Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness

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Author :
Publisher : National Academies Press
ISBN 13 : 0309474442
Total Pages : 95 pages
Book Rating : 4.3/5 (94 download)

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Book Synopsis Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness by : National Academies of Sciences, Engineering, and Medicine

Download or read book Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-08-18 with total page 95 pages. Available in PDF, EPUB and Kindle. Book excerpt: Millions of people in the United States live with serious illnesses such as cancer, heart disease, chronic obstructive pulmonary disorder (COPD), amyotrophic lateral sclerosis, Parkinson's disease, and dementiaâ€"often for many years. Those facing serious illness have a range of interconnected medical and non-medical needs, and the way their care is financed has a large impact on the care they receive. Medicare is the predominant payer, but both Medicaid and private payers also play significant roles in financing care for serious illness. In an effort to address the complex needs of people with serious illness, public and private health care payers are testing innovative financing strategies and alternative payment models. These innovative approaches signal a gradual transition from the traditional-fee-for-service system that pays providers based on the quantity of services to a system based on the value of care provided and a heightened focus on improved quality of care at lower cost. To explore this evolving financing and payment landscape for serious illness care within public- and private-sector programs, the Roundtable on Quality Care for People with Serious Illness developed a workshop, Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness. The workshop convened clinicians, researchers, policy analysts, and patient advocates, as well as representatives from academia, government and private health care plans, and insurers to discuss challenges and opportunities in financing high-quality care for people with serious illness. This publication summarizes the presentations and discussions from the workshop.

Dying in America

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Publisher : National Academies Press
ISBN 13 : 0309303133
Total Pages : 638 pages
Book Rating : 4.3/5 (93 download)

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Book Synopsis Dying in America by : Institute of Medicine

Download or read book Dying in America written by Institute of Medicine and published by National Academies Press. This book was released on 2015-03-19 with total page 638 pages. Available in PDF, EPUB and Kindle. Book excerpt: For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.

Crossing the Quality Chasm

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Publisher : National Academies Press
ISBN 13 : 0309072808
Total Pages : 360 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis Crossing the Quality Chasm by : Institute of Medicine

Download or read book Crossing the Quality Chasm written by Institute of Medicine and published by National Academies Press. This book was released on 2001-08-19 with total page 360 pages. Available in PDF, EPUB and Kindle. Book excerpt: Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

Models and Strategies to Integrate Palliative Care Principles into Care for People with Serious Illness

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Author :
Publisher : National Academies Press
ISBN 13 : 0309466113
Total Pages : 103 pages
Book Rating : 4.3/5 (94 download)

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Book Synopsis Models and Strategies to Integrate Palliative Care Principles into Care for People with Serious Illness by : National Academies of Sciences, Engineering, and Medicine

Download or read book Models and Strategies to Integrate Palliative Care Principles into Care for People with Serious Illness written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-03-28 with total page 103 pages. Available in PDF, EPUB and Kindle. Book excerpt: Palliative care is the interdisciplinary specialty focused on improving quality of life for people with serious illness and their families. This interdisciplinary care is provided by doctors, nurses, social workers, chaplains and others who work together with the patient's other doctors to provide an extra layer of support. Such care is appropriate for people at any age and at any stage in a serious illness, and can be provided together with curative treatment to address clinical, emotional, psychosocial and spiritual concerns of the patient and their family. To better understand how the principles of palliative care can be integrated into the overall provision of care and services to those facing serious illness, the Roundtable on Quality Care for People with Serious Illness held a public workshop in April 2017. This publication summarizes the presentations and discussions from the workshop.

Approaching Death

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Publisher : National Academies Press
ISBN 13 : 0309518253
Total Pages : 457 pages
Book Rating : 4.3/5 (95 download)

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Book Synopsis Approaching Death by : Committee on Care at the End of Life

Download or read book Approaching Death written by Committee on Care at the End of Life and published by National Academies Press. This book was released on 1997-10-30 with total page 457 pages. Available in PDF, EPUB and Kindle. Book excerpt: When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening. Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care. This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life: Determining diagnosis and prognosis and communicating these to patient and family. Establishing clinical and personal goals. Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances. Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."

