program...
January 19, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28108823/which-clinical-and-patient-factors-influence-the-national-economic-burden-of-hospital-readmissions-after-total-joint-arthroplasty
#19
Steven M Kurtz, Edmund C Lau, Kevin L Ong, Edward M Adler, Frank R Kolisek, Michael T Manley
BACKGROUND: The Affordable Care Act of 2010 advanced the economic model of bundled payments for total joint arthroplasty (TJA), in which hospitals will be financially responsible for readmissions, typically at 90 days after surgery. However, little is known about the financial burden of readmissions and what patient, clinical, and hospital factors drive readmission costs. QUESTIONS/PURPOSES: (1) What is the incidence, payer mix, and demographics of THA and TKA readmissions in the United States? (2) What patient, clinical, and hospital factors are associated with the cost of 30- and 90-day readmissions after primary THA and TKA? (3) Are there any differences in the economic burden of THA and TKA readmissions between payers? (4) What types of THA and TKA readmissions are most costly to the US hospital system? METHODS: The recently developed Nationwide Readmissions Database from the Healthcare Cost and Utilization Project (2006 hospitals from 21 states) was used to identify 719,394 primary TJAs and 62,493 90-day readmissions in the first 9 months of 2013 based on International Classification of Diseases, 9th Revision, Clinical Modification codes...
January 20, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28107299/information-sharing-best-practices-that-support-transitions-in-care
#20
Jane Cobler, Grace Wang, Chris Stout, Jeff Piejak, Mary F Rodts
Care coordination that improves patient care and patient outcomes is becoming increasingly necessary as bundled payment programs are developed. Rather than looking at each aspect of the patient's care, the entire care continuum from preoperative preparation through completion of the episode will become the norm. The length of the episode of care may be 30 days or as long as 90 days. The transition to different care providers during that episode requires information sharing. This is best accomplished by a technology platform that allows for real-time information sharing...
January 2017: Orthopaedic Nursing
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