Not Your Usual Suspects: Roles For State Agencies In PCMH Payment Reforms
The growth of multipayer patient centered medical home (PCMH) reform across the country, accelerated by the Affordable Care Act, offers the opportunity to widely transform the primary care delivery system. Recent Health Affairs research noted 17 multipayer PCMH initiatives had been launched since 2008; and with State Innovation Model (SIM) grants awarded to 39 states and territories, these numbers will grow — multipayer payment reform is a core requirement of SIM funding.
States have played a dominant role in multipayer PCMH initiatives with Medicaid agencies overwhelmingly providing the infrastructure and support, b...
Source: Health Affairs Blog - December 8, 2015 Category: Health Management Authors: Mary Takach and Ledia Tabor Tags: Costs and Spending Featured Hospitals Medicaid and CHIP Payment Policy Public Health Maine Montana Patient-Centered Medical Home Payment Reform States vaccines Vermont Source Type: blogs
A Usability Conundrum: Whether it is EHRs or Hospital Gowns, One Size Never Fits All…
By JEROME H CARTER, MD
Building clinical care systems that intimately support clinical work has to begin with the acknowledgement that clinicians perform many tasks within the context of a patient encounter, and those tasks very in type, number, and sequence. Everyone knows this. So, one might ask, if this is common knowledge, why are there so many problems with EHR usability? The answer is very simple. EHR systems are designed to be one-size-fits-all.
One-size-fits-all (OSFA) is such a fundamental precept of EHR design that no one even questions it. Instead, there is a pursuit of every possible means of fixing...
Source: The Health Care Blog - December 1, 2015 Category: Consumer Health News Authors: Simon Nath Tags: Tech Jerome H Carter Source Type: blogs
A Usability Conundrum: Whether it is EHRs or Hospital Gowns, One Size Never Fits All…
By JEROME H CARTER, MD
Building clinical care systems that intimately support clinical work has to begin with the acknowledgement that clinicians perform many tasks within the context of a patient encounter, and those tasks very in type, number, and sequence. Everyone knows this. So, one might ask, if this is common knowledge, why are there so many problems with EHR usability? The answer is very simple. EHR systems are designed to be one-size-fits-all.
One-size-fits-all (OSFA) is such a fundamental precept of EHR design that no one even questions it. Instead, there is a pursuit of every possible means of fixin...
Source: The Health Care Blog - November 30, 2015 Category: Consumer Health News Authors: Simon Nath Tags: THCB Jerome H Carter Source Type: blogs
‘Growth Clouds’ On The Horizon For Health Spending?
I was honored to work with the National Health Expenditures (NHE) Team in the CMS Office of the Actuary throughout 1995-2012, and I am honored again to have the opportunity to provide some thoughts on long-range spending trends in the U.S. Many health policy experts have referred to these accounts as the “gold standard” for comprehensive and authoritative information about the cost of health care in the United States, and the NHE Team’s articles on both the historical and projected NHE accounts routinely appear at the top of Health Affairs’ “most frequently read” list.
The current focus on the long history of t...
Source: Health Affairs Blog - November 23, 2015 Category: Health Management Authors: Richard Foster Tags: Costs and Spending Drugs and Medical Technology Featured Health Professionals Hospitals Medicaid and CHIP Medicare Payment Policy Aging Cadillac tax Nurses PCORI physician assistants Physicians States Source Type: blogs
Direct primary care is a social movement. And it faces the same challenges.
The emergence of direct primary care (DPC) has the characteristics of a social movement, defined as a “purposive and collective attempt of a number of people to change individuals or societal institutions and structures.”
Moreover, the DPC movement has thus far succeeded largely because it is based on a guiding set of strongly-held principles from which its founders have not wavered. The concept of direct primary care as a reordering of the incentives and priorities of doctors and patients away from those of third-party payers has attracted a large following among physicians and members of the public who laud it as ...
