How Should The Trump Administration Handle Medicare ’s New Bundled Payment Programs?

Conclusion The Department of Health and Human Services has several options for addressing Secretary Price’s prior objections to the hospital-at-risk structure of the CJR and EPM models that could maintain the integrity of these payment reform initiatives. In our view, however, the Department does not have a good alternative to the mandatory structure used for CJR and EPM that could preserve the integrity of the models tests and the scope of their potential impact. Making these models optional would be a severe blow to efforts to use bundled payments to improve care delivery in orthopedics and cardiac care, and to the chances for bringing bundled payments to scale nationally in the coming years. Note 1 The prospective payments systems Medicare uses for inpatient and outpatient services are arguably bundled payments relative to older payment arrangements based on individual items and services. For purposes of this paper, however, we focus on arrangements that span an entire episode of care over a period of time measured in months rather than days and that cover the services of multiple providers of care.
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Costs and Spending Featured Medicare Quality bundled payment Bundled Payments for Care Improvement Initiative CMS Innovation Center Comprehensive Care for Joint Care Model Episode Payment Model oncology care model Seema Varma tom pri Source Type: blogs

Related Links:

Publication date: Available online 20 February 2020Source: Seminars in Cancer BiologyAuthor(s): Licia Iacoviello, Marialaura Bonaccio, Giovanni de Gaetano, Maria Benedetta DonatiAbstractBreast cancer is the leading cause of death in women aged 20 to 50 years, with some geographical difference. The yearly incidence of the disease is increasing while the related mortality is steadily decreasing. Breast cancer is associated not only with specific hormones or factors related with reproduction, but mostly to more general environmental factors, linked to socioeconomic conditions and lifestyles (smoking, stress, physical exercise...
Source: Seminars in Cancer Biology - Category: Cancer & Oncology Source Type: research
Conclusion CAS in maintenance hemodialysis patients may be feasible and effective for the prevention of stroke with proper case selection, appropriate technique and strict perioperative management. The most common causes of death during the follow-up of maintenance hemodialysis patients were diseases other than stroke. PMID: 32062623 [PubMed - in process]
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
CONCLUSIONS: In this population-based study, aromatase inhibitors were associated with increased risks of heart failure and cardiovascular mortality compared with tamoxifen. There were also trends toward increased risks, although nonsignificant, of myocardial infarction and ischemic stroke. The increased risk of cardiovascular events associated with aromatase inhibitors should be balanced with their favorable clinical benefits compared with tamoxifen. PMID: 32065766 [PubMed - in process]
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
Type 2 diabetes (T2D) is a metabolic disorder of insulin resistance — a reduced sensitivity to the action of insulin — which leads to high blood sugar, or hyperglycemia. Approximately 12% of American adults have T2D, and more than one-third of Americans have prediabetes, a precursor to T2D. This is a major public health concern, as T2D dramatically increases risk for heart disease, including heart attacks, atrial fibrillation, and heart failure. The development and progression of T2D is affected by many factors. Some, such as a person’s race/ethnicity, age, and gender cannot be modified. Others, including...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Diabetes Exercise and Fitness Healthy Eating Heart Health Source Type: blogs
Discussion of the Evolutionary Genetics of Aging Thymic Involution Contributes to Immunosenescence and Inflammaging The Potential for Exosome Therapies to Treat Sarcopenia Correlations of Mitochondrial DNA Copy Number and Epigenetic Age Measures Evidence for PASK Deficiency to Reduce the Impact of Aging in Mice The Aging Retina, a Mirror of the Aging Brain Evidence for Loss of Capillary Density to be Important in Heart Disease Aspects of Immune System Aging Proceed More Rapidly in Men Deacetylation of the NLRP3 Inflammasome as a Way to Control Chronic Inflammation Transplantation of Senescent Cells is an ...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
In conclusion, MIAT was frequently overexpressed in CCA. MIAT contributed to the growth of CCA cells by targeting miR-551b-3p/CCND1 axis. PMID: 32064660 [PubMed - as supplied by publisher]
Source: Clinical and Experimental Pharmacology and Physiology - Category: Drugs & Pharmacology Authors: Tags: Clin Exp Pharmacol Physiol Source Type: research
Abstract Heart disease (especially myocardial infarction (MI)) and cancer are major causes of death. Recently, aptasensors with the applying of different nanostructures have been able to provide new windows for the early and inexpensive detection of these deadly diseases. Early, inexpensive, and accurate diagnosis by portable devices, especially aptasensors can increase the likelihood of survival as well as significantly reduce the cost of treatment. In this review, recent studies based on the designed aptasensors for the diagnosis of these diseases were collected, ordered, and reviewed. The biomarkers for the dia...
Source: Biosensors and Bioelectronics - Category: Biotechnology Authors: Tags: Biosens Bioelectron Source Type: research
Telomerase gene therapy is considered in some quarters to be a viable treatment for aging. Telomeres are the caps of repeated DNA sequences at the ends of chromosomes. They are an important part of the mechanism limiting the number of times that somatic cells in the body can divide, the Hayflick limit. A little telomere length is lost with each cell division, and short telomeres trigger cellular senescence or programmed cell death, halting replication. Stem cell populations use telomerase to lengthen their telomeres and thus self-renew to provide a continual supply of new somatic daughter cells with long telomeres to repla...
Source: Fight Aging! - Category: Research Authors: Tags: Medicine, Biotech, Research Source Type: blogs
Medical research drives innovation and improves outcomes. In cardiology, advances in diagnosis, prevention, and treatment reduced the 30-day mortality from acute myocardial infarction from 20% to 12.4% between 1995 and 2014. Similarly, for women diagnosed with breast cancer, 5-year survival has increased from 74% to 88.5% over the past 4 decades in parallel with advances in diagnosis and targeted therapy, including chemotherapeutic regimens such as cyclophosphamide, methotrexate, and fluorouracil (CMF), trastuzumab, and aromatase inhibiors.
Source: JAMA - Journal of the American Medical Association - Category: General Medicine Source Type: research
The authors of this open access review walk through some of the evidence for delivery of exosomes, such as those derived from stem cells, to be a basis for treating sarcopenia. Sarcopenia is the progressive loss of muscle mass and strength that takes place with aging. While a fair degree of sarcopenia is preventable, being the consequence of an age of comfort, leisure, and too little exercise, the rest of it is still inevitable absent some way to interfere in the mechanisms of aging that disrupt muscle tissue maintenance. The delivery of cell signals encapsulated in exosomes might be capable of forcing muscle stem cells in...
Source: Fight Aging! - Category: Research Authors: Tags: Daily News Source Type: blogs
More News: Academies | Blogging | Cancer | Cancer & Oncology | Cardiology | Cardiovascular & Thoracic Surgery | Chemotherapy | Emergency Medicine | Health Insurance | Health Management | Health Medicine & Bioethics Commentators | Heart | Heart Attack | History of Medicine | Hospital Management | Insurance | Medicaid | Medicare | Nurses | Nursing | Orthopaedics | Physical Therapy | Politics | Rehabilitation | Statistics