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Novel Care Delivery Systems

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25 papers 0 to 25 followers
Mark W Friedberg, Meredith B Rosenthal, Rachel M Werner, Kevin G Volpp, Eric C Schneider
IMPORTANCE: Published evaluations of medical home interventions have found limited effects on quality and utilization of care. OBJECTIVE: To measure associations between participation in the Northeastern Pennsylvania Chronic Care Initiative and changes in quality and utilization of care. DESIGN, SETTING, AND PARTICIPANTS: The northeast region of the Pennsylvania Chronic Care Initiative began in October 2009, included 2 commercial health plans and 27 volunteering small primary care practice sites, and was designed to run for 36 months...
August 2015: JAMA Internal Medicine
Hoangmai H Pham, Melissa Cohen, Patrick H Conway
No abstract text is available yet for this article.
October 22, 2014: JAMA: the Journal of the American Medical Association
Lara Goitein
No abstract text is available yet for this article.
December 2014: JAMA Internal Medicine
Sabrina M Chase, Benjamin F Crabtree, Elizabeth E Stewart, Paul A Nutting, William L Miller, Kurt C Stange, Carlos R Jaén
BACKGROUND: Current research on primary care practice redesign suggests that outside facilitation can be an important source of support for achieving substantial change. OBJECTIVES: To analyse the specific sequence of strategies used by a successful practice facilitator during the American Academy of Family Physicians' (AAFP) National Demonstration Project (NDP). METHODS: This secondary analysis describes a sequence of strategies used to produce change in family medicine practices attempting to adopt a new model of care...
February 2015: Family Practice
Cristiano Codagnone, Giuseppe Alessandro Veltri, Francisco Lupiáñez-Villanueva, Francesco Bogliacino
No abstract text is available yet for this article.
October 2014: Journal of Epidemiology and Community Health
Christine K Cassel, Robert S Saunders
No abstract text is available yet for this article.
August 27, 2014: JAMA: the Journal of the American Medical Association
Lena M Chen, Adam S Wilk, Jyothi R Thumma, John D Birkmeyer, Mousumi Banerjee
IMPORTANCE: Payments around episodes of inpatient surgery vary widely among hospitals. As payers move toward bundled payments, understanding sources of variation, including use of medical consultants, is important. OBJECTIVE: To describe the use of medical consultations for hospitalized surgical patients, factors associated with use, and practice variation across hospitals. DESIGN, SETTING, AND PARTICIPANTS: Observational retrospective cohort study of fee-for-service Medicare patients undergoing colectomy or total hip replacement (THR) between January 1, 2007, and December 31, 2010, at US acute care hospitals...
September 2014: JAMA Internal Medicine
Clemens S Hong, Melinda K Abrams, Timothy G Ferris
Many observers of U.S. health care are now convinced that improved management of the care of patients with complex, high-cost conditions is an essential part of the solution to our health care cost problem. Increasing evidence supports the use of specially trained, primary care–integrated,..
August 7, 2014: New England Journal of Medicine
Janice L Pringle, Annette Boyer, Mark H Conklin, Jesse W McCullough, Arnie Aldridge
Improving medication adherence across the health care system is an ingredient that is vital to improving patient outcomes and reducing downstream health care costs. The Pennsylvania Project, a large-scale community pharmacy demonstration study, evaluated the impact of a pharmacy-based intervention on adherence to five chronic medication classes. To implement the study, 283 pharmacists from a national community pharmacy chain were assigned to the intervention group. Collectively, they screened 29,042 patients for poor adherence risk and provided brief interventions to people with an elevated risk...
August 2014: Health Affairs
Sandeep Jauhar, David Battinelli
No abstract text is available yet for this article.
July 15, 2014: Annals of Internal Medicine
Ryan J Shaw, Jennifer R McDuffie, Cristina C Hendrix, Alison Edie, Linda Lindsey-Davis, Avishek Nagi, Andrzej S Kosinski, John W Williams
BACKGROUND: Changes in federal health policy are providing more access to medical care for persons with chronic disease. Providing quality care may require a team approach, which the American College of Physicians calls the "medical home." One new model may involve nurse-managed protocols. PURPOSE: To determine whether nurse-managed protocols are effective for outpatient management of adults with diabetes, hypertension, and hyperlipidemia. DATA SOURCES: MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, and CINAHL from January 1980 through January 2014...