Models and Strategies to Integrate Palliative Care Principles into Care for People with Serious Illness

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Author :
Publisher : National Academies Press
ISBN 13 : 0309466148
Total Pages : 103 pages
Book Rating : 4.3/5 (94 download)

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Book Synopsis Models and Strategies to Integrate Palliative Care Principles into Care for People with Serious Illness by : National Academies of Sciences, Engineering, and Medicine

Download or read book Models and Strategies to Integrate Palliative Care Principles into Care for People with Serious Illness written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-02-28 with total page 103 pages. Available in PDF, EPUB and Kindle. Book excerpt: Palliative care is the interdisciplinary specialty focused on improving quality of life for people with serious illness and their families. This interdisciplinary care is provided by doctors, nurses, social workers, chaplains and others who work together with the patient's other doctors to provide an extra layer of support. Such care is appropriate for people at any age and at any stage in a serious illness, and can be provided together with curative treatment to address clinical, emotional, psychosocial and spiritual concerns of the patient and their family. To better understand how the principles of palliative care can be integrated into the overall provision of care and services to those facing serious illness, the Roundtable on Quality Care for People with Serious Illness held a public workshop in April 2017. This publication summarizes the presentations and discussions from the workshop.

Integrating Health Care and Social Services for People with Serious Illness

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Author :
Publisher : National Academies Press
ISBN 13 : 0309488192
Total Pages : 99 pages
Book Rating : 4.3/5 (94 download)

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Book Synopsis Integrating Health Care and Social Services for People with Serious Illness by : National Academies of Sciences, Engineering, and Medicine

Download or read book Integrating Health Care and Social Services for People with Serious Illness written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2019-03-29 with total page 99 pages. Available in PDF, EPUB and Kindle. Book excerpt: A growing body of research indicates that social determinants of health have a significant impact on health care utilization and outcomes. Researchers and policymakers in the United States have spent decades exploring and discussing approaches to integrating health care and social services. While no nation has a truly integrated system, many other industrialized nations invest more heavily in social services than the United States, and are more effective in integrating these services with health care. Integrating health care and social services, such as accessible housing, meals and nutrition services, transportation, and caregiver training, is particularly important for those facing serious illness who typically encounter multiple chronic conditions, pain and other symptoms, functional dependency, frailty, and significant family caregiver needs. In an effort to better understand and facilitate discussions about the challenges and opportunities related to integrating health care and social services for people with serious illness, the National Academies of Sciences, Engineering, and Medicine held a full-day public workshop on July 19, 2018 in Washington, DC. The workshop featured a broad range of experts and stakeholders including researchers, policy analysts, patient and family caregiving advocates, and representatives of federal agencies. This publication summarizes the presentations and discussions from the workshop.

Supporting and Sustaining the Current and Future Workforce to Care for People with Serious Illness

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Author :
Publisher : National Academies Press
ISBN 13 : 9780309712125
Total Pages : 0 pages
Book Rating : 4.7/5 (121 download)

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Book Synopsis Supporting and Sustaining the Current and Future Workforce to Care for People with Serious Illness by : Health and Medicine Division

Download or read book Supporting and Sustaining the Current and Future Workforce to Care for People with Serious Illness written by Health and Medicine Division and published by National Academies Press. This book was released on 2025-08-15 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: There are significant challenges facing the workforce needed to provide high-quality care to increasing numbers of people living with serious illness. The National Academies Roundtable on Quality Care for People with Serious Illness hosted a hybrid public workshop in April 2023 to explore strategies and approaches to address major workforce challenges, such as health professional well-being; workforce shortages; workforce training and retention; as well as how to advance the diversity, equity, and inclusion of the workforce caring for people of all ages and all stages of serious illness. This workshop builds on the 2019 Roundtable workshop Building the Workforce We Need to Care for People with Serious Illness.

