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THCB 20th Birthday Classic: Value-based care – no progress since 1997?
As the 20th Birthday rolls on I thought I’d bring out a more recent piece first published in October 2020, albeit one that relies heavily on 25 year old data to make a point. This is some evidence to back up Jeff Goldsmith’s comment on the original that for all the talk “ ‘Value based” payment is a religious movement, not a business trend’ ” By the way, Humana updated these numbers last year and there’s been basically no change — Matthew Holt
By MATTHEW HOLT
Humana is out with a report saying that its Medicare Advantage members who are covered by value-based care (VBC) ar...
Source: The Health Care Blog - August 24, 2023 Category: Consumer Health News Authors: matthew holt Tags: The Business of Health Care Capitation Humana Medicare Advantage VBC Source Type: blogs
Accountable Care Organizations: Risk and Reward
In January 2015, HHS set the target of funneling 50% of Medicare payments through alternative payment models and tying 90% of fee-for-service payments to quality or value by the end of 2018. MACRA is part of that shift by changing the way Medicare pays physicians. Now, as reported by Modern Healthcare, the prospect of rewards from value-based care arrangements like ACOs is luring a “small but growing” number of ACOs into risker contracts with Medicare. However, as the article stresses, this is still a minority number of ACOs, with the vast majority in “upside-only” models where they share in savings but do not risk...
Source: Policy and Medicine - July 20, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
Standards Revisions for Emergency Management Final Rule in Ambulatory Health Care
Joint Commission. 10/30/2017 This seven-page document provides prepublication standards for the Centers for Medicare and Medicaid Services Emergency Preparedness Rule, with revisions for ambulatory health care. (PDF)
Source: Disaster Lit: Resource Guide for Disaster Medicine and Public Health - November 15, 2017 Category: International Medicine & Public Health Authors: The U.S. National Library of Medicine Source Type: news
Standards Revisions for Emergency Management Final Rule in Home Care
Joint Commission. 10/30/2017 This 10-page document provides prepublication standards for the Centers for Medicare and Medicaid Services Emergency Preparedness Rule, with revisions for home care. (PDF)
Source: Disaster Lit: Resource Guide for Disaster Medicine and Public Health - November 15, 2017 Category: International Medicine & Public Health Authors: The U.S. National Library of Medicine Source Type: news
Intermediate Care Facility for Individuals with Intellectual Disabilities Requirements: CMS (Centers for Medicare and Medicaid Services) Emergency Preparedness Final Rule
U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. 12/12/2017 This 48-page document from TRACIE (Technical Resources, Assistance Center, and Information Exchange) combines excerpts from the Emergency Preparedness Final Rule and the recently released Interpretive Guidelines from the Centers for Medicare and Medicaid Services (CMS) to provide a consolidated overview document for the Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) Requirements. It provides the requirements for the Emergency Plan, Policies and Procedures, Communicat...
Source: Disaster Lit: Resource Guide for Disaster Medicine and Public Health - December 14, 2017 Category: International Medicine & Public Health Authors: The U.S. National Library of Medicine Source Type: news
Long Term Care Requirements: CMS (Centers for Medicare and Medicaid Services) Emergency Preparedness Final Rule
U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. 12/12/2017 This 66-page document from TRACIE (Technical Resources, Assistance Center, and Information Exchange) combines excerpts from the Emergency Preparedness Final Rule and the recently released Interpretive Guidelines from the Centers for Medicare and Medicaid Services (CMS) to provide a consolidated overview document for the Long Term Care (LTC) Requirements. It provides requirements for the Emergency Plan, Policies and Procedures, Communications Plan, Training and Testing, Emergency and Standby Power System...
Source: Disaster Lit: Resource Guide for Disaster Medicine and Public Health - December 14, 2017 Category: International Medicine & Public Health Authors: The U.S. National Library of Medicine Source Type: news
Programs of All-Inclusive Care for the Elderly Requirements: CMS (Centers for Medicare and Medicaid Services) Emergency Preparedness Final Rule
U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. 12/12/2017 This 49-page document from TRACIE (Technical Resources, Assistance Center, and Information Exchange) combines excerpts from the Emergency Preparedness Final Rule and the recently released Interpretive Guidelines from the Centers for Medicare and Medicaid Services (CMS) to provide a consolidated overview document for the Programs of All-Inclusive Care for the Elderly (PACE) requirements. It provides the requirements for the Emergency Plan, Policies and Procedures, Communications Plan, Training and Testin...
