On Moving the Physician Movement Forward
By RICHARD L. REECE, MD
There are always two parties, the party of the Past, and the party of the Future. The Establishment and the Movement.
— Ralph Waldo Emerson (1903-1882), Notes on Life and Letters of New England
On July 20-26, 2015, a new physician organization, the United Physicians and Surgeons (UPSA), held a conference, dubbed the Summit at the Summit, in Keystone, Colorado.
The conference featured over 40 speakers. Speakers represented many physicians and physician organizations, both bearing workable innovative ideas. The conference was designed to restore physician autonomy, protect the patient-physician ...
Source: The Health Care Blog - September 1, 2015 Category: Consumer Health News Authors: Simon Nath Tags: THCB American Medical Association Obamacare Physicians Ralph Waldo Emerson Richard L. Reece United Physician and Surgical Association Source Type: blogs
The Medicaid Expansion Experience In Michigan
As of July 2015, 30 states and the District of Columbia have expanded or planned to expand Medicaid under the Affordable Care Act (ACA). Michigan is one of only six states with a fully Republican-led state government to expand the program. The Healthy Michigan Plan (Michigan’s version of the Medicaid expansion) went into effect on April 1, 2014. One year into this expansion, Michigan’s experience has confirmed some expectations but vastly exceeded others.
Michigan’s Path To Expansion
In late 2012, Republican Governor Rick Snyder expressed initial concerns that the state would not have enough health care providers to ...
Source: Health Affairs Blog - August 28, 2015 Category: Health Management Authors: Marianne Udow-Phillips, Kersten Burns Lausch, Erin Shigekawa, Richard Hirth and John Ayanian Tags: Equity and Disparities Following the ACA Medicaid and CHIP Population Health Public Health CMS Healthy Michigan Plan Republican Rick Snyder Source Type: blogs
CMS Proposed Fee Schedule for 2016 Overview
As we previously published, on July 15, 2015, the Centers for Medicare & Medicaid Services (CMS) published its proposed rule to update the Medicare physician fee schedule for 2016. Among the many proposals, CMS seeks comment on whether to add Open Payments data to its “Physician Compare” website. Additionally, the proposal includes funding previously controversial advance care planning codes, the first regulations implementing the post-SGR legislation, Stark Law exceptions, and more.
Comments are due no later than 5 p.m. on September 8, 2015. You may submit electronic comments on this regulation to www.regulations....
Source: Policy and Medicine - August 21, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
Breaking The Fee-For-Service Addiction: Let’s Move To A Comprehensive Primary Care Payment Model
This article is part of a series of blog posts by leaders in health and health care who participated in Spotlight Health from June 25-28, the opening segment of the Aspen Ideas Festival. This year’s theme was Smart Solutions to the World’s Toughest Challenges. Stayed tuned for more.
With much fanfare earlier this year, the Obama administration announced an aggressive goal to process half of all Medicare payments by the end of 2018 through alternative payment models as opposed to traditional fee-for-service (FFS). Primary care is one of the most urgent sectors needing such payment reform. As Bob Berenson succinct...
Source: Health Affairs Blog - August 17, 2015 Category: Health Management Authors: Rushika Fernandopulle Tags: Costs and Spending Equity and Disparities Featured Health Professionals Hospitals Long-term Services and Supports Medicare Organization and Delivery Payment Policy Population Health Quality ACOs fee-for-service Grameen America Source Type: blogs
Advancing Integrated Behavioral Health Care In Texas And Maine: Lessons From The Field
Conclusion
Texas and Maine are among the many states in which foundations have supported the establishment and spread of integrated care through grants, augmented with learning communities, policy advocacy, and evaluation. The evaluations related to initiatives that promote integrated care already reveal critical elements that facilitate successful integrated care and will develop more refined lessons as integrated care becomes the standard of care across America. Sharing lessons learned across states can accelerate the spread of integrated care until it becomes the standard of care.
Related Resources
Cohen, Deborah. Addre...