July 15, 2014: Annals of Internal Medicine
Leif I Solberg, A Lauren Crain, Juliana O Tillema, Patricia L Fontaine, Robin R Whitebird, Thom J Flottemesch, Sarah Hudson Scholle, Benjamin F Crabtree
BACKGROUND: Little is known about the most important organizational factors and strategies for transforming primary care clinics into patient-centered medical homes (PCMHs), so we studied this in newly certified medical homes in Minnesota. METHODS: We collected the following information from the first 120 clinics serving adults to be certified: (1) a 105-item survey about the presence and function of practice systems now and 3 years ago; (2) standardized composite clinic performance measures for diabetes and cardiovascular disease; and (3) a 44-item survey about PCMH transformation derived from 31 qualitative interviews about barriers, facilitators, and change strategies with participants from 9 diverse clinics...
July 2014: Journal of the American Board of Family Medicine: JABFM
Erik J Lindbloom, Erika Ringdahl
BACKGROUND AND OBJECTIVES: Family medicine residency programs are challenged with balancing hospital-based training with a longitudinal primary care continuity experience. In response to the Preparing the Personal Physician for Practice (P4) Initiative, the University of Missouri (MU) Family Medicine Residency Program sought to increase the presence of its residents in their continuity clinic, ie, the patient-centered medical home (PCMH). While initially successful, these efforts encountered formidable barriers with the July 2011 duty hour regulations from the Accreditation Council for Graduate Medical Education (ACGME)...
June 2014: Family Medicine
James R Dunn
No abstract text is available yet for this article.
July 2014: Journal of Epidemiology and Community Health
Lisa M Kern, Alison Edwards, Rainu Kaushal
BACKGROUND: The patient-centered medical home (PCMH) model of primary care is being implemented widely, although its effects on quality are unclear. The PCMH typically involves electronic health records (EHRs), organizational practice change, and payment reform. OBJECTIVE: To compare quality of care provided by physicians in PCMHs with that provided by physicians using paper medical records and, separately, with that provided by physicians using EHRs without the PCMH (to determine whether effects were driven by EHRs)...
June 3, 2014: Annals of Internal Medicine
Peter Shin, Jessica Sharac
OBJECTIVE: Determine the factors that impact HIT use and MU readiness for community health centers (CHCs). BACKGROUND: The HITECH Act allocates funds to Medicaid and Medicare providers to encourage the adoption of electronic health records (EHR), in an effort to improve health care quality and patient outcomes, and to reduce health care costs. METHODS: We surveyed CHCs on their Readiness for Meaningful Use (MU) of Health Information Technology (HIT) and Patient Centered Medical Home (PCMH) Recognition, then we combined responses with 2009 Uniform Data System data to determine which factors impact use of HIT and MU readiness...
2013: Medicare & Medicaid Research Review
Karissa A Hahn, Martha M Gonzalez, Rebecca S Etz, Benjamin F Crabtree
The National Committee for Quality Assurance (NCQA) has promoted patient-centered medical home (PCMH) recognition among primary care practices since 2008 as a standard indicator of which practices have transformed into medical homes. A 40% PCMH adoption rate among a large national cohort of identified practices with innovative staffing (n = 131) calls into question whether the NCQA recognition process is truly transformative and patient-centered or simply another certificate to hang on the wall.
May 2014: Journal of the American Board of Family Medicine: JABFM
Benjamin D Sommers, Sharon K Long, Katherine Baicker
BACKGROUND: The Massachusetts 2006 health care reform has been called a model for the Affordable Care Act. The law attained near-universal insurance coverage and increased access to care. Its effect on population health is less clear. OBJECTIVE: To determine whether the Massachusetts reform was associated with changes in all-cause mortality and mortality from causes amenable to health care. DESIGN: Comparison of mortality rates before and after reform in Massachusetts versus a control group with similar demographics and economic conditions...
May 6, 2014: Annals of Internal Medicine
Kristin L Reiter, Jacqueline R Halladay, C Madeline Mitchell, Kimberly Ward, Shoou-Yih D Lee, Beat Steiner, Katrina E Donahue
Primary care organizations must transform care delivery to realize the Institute for Healthcare Improvement's Triple Aim of better healthcare, better health, and lower healthcare costs. However, few studies have considered the financial implications for primary care practices engaged in transformation. In this qualitative, comparative case study, we examine the practice-level personnel and nonpersonnel costs and the benefits involved in transformational change among 12 primary care practices participating in North Carolina's Improving Performance in Practice (IPIP) program...
March 2014: Journal of Healthcare Management / American College of Healthcare Executives
Farzad Mostashari, Darshak Sanghavi, Mark McClellan
No abstract text is available yet for this article.
May 14, 2014: JAMA: the Journal of the American Medical Association
2014-08-22 03:04:25
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