Source: Kevin, M.D. - Medical Weblog - November 20, 2015 Category: Journals (General) Authors: James Breen, MD Tags: Policy Primary care Source Type: blogs
Adding a Lawyer to the Health Care Team: Addressing Social Determinants through Medical-Legal Partnerships
By: Elizabeth Tobin-Tyler, JD, MA, assistant professor of family medicine, Warren Alpert Medical School, and assistant professor of health services, policy and practice, School of Public Health, Brown University
As a lawyer who has taught medical students for many years about the role of law and policy in health disparities and the social determinants of health, I am well acquainted with the question, “but what can I do about it?” What can a doctor do if a patient is being evicted or has her utilities shut off, lives in a house with mold that is exacerbating her child’s asthma, or is financially dependent on an abusi...
Source: Academic Medicine Blog - November 16, 2015 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective graduate medical education interprofessional education medical-legal partnership social determinants undergraduate medical education Source Type: blogs
Share our stories and let the world know that health is primary
The U.S. health care system is under intense pressure to change from volume to value. Primary care physicians must become the leaders our health system needs us to be: finding solutions to the problems that continue to plague this system. Costs continue to rise, access to physicians is quite limited in many locations, care often remains fragmented, and quality is uneven. To provide excellent care across the country and ensure that people in our nation are healthier, primary care physicians must be on the teams that decide what health care delivery, patient-centered care, quality improvement, cost-effective care, and provid...
Source: Kevin, M.D. - Medical Weblog - October 31, 2015 Category: Journals (General) Authors: Jay W. Lee, MD, MPH Tags: Physician Primary care Source Type: blogs
Who Is to Blame for Health Care’s Problems? A Tale of Two Narratives
By JEFF GOLDSMITH
What to do about the seemingly inexorable rise in health spending has been the central health policy challenge for two generations of health economists and policymakers. In 1965, before Medicare and Medicaid, health spending was about 5.8 percent of GDP. In 2013, it was nearly 18 percent. And GDPquadrupled during this same period.
Over the past 30 years, there are been two warring political narratives explaining health spending growth, with two different culprits and indicated remedies. At their cores, these narratives blame the main actors in the health care drama—patients and physicians—for rising ...
Source: The Health Care Blog - October 28, 2015 Category: Consumer Health News Authors: Simon Nath Tags: THCB Jeff Goldsmith Source Type: blogs
Moral Failure And Health Costs: Two Simplistic Spending Narratives
What to do about the seemingly inexorable rise in health spending has been the central health policy challenge for two generations of health economists and policymakers. In 1965, before Medicare and Medicaid, health spending was about 5.8 percent of GDP. In 2013, it was nearly 18 percent. And GDP quadrupled during this same period
Over the past 30 years, there are been two warring political narratives explaining health spending growth, with two different culprits and indicated remedies. At their cores, these narratives blame the main actors in the health care drama—patients and physicians—for rising costs.
The...
Source: Health Affairs Blog - October 27, 2015 Category: Health Management Authors: Jeff Goldsmith Tags: Costs and Spending Equity and Disparities Featured Health Professionals Hospitals Insurance and Coverage Long-term Services and Supports Medicare Payment Policy Population Health Public Health Affordable Care Act conservative phy Source Type: blogs
How a retirement community can be a model for primary care
Part of a series.
Readers of my posts know that I am a strong advocate for primary care and for granting the PCP added time per patient. Older patients in particular with both their many impairments and chronic illnesses need more time per visit. Here is an approach by a continuing care retirement community developer/manager to assure that the PCPs have adequate time for each resident, most of whom have multiple chronic illnesses. The program uses, in part, a Medicare Advantage plan to achieve its ends.
Older individuals have more health concerns with many more complex chronic illnesses along with impaired vision, hearing,...
Source: Kevin, M.D. - Medical Weblog - October 22, 2015 Category: Journals (General) Authors: Stephen C. Schimpff, MD Tags: Policy Primary care Source Type: blogs
We’d Be In The Dark Without AHRQ
Here at Health Affairs we take the policy relevance of our work very seriously. As the leading health policy journal in the country, with the highest impact factor in our field, we work assiduously to find, edit, and publish the best scholarship that helps policymakers do their job.