Source: Health Affairs Blog - August 11, 2015 Category: Health Management Authors: Becky Hayes Boober and Rick Ybarra Tags: GrantWatch Health Professionals Organization and Delivery Behavioral Health Health Care Delivery Health Philanthropy integrated care Maine Mental Health Primary Care Texas Workforce Source Type: blogs
This is what a successful direct primary care practice looks like
I recently attended (and spoke at) the Concierge Medicine Assembly in Atlanta. My role was to give the perspective of a “successful” direct primary care (DPC) practice. This being the second such conference in three weeks, I’ve learned that my panel of 600+ patients and survival for two and a half years puts me in the higher ranks of solo DPC practices. The Atlanta conference was actually a combination conference, catering to both the more recent “direct care” style of practices like mine, and the more traditional “concierge” practices, with their higher fees and smaller pa...
Source: Kevin, M.D. - Medical Weblog - August 10, 2015 Category: Journals (General) Authors: Rob Lamberts, MD Tags: Physician Primary care Source Type: blogs
A More Cohesive Home: Integrating Primary And Palliative Care For Seriously Ill Patients
Treatment for Mr. M’s advanced heart failure was no longer extending or improving his life. He was becoming increasingly short of breath and confused -and hospital stays provided only short-term relief. Mr. M’s cardiologist contacted Dr. P, his long-time primary care physician, to initiate a discussion about his goals of care. Dr. P met with Mr. M and his family at their home. Mr. M was adamant that he would rather spend time with his family than go to the hospital again. Dr. P referred Mr. M to hospice and collaborated with hospice nurses to manage his pain and breathlessness. Mr. M later died peacefully a short while...
Source: Health Affairs Blog - August 3, 2015 Category: Health Management Authors: Ravi Parikh, Anya Lepp and Russell Phillips Tags: Equity and Disparities Health Professionals Long-term Services and Supports Organization and Delivery Population Health Quality Dying in America End-of-Life Care integrated care Palliative Care patient-centered medical homes Ravi Par Source Type: blogs
Health Affairs Web First: Michigan Medicaid Expansion Yields Primary Care Availability
This study, also to appear in the August issue of Health Affairs, was supported by the Blue Cross Blue Shield of Michigan Foundation and the Robert Wood Johnson Foundation.
Tipirneni, Hayward, Lichtenstein, Reamer, and Davis are affiliated with the University of Michigan, in Ann Arbor; Rhodes is with the University of Pennsylvania, in Philadelphia. (Source: Health Affairs Blog)
Source: Health Affairs Blog - July 22, 2015 Category: Health Management Authors: Lucy Larner Tags: Costs and Spending Elsewhere@ Health Affairs Equity and Disparities Insurance and Coverage Medicaid and CHIP Quality ACA Blue Cross Blue Shield of Michigan Foundation HHS Primary Care RWJF Web First Source Type: blogs
We May Already Know How To Reduce The High Cost Of Covering New Medicaid Enrollees
Last week, the Centers for Medicare and Medicaid Services’ independent Office of the Actuary released its 2014 Actuarial Report on the Financial Outlook for Medicaid.
Unlike previous years, this annual report is making headlines because the actuaries project that for 2014 the newly eligible Medicaid expansion population will have costs greater than the non-newly eligible Medicaid population. Continue on to the next paragraph of the report and the actuaries write that a major contributor to this increased cost projection is that states anticipated and, in their managed care contracts, accounted for high first-year costs ...
Source: Health Affairs Blog - July 20, 2015 Category: Health Management Authors: Emma Sandoe Tags: Costs and Spending Equity and Disparities Featured Medicaid and CHIP Organization and Delivery Payment Policy Population Health Public Health ACA Care coordination Coverage Emma Sandoe Enrollment Health Care Coverage Initiative Source Type: blogs
To Reduce Unnecessary Care, Choosing Wisely Moves from Awareness to Implementation
In 2012 the ABIM Foundation launched the Choosing Wisely campaign with the goal of kick-starting an important and needed national conversation about unnecessary health care tests and procedures. A pervasive and persistent problem in our health care system, unnecessary care was estimated by the Institute of Medicine to amount to $750 billion a year—roughly 30 percent of health care spending—and was projected to keep growing.
Since then, Choosing Wisely has grown precipitously, adding more than 100 new partners and evolving its approach to make a lasting impact. Most recently, through the support of grants from the Rober...
