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Do the Medicaid and Medicare programs compete for access to health care services? A longitudinal analysis of physician fees, 1998–2004
Abstract As the demand for publicly funded health care continues to rise in the U.S., there is increasing pressure on state governments to ensure patient access through adjustments in provider compensation policies. This paper longitudinally examines the fees that states paid physicians for services covered by the Medicaid program over the period 1998–2004. Controlling for an extensive set of economic and health care industry characteristics, the elasticity of states’ Medicaid fees, with respect to Medicare fees, is estimated to be in the range of 0.2–0.7 depending on the type of physician service examined....
Source: International Journal of Health Care Finance and Economics - September 1, 2014 Category: Health Management Source Type: research

Glimpse of 12th Annual World Health Care Congress
Conclusion The 12th Annual World Health Care Congress event delivered expert content, rich conversations and meaningful connections. I hope to attend the 13th Annual World Health Care Congress event. One recommendation I would make is to add Patient Opinion Leader to the “Who Should Attend?” area of the website and reserve a select number of compensated passes for real-world, experienced Patient Opinion Leaders to attend. We are often not salaried or sponsored. I owe a debt of gratitude to Disruptive Women in Healthcare for the opportunity to strengthen my knowledge and network. Though I can’t walk a mile in any of m...
Source: Disruptive Women in Health Care - April 7, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Consumer Health Care Cost Coverage Policy Health Reform Mental Health Source Type: blogs

Top Policy and Medicine Stories for 2015
  At the end of each year, we attempt to give you an overview of what happened in previous year and give some spin on predictions for the coming year, much like an end-of-the-year family newsletter. For those who are a bit more nostalgic, here is a link to our 2014 story. Perhaps the End of Off Label Lawsuits? With the Amarin Injunction, Caronia standing for two years without any pushback from the government, and the recent settlement with Pacira, there seems to be a trend of the FDA pulling away from off-label citations. Perhaps this trend is a signal of the end of cases against manufacturers for off label pr...
Source: Policy and Medicine - December 30, 2015 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

A Comprehensive Strategy For Primary Care Payment Reform in Medicine
By MOSTASHARI,  KOCHER and McCLELLAN Strengthening primary care has been a core goal of health care payment reform over the past several years. Primary care physicians are the cornerstone of the health care delivery, directing billions of dollars of follow-on care. With better support, the models presume, primary care doctors could guide their patients toward a better health, direct them to the right care when needed, and in so doing, bring down unnecessary medical costs. Moreover, especially if coupled with payment reforms that can support better coordination with specialist practices, these reforms can provide an altern...
Source: The Health Care Blog - May 10, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Bob Kocher Comprehensive Primary Care Farzad Mostashari Mark McClellan Source Type: blogs

The Humanity In End-Of-Life Care
Health care is personal, especially when it comes to caring for someone as they approach death. However, half of Americans feel they have too little control over end-of-life medical decisions. As the industry moves toward a more holistic approach to care delivery, health care organizations are beginning to rethink how they treat patients and starting to embed end-of-life care plans into the overall approach earlier on, sometimes before people even become ill. In a recent report on end-of-life care by the Aspen Health Strategy Group, several principles are discussed that take a broader view around caring for seriously ill p...
Source: Health Affairs Blog - May 19, 2017 Category: Health Management Authors: Susan DeVore Tags: Costs and Spending End of Life & Serious Illness Long-term Services and Supports Payment Policy Quality advance care planning Palliative Care Source Type: blogs

The Congressional Budget Deal ' s Effect on Health Care
In early February, Congress passed a massive bipartisan budget deal to fund the government through March 23, 2018, suspend the debt ceiling until 2019, raise budget caps by nearly $300 billion over two years, and fund various parts of the government. Naturally, passage of the budget agreement means that quite a few health care priorities made their way into the law. For example, several health care “extenders” were reauthorized, community health centers (CHCs) were funded, cuts to safety net hospitals were delayed, as were cuts to the CHRONIC Care Act and the Part B Improvement Act, while revisions to the Medicare Acc...
Source: Policy and Medicine - February 20, 2018 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Trauma transitional care coordination: A mature system at work
CONCLUSION Targeted outpatient support for high-risk patients can decrease 30-day readmission rates. As our TTCC program matured, we reduced 30-day readmission in patients with lower-extremity injury, complicated tracheostomy and bowel procedures. This represents over one million-dollar savings for the hospital per year through quality-based reimbursement. LEVEL OF EVIDENCE Therapeutic/care management, level III.
Source: The Journal of Trauma: Injury, Infection, and Critical Care - May 1, 2018 Category: Orthopaedics Tags: AAST 2017 Podium Paper Source Type: research

