Examining Provider Bias In Health Care Through Implicit Bias Rounds
In 2015, a 27-year-old patient presented to our primary care resident practice in intractable pain, having been recently discharged from the hospital following surgery for a complex shoulder fracture. The orthopedic surgeons evaluated him the day before and scheduled a second surgery but did not adequately treat his pain. The inpatient nurse had told him he would be discharged with the oral pain regimen he had been taking for the past day or so within the hospital. But upon discharge, he found himself without those prescriptions and came to our primary care practice in severe pain. When we reviewed his inpatient record to ...
Source: Health Affairs Blog - July 17, 2017 Category: Health Management Authors: Vidya Viswanathan, Matthew Seigerman, Edward Manning and Jaya Aysola Tags: Health Equity Population Health Quality Implicit Bias Rounds implicit biases provider bias Source Type: blogs
Patient Access to Medical Services Varies by Individual Physician ’ s Will to Fight Insurance Companies
American healthcare reform debates are focused on strategies to provide “access” to medical services for all. Lack of insurance (or under-insurance) seems to be the primary focus, as it is falsely assumed that coverage provides access. Unfortunately, the situation is far more complicated.
Once a person has health insurance, there is no guarantee that they will receive the medical services that they need. Not because their plan is insufficiently robust, but because the roadblocks for approval of services (provided in the plans) are so onerous that those providing the service often give up before they receive i...
Source: Better Health - July 3, 2017 Category: American Health Authors: Dr. Val Jones Tags: Health Policy Opinion Administrative Burden Coverage Is Not Care Health Insurance Roadblocks Pre-Authorization Underinsured Source Type: blogs
Rural Health Opioid Program
Grant Opportunity from HHS Health Resources and Services Administration (HRSA)
This announcement solicits applications for the Rural Health Opioid Program (RHOP). The purpose of RHOP is to promote rural health care services outreach by expanding the delivery of opioid related health care services to rural communities. The program will reduce the morbidity and mortality related to opioid overdoses in rural communities through the development of broad community consortiums to prepare individuals with opioid-use disorder (OUD) to start treatment, implement care coordination practices to organize patient care activities,[1] an...
Source: BHIC - June 27, 2017 Category: Databases & Libraries Authors: Annette Parde-Maass Tags: Opioid Abuse and Addiction Public Health Rural Scholarships and Grants Source Type: blogs
Hospitals Investing Capital in Variety of Outpatient Facilities: IT Serves as the Glue
I have a keen interest in the development of new types of healthcare facilities beyond"hospitals" as we know them today and have blogged about bedless facilities (see:The Future of Healthcare: Virtual Physician Visits& Bedless Hospitals;The Design of Bedless Hospitals Continue to Evolve Based on Cost and Technology;The Future of Healthcare: Virtual Physician Visits& Bedless Hospitals;Some Additional Ideas About the Bedless Hospitals of the Future). A recent article, focusing on increased hospital spending on outpatient care, touched many of these same points (see:Patient preferences tug hospital spending ...
Source: Lab Soft News - June 19, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Business Healthcare Delivery Healthcare Information Technology Hospital Executive Management Radiology Telemedicine Source Type: blogs
Moving The Needle On Primary Care: Covered California ’s Strategy To Lower Costs And Improve Quality
Many of the national policy discussions today are focused on who will be covered and the scope of benefits consumers will receive. Unfortunately, as important as these issues are, neither of them in any way addresses the underlying issues of high health care costs and the highly variable quality of care in the United States. To foster sustainable reform, we need to focus on promoting high-value care, which means we need to address not only insurance coverage but also reform of the delivery system. Covered California, a state health insurance exchange, has taken advantage of its role as a purchaser to work with health plans...
Source: Health Affairs Blog - June 14, 2017 Category: Health Management Authors: Lance Lang, Peter V. Lee and Kevin Grumbach Tags: Costs and Spending Featured Insurance and Coverage Organization and Delivery Quality CalPERS Covered California Health Benefit Exchange Contracting patient-centered medical homes Payment Reform Primary Care Source Type: blogs
Replicating Effective Models Of Complex Care Management For Older Adults
Improving our system of care for older adults with complex, chronic illnesses requires wrestling with a vexing dilemma. Models of care that are readily scalable have limited effectiveness, and effective models are difficult to scale. As an example of the former, the patient-centered medical home (PCMH) has become widespread, but its impact on population health and health care costs varies and has been modest overall. As a stand-alone solution, the PCMH appears insufficient to deliver the diverse set of interventions required by chronically ill, older adults with complex needs—a growing segment of the US population th...
Source: Health Affairs Blog - June 7, 2017 Category: Health Management Authors: Ken Coburn, Charlotte Grinberg, Sophia Demuynck and Margaret Hawthorne Tags: Costs and Spending Diffusion of Innovation Featured Medicare chronically ill older adults complex care management health and aging Health Quality Partners Source Type: blogs
Is the Direct Primary Care Model Dead?
By NIRAN AL-AGBA, MD
A recent Medical Economics article asked “Is the DPC model at risk of failing?”
The piece focuses on two large DPC-like organizations, Qliance Medical Management of Seattle, Washington and Turntable Health of Las Vegas, NV, working in partnership with Iora Health, which recently closed their doors. Qliance and Turntable were not actually DPC practices by strict definition; they were innovative large business operations providing healthcare services to patients and excluding third party payers. Their idea was commendable, but their closure indicates little cause for concern in regard to the growing ...