When we heard about threats to the Agency for Healthcare Research and Quality’s (AHRQ) future, we set out to understand how the loss of AHRQ would affect the nation’s understanding of critical health policy issues. The results caused us great concern.
While AHRQ contributes in many ways, we focused our analysis on the major data sources tha...
Source: Health Affairs Blog - October 15, 2015 Category: Health Management Authors: Alan Weil Tags: Health Professionals Once in a Weil Quality AHRQ Alan Weil health policy research policymakers Surveys Source Type: blogs
Thoughts on the Digital Health Gold Rush
The post below was originally published on Venture Valkyrie.
In 1998 I was forming my first venture fund with a focus on healthcare IT and healthcare services. It was an interesting time to be undertaking such a mission. The Internet boom was in full swing and the money was flooding away from healthcare. Few were yet talking about rising healthcare costs the disastrous state of healthcare errors, or the need to share data to improve the management of chronic disease, much less the operating efficiency of payers or providers. One seasoned VC, whose firm was in the process of laying off all of its healthcare partners in 1998...
Source: Disruptive Women in Health Care - October 13, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: HIT/Health Gaming Innovation Technology Source Type: blogs
This is what patient-centered family medicine looks like
I want to share a recent anecdote from my clinic that highlights how patient-centered family medicine is cost effective and simply good care for patients.
I saw Mr. F, a 75-year-old gentleman. Like many of my patients, he has a history of high blood pressure and obesity. He also had a heart attack in the past as well as two additional stents placed in his coronary arteries. I was seeing him in follow-up to his hospitalization. Given the patient-centered medical home (PCMH) model that Kaiser Permanente uses, I could easily pull up all the labs and notes from his hospitalization, as well as his cardiac catheterizatio...
Source: Kevin, M.D. - Medical Weblog - October 9, 2015 Category: Journals (General) Authors: Alex Mroszczyk-McDonald, MD Tags: Physician Primary care Source Type: blogs
Measuring What Matters In Primary Care
Editor’s Note: This is one of several posts Health Affairs Blog is publishing stemming from sessions at the June 2015 AcademyHealth Annual Research Meeting (ARM) in Minneapolis.
What Do We Mean By ‘Primary Care’
Numerous studies have confirmed the central role of excellent primary care to any health system. Yet how to define the presence of excellent primary care remains a challenge. A recent review found that five characteristics remain the “sine qua non” for primary care practice:
Accessible (first contact) care
Continuous care
Comprehensive care
Coordinated care
Accountable/whole-person care.
Each individual...
Source: Health Affairs Blog - October 6, 2015 Category: Health Management Authors: Eugene Rich and Ann O’Malley Tags: Costs and Spending Featured Health Professionals Hospitals Medicare Organization and Delivery Population Health Quality AcademyHealth 2015 ARM Access chronic conditions clinician productivity comprehensive care continuous care Source Type: blogs
MACRA: New Opportunities For Medicare Providers Through Innovative Payment Systems
Today, almost 60 million Americans are covered by Medicare — and 10,000 become eligible for Medicare every day.
For many years, Medicare was primarily a pure fee-for-service (FFS) payment system that paid health care providers based on the volume of services they delivered, not the value of those services. Over time, this contributed to increased costs with little improvement in the quality of care.
However, that system is changing as we work to improve our nation’s health care delivery system to ensure patients and their families receive the best care possible. And, we want to hear from you. Today, the Centers for...
Source: Health Affairs Blog - September 28, 2015 Category: Health Management Authors: Patrick H. Conway, Tim Gronniger, Hoangmai Pham, Kate Goodrich, Amy Bassano, JP Sharp, Alison Falb and Molly MacHarris Tags: Costs and Spending Featured Health Professionals Insurance and Coverage Long-term Services and Supports Medicaid and CHIP Medicare Organization and Delivery Payment Policy Population Health Alternative Payment Models fee-for-service Source Type: blogs