Source: Disaster Lit: Resource Guide for Disaster Medicine and Public Health - December 14, 2017 Category: International Medicine & Public Health Authors: The U.S. National Library of Medicine Source Type: news
Religious Nonmedical Health Care Institution Requirements: CMS (Centers for Medicare and Medicaid Services) Emergency Preparedness Final Rule
U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. 12/12/2017 This 43-page document from TRACIE (Technical Resources, Assistance Center, and Information Exchange) combines excerpts from the Emergency Preparedness Final Rule and the recently released Interpretive Guidelines from the Centers for Medicare and Medicaid Services (CMS) to provide a consolidated overview document for the Religious Nonmedical Health Care Institution (RNHCI) requirements. It provides the requirements for the Emergency Plan, Policies and Procedures, Communications Plan, and Training and Testing. (PDF)
Source: Disaster Lit: Resource Guide for Disaster Medicine and Public Health - December 14, 2017 Category: International Medicine & Public Health Authors: The U.S. National Library of Medicine Source Type: news
American Primary Care is a Big Waste of Time (When …)
By HANS DUVEFELT
Before Johannes Gutenberg invented the printing press in 1450, books in Europe were copied by hand, mostly by monks and clergy. Ironically, they were often called scribes, the same word we now use for the new class of healthcare workers employed to improve the efficiency of physician documentation.
Think about that for a moment: American doctors are employing almost medieval methods in what is supposed to be the era of computers. Why aren’t we using AI for documentation?
The pathetically cumbersome methods of documentation available (required) for our clinical encounters is only one of several a...
Source: The Health Care Blog - September 27, 2021 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Physicians Primary Care Hans Duvefelt Source Type: blogs
Template for an Antibiotic Stewardship Policy for Post-Acute and Long-Term Care Settings
In response to a rising concern for multidrug resistance and Clostridium difficile infections, the Centers for Medicare and Medicaid services (CMS) will require all long-term care (LTC) facilities to establish an antibiotic stewardship program by November 2017. Thus far, limited evidence describes implementation of antibiotic stewardship in LTC facilities, mostly in academic- or hospital-affiliated settings. To support compliance with CMS requirements and aid facilities in establishing a stewardship program, the Infection Advisory Committee at AMDA —The Society for Post-Acute and Long-Term Care Medicine, has developed an...
Source: Journal of the American Medical Directors Association - September 18, 2017 Category: Health Management Authors: Robin L.P. Jump, Swati Gaur, Morgan J. Katz, Christopher J. Crnich, Ghinwa Dumyati, Muhammad S. Ashraf, Elizabeth Frentzel, Steven J. Schweon, Philip Sloane, David Nace, Infection Advisory Committee for AMDA —The Society of Post-Acute and Long-Term Care Tags: Special Article Source Type: research
Older adult US Medicare beneficiaries with untreated obstructive sleep apnea are heavier users of health care than matched control patients
Journal of Clinical Sleep Medicine,Volume 16, Issue 1, Page 81-89, January 2020.
Source: Journal of Clinical Sleep Medicine : JCSM - January 14, 2020 Category: Sleep Medicine Authors: Emerson M. WickwireSarah E. TomAparna VadlamaniMontserrat Diaz-AbadLiesl M. CooperAbree M. JohnsonSteven M. ScharfJennifer S. Albrecht1Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland;2Sleep Disorders Center, Divisi Source Type: research
OIG review finds about 1/3 of all Medicare nursing home stays had inadequate care, care planning or discharge planning
This study is part of a larger body of work about SNF payments and quality of care.
...
For 37 percent of stays, SNFs did not develop care plans that met requirements or did not provide services in accordance with care plans. For 31 percent of stays, SNFs did not meet discharge planning requirements. Medicare paid approximately $5.1 billion for stays in which SNFs did not meet these quality-of-care requirements. Additionally, reviewers found examples of poor quality care related to wound care, medication management, and therapy. These findings raise concerns about what Medicare is paying for. They also demonstrate that SNF...
Source: HealthBlawg :: David Harlow's Health Care Law Blog - March 1, 2013 Category: Medical Lawyers and Insurers Authors: David Harlow Tags: CMS Compliance Health care policy Health Law Medicare Nursing Facilities OIG Patient safety Source Type: blogs
Incremental health care resource utilization and economic burden of venous thromboembolism recurrence from a U.S. payer perspective.
CONCLUSIONS: VTE recurrence associated with a hospitalization or ER visit is associated with substantial health care resource utilization, which is primarily inpatient care undergone within the first 30 days following an initial VTE event. Thus, a sizeable portion of the economic burden of recurrent VTE is also incurred during this short period of time following an initial VTE event. Given that rates of VTE recurrence were high among patients identified as having received anticoagulant treatment, strategies to improve anticoagulation therapy among VTE patients in addition to other preventative measures are needed to lessen...
Source: Journal of Managed Care Pharmacy - November 14, 2014 Category: Drugs & Pharmacology Tags: J Manag Care Pharm Source Type: research
Innovative care models for high-cost Medicare beneficiaries: delivery system and payment reform to accelerate adoption.
CONCLUSIONS: MA plans and ACOs stand to benefit financially from adopting care delivery models for high-risk Medicare beneficiaries that reduce hospitalization. Spreading these models to other organizations will require provider payment policy changes. Integration of acute and long-term care would further spur adoption of effective strategies for reducing or delaying entry into long-term institutional care.
PMID: 26167783 [PubMed - in process]
Source: The American Journal of Managed Care - July 17, 2015 Category: Health Management Authors: Davis K, Buttorff C, Leff B, Samus QM, Szanton S, Wolff JL, Bandeali F Tags: Am J Manag Care Source Type: research