Deaths In Acute Care Hospitals Drop for Medicare Patients Deaths In Acute Care Hospitals Drop for Medicare Patients
Intensive care unit use during the last month of life stabilized, and healthcare setting transitions during the final 3 days of life also declined, a study has found.Medscape Medical News
Source: Medscape Medical News Headlines - June 28, 2018 Category: Consumer Health News Tags: Critical Care News Source Type: news

Making Sense of the Health Care Merger Scene    
By JEFF GOLDSMITH In the past 12 months, there has been a raft of multi-billion-dollar mergers in health care. What do these deals tell us about the emerging health care landscape, and what will they mean for patients/consumers and the incumbent actors in the health system? Health Systems There have been a few large health system mergers in the past year, notably the $11 billion multi-market combinations of Aurora Health Care and Advocate Health Care Network in Milwaukee and suburban Chicago, as well as the proposed (but not yet consummated) $28 billion merger of Catholic Health Initiatives and Dignity Health. However, the...
Source: The Health Care Blog - July 23, 2018 Category: Consumer Health News Authors: matthew holt Tags: Hospitals Physicians The Business of Health Care Healthcare merger Healthcare systems the future of healthcare Source Type: blogs

Nurse Influence in Meeting Compliance With the Centers for Medicare and Medicaid Services Quality Measure: Early Management Bundle, Severe Sepsis/Septic Shock (SEP-1).
This article discusses the nurse's role in meeting the specific elements of each bundle and strategies to improve bundle compliance. PMID: 30702476 [PubMed - in process]
Source: Dimensions in Critical Care Nursing - February 1, 2019 Category: Nursing Tags: Dimens Crit Care Nurs Source Type: research

Improvement of Quality Outcomes and Cost of Health Care
Nurses are using data hand in hand with evidence-based practice, bundles, clinical practice guidelines, and various delivery care models to provide patient-centered care and yield improved outcomes. The addition of data analytics holds promise for identification and early intervention to improve outcomes. Data and health care informatics are part of the health care fabric today and essential to guide and document improved patient outcomes and decreased costs. All specialties and settings are held accountable for patient outcomes, and with Medicare Access and CHIP (Children's Health Insurance Program) Reauthorization Act (M...
Source: Critical Care Nursing Clinics of North America - April 30, 2019 Category: Nursing Authors: Deborah Delaney Garbee, Denise M. Danna Tags: Preface Source Type: research

The Primary Cares Initiative: How Value-Based Payment Models Aim to Strengthen Primary Care
Conclusion The Primary Cares Initiative represents not just a single push to improve the health care system as a whole through primary care, but an overarching drive to do so via many initiatives and programs. Bringing more practices on board with initiatives such as the PCMH, CPC+, innovation within Medicare Advantage, and the Primary Cares Initiative will undoubtedly solidify the success of these and future programs, as stakeholders and policymakers come to a greater understanding of how to incentivize and create a path toward improved health care outcomes. Chris Jaeger is the Advisor for ACO and Health System Stra...
Source: The Health Care Blog - February 11, 2020 Category: Consumer Health News Authors: Christina Liu Tags: Health Policy Primary Care AristaMD Chris Jaeger CMS primary cares initiative Source Type: blogs

The Parallel Realities of Health Care: Ratio and Intellectus
By HANS DUVEFELT Every patient is unique, with some common basic and measurable features and parameters. For a couple of decades now, healthcare has professed to be patient centered. But the prevailing culture of “quality” (and the reality of getting paid for what you do) has us spending at least half our time documenting for outsiders, who are non-clinicians, the substance and value of our patient interactions. That means our patients get half of our attention and others get half. But of course, if you really wanted to be patient centered, you’d have to ask what patients actually care about, like their blood p...
Source: The Health Care Blog - April 19, 2021 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Physicians Primary Care Hans Duvefelt Source Type: blogs

Serious Illness Discussion in Palliative Care —A Case Study Approach in an African American Patient with Cancer
This article will address barriers to, cultural influences on, framing of, and documentation of serious illness discu ssions using a case study approach.
Source: Critical Care Nursing Clinics of North America - January 21, 2022 Category: Nursing Authors: Deborah Russell, Jo Clarke, Lynne Brophy, Michele L. Weber Source Type: research

Innovative models of home-based palliative care
The focus of palliative care is to alleviate pain and suffering for patients, potentially while they concurrently pursue life-prolonging or curative therapy. The potential breadth of palliative care is recognized by the Medicare program, but the Medicare hospice benefit is narrowly defined and limited to care that is focused on comfort and not on cure. Any organization or setting that has been accredited or certified to provide health care may provide palliative care. Home health agencies are highly attuned to patients’ need for palliative care, and often provide palliative care for patients who are ineligible for ho...
Source: Cleveland Clinic Journal of Medicine - February 18, 2013 Category: Journals (General) Authors: LABSON, M. C., SACCO, M. M., WEISSMAN, D. E., GORNET, B., STUART, B. Tags: Technology innovations and palliative care Source Type: research