The Journal of Ambulatory Care Management This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

ACTively Integrating Suicide Risk Assessment Into Primary Care Settings
Adequate evaluation and response to suicide risk require (i) awareness of need, (ii) comfort gathering key information, and (iii) ongoing training. A survey administered at 2 urban primary care settings in the process of implementing integrated care measured awareness, comfort, and training related to suicide risk assessment among 31 primary care providers (PCPs). Greater PCP comfort asking patients about psychological trauma was associated with more frequent engagement in safety planning with suicidal patients. Findings highlight the need for trauma-informed primary care while showcasing the importance of enhancing PCP tr...
Source: The Journal of Ambulatory Care Management - February 24, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Offsetting Patient-Centered Medical Homes Investment Costs Through Per-Member-Per-Month or Medicare Merit-based Incentive Payment System Incentive Payments
We examined potential offsets through commercial payer per-member-per-month (PMPM) payments and the Medicare Merit-based Incentive Payment System (MIPS) for a network that spent $4 818 260 over 4 years obtaining and renewing PCMH recognition for 57 practices. With PMPM payments of $3.37 to $8.98, “breakeven” requires that 2.4% to 6.4% of the network's 1645 commercially insured patients per physician be covered, while applying MIPS incentive payments of half the maximum available each year to the network's average 2016 Medicare reimbursement of $196 812 per physician showed they would exceed PCMH costs by 2022. (Source:...
Source: The Journal of Ambulatory Care Management - February 24, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

A Comment on Moving Towards Paying for Outcomes in Medicaid
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - February 24, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Paying for Outcomes in Medicaid: The Time Is Now
Medicaid can improve quality and reduce costs by adopting a transparent quality measurement system based on outcomes that will improve quality and reduce costs. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - February 24, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Medicaid's Enduring Role in the American Health Care System
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - February 24, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Commentary on “Moving Toward Paying for Outcomes in Medicaid”
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - February 24, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Moving Toward Paying for Outcomes in Medicaid
Medicaid can improve beneficiary health and help sustain its own future by embracing payment for outcomes. Good precedents exist from states such as Florida, Maryland, Minnesota, New York, Ohio, Pennsylvania, and Texas. Medicaid outcome measures include preventable admissions, readmissions, emergency department visits, and inpatient complications; early elective deliveries; infant and child mortality; patient-reported outcomes, satisfaction, and confidence; and reduction in low-value care. Criteria to prioritize initiatives include potential savings, availability of established models, impact on health status, and Medicaid...
Source: The Journal of Ambulatory Care Management - February 24, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

From the Editor
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - February 24, 2018 Category: Emergency Medicine Tags: From the Editor Source Type: research

The Impact of Hospital Health Network Affiliation on Discharge Communication Preferences of Primary Care Providers
Primary care physicians (PCPs) experience differential postdischarge access to electronic health records, depending upon affiliation with the discharging hospital's health network. To better understand whether this affiliation impacts discharge communication preferences, we surveyed a convenience sample of PCPs in and out of our hospital's health network. We also surveyed hospitalists and compared PCPs' and hospitalists' responses. We found that PCP discharge communication preferences differed by hospital health network affiliation. In addition, PCPs and hospitalists reported different expectations of responsibility for pe...
Source: The Journal of Ambulatory Care Management - January 1, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Rural Patients' and Primary Care Clinic Staffs' Perceptions of EHR Implementation: An Ethnographic Exploration
This focused ethnographic research study explores patients' and clinic staffs' experience of electronic health record (EHR) implementation in a small, independent, rural primary care practice. On the basis of participant observation of clinic staff, staff focus group, and patient interviews, results demonstrate that both patients and clinic staff have distrust and disconnect from technology. Yet, patients and clinic staff embrace patient-centered approaches and value team-based care. Understanding patients' and staffs' experience can facilitate the EHR implementation in the rural primary care setting and facilitate online ...
Source: The Journal of Ambulatory Care Management - January 1, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Cost Estimates for Designing and Implementing a Novel Team Care Model for Chronically Ill Patients
Little is known about the cost of implementing chronic care models. We estimate the human resource cost of implementing a novel team-based chronic care model “Champion,” at a large multispecialty group practice. We used activity-based costing to calculate costs from development through rollout and stabilization in 1 clinic with 12 000 chronic care patients. Data analyzed included Microsoft Outlook meeting metadata, supporting documents, and 2014 employee wages. Implementation took more than 29 months, involved 168 employees, and cost the organization $2 304 787. Payers may need to consider a mixed-payment model to supp...
Source: The Journal of Ambulatory Care Management - January 1, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Comparing Patient-Centered Medical Home Implementation in Urban and Rural VHA Clinics: Results From the Patient Aligned Care Team Initiative
Rural Veterans Health Administration (VHA) primary care clinics are smaller, have fewer staff, and serve more rural patients compared with urban VHA primary care clinics. This may lead to different challenges to implementation of the Patient-Centered Medical Home (PCMH) model, the Patient Aligned Care Team, in the VHAs' large integrated health system. In this cross-sectional observational study of 905 VHA primary clinics in the United States and Puerto Rico, we found overall PCMH implementation was greater in rural compared to urban primary care clinics. Urban-rural differences in PCMH implementation may largely be related...
Source: The Journal of Ambulatory Care Management - January 1, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Primary Care and the Hypertension Care Continuum in Brazil
This study provides estimates of hypertension prevalence, awareness, treatment, and control in Brazil and assesses how well different modes of primary care delivery achieve each of these outcomes. Over one-third of the Brazilian adult population had measured hypertension or prior diagnosis. Nearly 90% of these had recent contact with the health system, but only 65% were aware of their condition. Only 62% of these regularly sought care for hypertension, but of these 92% received treatment. Hypertension control was 33% overall, but increased to 57% among those who received all levels of care. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - January 1, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Brazilian Payment for Performance (PMAQ) Seen From a Global Health and Public Policy Perspective: What Does It Mean for Research and Policy?
This supplement of the Journal of Ambulatory Care Management on the Brazilian National Program for Improving Access and Quality of Primary Care (PMAQ) reveals a relevant gap in the Brazilian literature on pay for performance/PMAQ, and is therefore an opportunity to bring contributions from global health and public policy to the debate. We discuss the relevant gap in the light of developments in evaluation and policy analysis. We afterward present the state of knowledge regarding global health and public policy in pay for performance, giving attention to diverse themes, methods, types of analyses, theoretical contributions,...
Source: The Journal of Ambulatory Care Management - January 1, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research