Resolving Ethical Dilemmas

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Author :
Publisher : Lippincott Williams & Wilkins
ISBN 13 : 1975142152
Total Pages : 384 pages
Book Rating : 4.9/5 (751 download)

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Book Synopsis Resolving Ethical Dilemmas by : Bernard Lo

Download or read book Resolving Ethical Dilemmas written by Bernard Lo and published by Lippincott Williams & Wilkins. This book was released on 2019-01-02 with total page 384 pages. Available in PDF, EPUB and Kindle. Book excerpt: Publisher's Note: Products purchased from 3rd Party sellers are not guaranteed by the Publisher for quality, authenticity, or access to any online entitlements included with the product. What are the ethical issues raised by the increasing use of big data and artificial intelligence in health care? How should physicians respond when they have a conscientious objection to an intervention requested by a patient? How should health care organizations respond to physician requests? How can physicians best help patients make informed decisions about end-of-life and life-sustaining care? How should interns and residents respond to ethical dilemmas created by duty hours restrictions? Resolving Ethical Dilemmas: A Guide for Clinicians helps residents, students, and practitioners work through these and many more common and challenging ethical questions that affect patient care. The 6th Edition reflects important changes in medicine and healthcare policy and provides additional clarity to complex concepts. Offering practical, real-world advice, it helps you think through and resolve difficult cases, prompting thoughtful, well-reasoned answers to the question of “What do I do in this situation?”

Implementing Quality Measures for Accountability in Community-Based Care for People with Serious Illness

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Publisher : National Academies Press
ISBN 13 : 0309482070
Total Pages : 109 pages
Book Rating : 4.3/5 (94 download)

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Book Synopsis Implementing Quality Measures for Accountability in Community-Based Care for People with Serious Illness by : National Academies of Sciences, Engineering, and Medicine

Download or read book Implementing Quality Measures for Accountability in Community-Based Care for People with Serious Illness written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2019-01-11 with total page 109 pages. Available in PDF, EPUB and Kindle. Book excerpt: Millions of Americans of all ages face the challenge of living with serious illnesses such as advanced cancer, heart, or lung disease. Many people with serious illness are increasingly cared for in community settings. While the number of community-based programs to provide care for those with serious illness has grown significantly, the quality of care provided is not consistent across geographic locations or care settings. Care for the serious illness population often features gaps in coordination across sites of care and poor patient and family perceptions as to the quality of care provided. In an effort to better understand and facilitate discussions about the challenges and opportunities related to identifying and implementing quality measures for accountability purposes in community-based serious illness care, the National Academies of Sciences, Engineering, and Medicine held a public workshop on April 17, 2018, in Washington, DC. Workshop participants explored the current state of quality measurement for people with serious illness, their families, and caregivers, with the aim of identifying next steps toward effectively implementing measures to drive improvement in the quality of community-based care for those facing serious illness. This publication summarizes the presentations and discussions from the workshop.

Integrating Social Care into the Delivery of Health Care

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Publisher : National Academies Press
ISBN 13 : 0309493463
Total Pages : 195 pages
Book Rating : 4.3/5 (94 download)

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Book Synopsis Integrating Social Care into the Delivery of Health Care by : National Academies of Sciences, Engineering, and Medicine

Download or read book Integrating Social Care into the Delivery of Health Care written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2019-12-30 with total page 195 pages. Available in PDF, EPUB and Kindle. Book excerpt: Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health was released in September 2019, before the World Health Organization declared COVID-19 a global pandemic in March 2020. Improving social conditions remains critical to improving health outcomes, and integrating social care into health care delivery is more relevant than ever in the context of the pandemic and increased strains placed on the U.S. health care system. The report and its related products ultimately aim to help improve health and health equity, during COVID-19 and beyond. The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and health equity is likely to depend â€" at least in part â€" on mitigating adverse social determinants. This recognition has been bolstered by a shift in the health care sector towards value-based payment, which incentivizes improved health outcomes for persons and populations rather than service delivery alone. The combined result of these changes has been a growing emphasis on health care systems addressing patients' social risk factors and social needs with the aim of improving health outcomes. This may involve health care systems linking individual patients with government and community social services, but important questions need to be answered about when and how health care systems should integrate social care into their practices and what kinds of infrastructure are required to facilitate such activities. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health examines the potential for integrating services addressing social needs and the social determinants of health into the delivery of health care to achieve better health outcomes. This report assesses approaches to social care integration currently being taken by health care providers and systems, and new or emerging approaches and opportunities; current roles in such integration by different disciplines and organizations, and new or emerging roles and types of providers; and current and emerging efforts to design health care systems to improve the nation's health and reduce health inequities.