Source: Health Affairs Blog - July 1, 2015 Category: Health Management Authors: Daniel Wolfson and Susan Mende Tags: Costs and Spending Drugs and Medical Technology GrantWatch Health Professionals Quality Choosing Wisely Consumers Effectiveness Health Philanthropy Physicians Source Type: blogs
Tackling Medicaid In Massachusetts
Editor’s note: This post is part of a series stemming from the Third Annual Health Law Year in P/Review event held at Harvard Law School on Friday, January 30, 2015. The conference brought together leading experts to review major developments in health law over the previous year, and preview what is to come. A full agenda and links to video recordings of the panels are here.
The Affordable Care Act (ACA) provides a number of tools to address longstanding problems in our fragmented health care system. At the national level, the Centers for Medicare and Medicaid Services (CMS) are redefining Medicare through initiative...
Source: Health Affairs Blog - June 22, 2015 Category: Health Management Authors: Jeffrey Sánchez Tags: Costs and Spending Featured Insurance and Coverage Medicaid and CHIP Medicare Organization and Delivery Payment Policy ACA CMS DSRIP legislation MassHealth SIM Initiative States Source Type: blogs
Nature And Nurture: What’s Behind the Variation In Recent Medical Home Evaluations?
Recent evaluations of two regional medical home pilots (i.e., efforts to improve the capabilities and performance of primary care practices) within the Pennsylvania Chronic Care Initiative (PACCI) have produced differing results.
In the southeast region of the state, the intervention was associated with improvements in diabetes care, but no changes in other measures of quality, utilization, or costs relative to comparison practices. By contrast, the northeast region’s intervention was associated with favorable changes, relative to comparison practices, in a wider array of quality measures as well as reductions in rates o...
Source: Health Affairs Blog - June 19, 2015 Category: Health Management Authors: Mark Friedberg, Connie Sixta and Michael Bailit Tags: Featured Health Professionals Hospitals Long-term Services and Supports Organization and Delivery Population Health Quality AHRQ Chronic Care Commonwealth Fund EHRs medical homes NCQA Patient-Centered Medical Home Pennsylvania Source Type: blogs
From the People Who Brought You ACOs: A New Model For Healthcare Transformation
By FARZAD MOSTASHARI, MD
When my co-founder Mat Kendall and I launched Aledade last June, I wrote that our mission was simple: empowering doctors on the front lines of medicine to put them back in control of health care—and rewarding them for the unique value they create. Today, a few days shy of our first birthday, we are announcing that we have raised $30 million in a funding round led by ARCH Venture Partners, and including our Series A funding partners at Venrock. This investment is a testament to the growing demand for our technology-enabled services, and to the rapid progress we have made in creating a platform for...
Source: The Health Care Blog - June 15, 2015 Category: Consumer Health News Authors: John Irvine Tags: THCB Accountable Care Organizations Source Type: blogs
Do higher primary care practice performance scores predict lower rates of emergency admissions for persons with serious mental illness? An analysis of secondary panel data
This study aimed to test whether or not better-quality primary care, as assessed by the SMI quality indicators measured routinely in the Quality and Outcomes Framework, is associated with lower rates of emergency hospital admissions for people with SMIs, for both mental and physical conditions and with higher rates of elective admissions for physical conditions in people with a SMI.
Report
Summary
Abstract (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - April 28, 2015 Category: UK Health Authors: The King's Fund Information & Knowledge Service Tags: Mental Health NHS measurement and performance Source Type: blogs
More Barbarians at the Gates: Private Equity Puts Primary Care in Play
There are still some idealistic physicians who enter primary care practice as a calling.The usual informal definition of primary care is care which is continuous, coordinated, comprehensive and compassionate. The official definition used by the American Academy of Family Physicians (AAFP) is:Primary care is that care provided by physicians specifically trained for and skilled in comprehensive first contact and continuing care for persons with any undiagnosed sign, symptom, or health concern (the 'undifferentiated' patient) not limited by problem origin (biological, behavioral, or social), organ system, or diagnosi...
Source: Health Care Renewal - April 26, 2015 Category: Health Management Tags: corporate physician primary care private equity You heard it here first Source Type: blogs