Source: The Health Care Blog - June 6, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Qliance Turntable Health Source Type: blogs
Preserving The Bipartisan Commitment To Health Care Delivery System Reform
Editor’s Note: This is the first in a five-part Health Affairs Blog series, produced in conjunction with the Bipartisan Policy Center, examining current issues and care models in the delivery system reform effort. Each post will be jointly authored by Democratic and Republican leaders in health policy. Check back for the next entry in the series on May 25.
Improving and reforming our health care delivery system is not a partisan issue. The need to improve health care delivery models, as a means for ensuring better patient outcomes and a more efficient health care system, enjoys broader consensus than elements surrounding...
Source: Health Affairs Blog - May 18, 2017 Category: Health Management Authors: Alice M. Rivlin and Sheila Burke Tags: Featured Health Professionals Hospitals Medicare Organization and Delivery Payment Policy bipartisan delivery system reform Bipartisan Policy Center delivery reform value based care Source Type: blogs
Diffusion Of Innovations In Health Care — Obtaining Evidence To Move Faster
We are living in an extraordinary time in health care. Amid unsustainable rising health care costs that did not deliver commensurate value or quality of care, a remarkable transformation in health care payment was put in motion over the past decade. A proliferation of new payment models is now underway, with an estimated 25 percent of payments across commercial, Medicaid, and Medicare Advantage plans meeting the Health Care Payment Learning and Action Network’s (HCP-LAN) definition of value-based alternative payment models (APM) in 2016. There are at least 840 accountable care organization (ACO) contracts across the nati...
Source: Health Affairs Blog - May 16, 2017 Category: Health Management Authors: William Shrank and Donna Keyser Tags: Costs and Spending Diffusion of Innovation Featured Insurance and Coverage Payment Policy Population Health ACOs Alternative Payment Models behavioral economics Bundled Payments National Center for Advancing Translational Sciences Pa Source Type: blogs
Accelerating Adoption And Diffusion Of Innovations In Care Delivery
“When I come here, they know me,” says Mary Febus, a severe chronic asthma patient, of the Family Physicians Group in Kissimmee, Florida. For years, Febus was a victim of inadequate, poorly coordinated, and unnecessarily expensive care for her uncontrolled asthma and other complex health conditions. More than a dozen hospitalizations per year for many days at a time took her away from her young son, who was himself a patient with complex needs.
All this ended when Febus came upon the Family Physicians Group, one of a handful of high-performing primary care practices identified by America’s Most Valuable Care, a resea...
Source: Health Affairs Blog - May 16, 2017 Category: Health Management Authors: Jeff Selberg, Prabhjot Singh and Jorge Alday Tags: Costs and Spending Diffusion of Innovation Featured Quality America’s Most Valuable Care study Clinical Excellence Research Center health services research Peterson Center on Healthcare Source Type: blogs
Investment In Primary Care Is Needed To Achieve The Triple Aim
Primary care in the United States is in crisis for a number of reasons. An increasing percentage of our workforce is experiencing burnout, and reimbursement for primary care is insufficient to provide needed services for patients and adequate compensation for primary care teams. Additionally, funding shortfalls and payment mechanisms hinder transformation that improves value, even as policy makers look to primary care to drive value in health care.
In this context, there is much to learn from the experience of Rhode Island’s statewide payment innovation model and the Center for Medicare and Medicaid Innovation (CMMI). Ea...
Source: Health Affairs Blog - May 10, 2017 Category: Health Management Authors: Russell Phillips Tags: Costs and Spending Insurance and Coverage Medicaid and CHIP Medicare Payment Policy Quality Comprehensive Primary Care initiative Comprehensive Primary Care Plus patient-centered medical homes Rhode Island Source Type: blogs
Electronic Medical Records 2017: Science Ignored, Opportunity Lost
By KENNETH BARTHOLOMEW, MD
My big brother Bill, may he rest in peace, taught me a valuable lesson four decades ago. We were gearing up for an extended Alaskan wilderness trip and were having trouble with a piece of equipment. When we finally rigged up a solution, I said “that was harder than it should have been” and he quipped in his wry monotone delivery, “There are no hard jobs, only the wrong tools.”
That lesson has stuck in my mind all these years because, as simple as it seems, it carries a large truth. It rings of Archimedes when he was speaking about the simple tool known as the lever: “Give me but one fir...
Source: The Health Care Blog - May 8, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized EHR EMR Knowledge Coupler Number Needed to Kill POMR value-based care Source Type: blogs
Dear President Trump, About That Health Care Law
By NIRAN AL-AGBA, MD
I hope you read this letter. I doubt you will.
I know you’re busy rebuilding Washington, reshaping the international order and doing a lot of other weighty stuff. Full disclosure, I voted for you. Not because you promised to repeal the Affordable Care Act, or because you tweeted at me about it, but because our healthcare system is hopelessly broken and requires an overhaul that does not simply convert over to a single payer system.
Recently you were quoted in an interview with Reuters:
“I loved my previous life… I had so many things going… this is more work than my previous life. I tho...
Source: The Health Care Blog - May 5, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Can Interactive Group Therapy Boost Productivity in Medicine?
By DEVON HERRICK
Imagine attending private lectures and taking all your college exams in your professors’ offices individually, one-on-one. Your instructors lecture you, then pepper you with questions, grading your answers and recording your scores. This is not unlike traditional physician visits. Contrast this to attending classroom lectures and taking online multiple choice exams where a computer algorithm or Scantron tallies your answers and calculates your grade. Classroom instruction with standardized testing is much more efficient that private tutoring. Hundreds of students can learn and take their online exams si...
Source: The Health Care Blog - April 27, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Asynchronous Communication Physician Communication Robert Graboyes Telemedicine Source Type: blogs