Health-Care Utilization as a Proxy in Disability Determination

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Publisher : National Academies Press
ISBN 13 : 030946921X
Total Pages : 161 pages
Book Rating : 4.3/5 (94 download)

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Book Synopsis Health-Care Utilization as a Proxy in Disability Determination by : National Academies of Sciences, Engineering, and Medicine

Download or read book Health-Care Utilization as a Proxy in Disability Determination written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-04-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

Care Without Coverage

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Publisher : National Academies Press
ISBN 13 : 0309083435
Total Pages : 213 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis Care Without Coverage by : Institute of Medicine

Download or read book Care Without Coverage written by Institute of Medicine and published by National Academies Press. This book was released on 2002-06-20 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt: Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

Integrating Health Care and Social Services for People with Serious Illness

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Author :
Publisher : National Academies Press
ISBN 13 : 0309488168
Total Pages : 99 pages
Book Rating : 4.3/5 (94 download)

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Book Synopsis Integrating Health Care and Social Services for People with Serious Illness by : National Academies of Sciences, Engineering, and Medicine

Download or read book Integrating Health Care and Social Services for People with Serious Illness written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2019-04-29 with total page 99 pages. Available in PDF, EPUB and Kindle. Book excerpt: A growing body of research indicates that social determinants of health have a significant impact on health care utilization and outcomes. Researchers and policymakers in the United States have spent decades exploring and discussing approaches to integrating health care and social services. While no nation has a truly integrated system, many other industrialized nations invest more heavily in social services than the United States, and are more effective in integrating these services with health care. Integrating health care and social services, such as accessible housing, meals and nutrition services, transportation, and caregiver training, is particularly important for those facing serious illness who typically encounter multiple chronic conditions, pain and other symptoms, functional dependency, frailty, and significant family caregiver needs. In an effort to better understand and facilitate discussions about the challenges and opportunities related to integrating health care and social services for people with serious illness, the National Academies of Sciences, Engineering, and Medicine held a full-day public workshop on July 19, 2018 in Washington, DC. The workshop featured a broad range of experts and stakeholders including researchers, policy analysts, patient and family caregiving advocates, and representatives of federal agencies. This publication summarizes the presentations and discussions from the workshop.

Changing Health Care Systems and Rheumatic Disease

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Author :
Publisher : National Academies Press
ISBN 13 : 0309056837
Total Pages : 253 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis Changing Health Care Systems and Rheumatic Disease by : Institute of Medicine

Download or read book Changing Health Care Systems and Rheumatic Disease written by Institute of Medicine and published by National Academies Press. This book was released on 1997-02-09 with total page 253 pages. Available in PDF, EPUB and Kindle. Book excerpt: Market forces are driving a radical restructuring of health care delivery in the United States. At the same time, more and more people are living comparatively long lives with a variety of severe chronic health conditions. Many such people are concerned about the trend toward the creation of managed care systems because their need for frequent, often complex, medical services conflicts with managed care's desires to contain costs. The fear is that people with serious chronic disorders will be excluded from or underserved by the integrated health care delivery networks now emerging. Responding to a request from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, this book reflects the results of a workshop that focused on the following questions: Does the model of managed care or an integrated delivery system influence the types of interventions provided to patients with chronic conditions and the clinical and health status outcomes resulting from those interventions? If so, are these effects quantitatively and clinically significant, as compared to the effects that other variables (e.g., income, education, ethnicity) have on patient outcomes? If the type of health care delivery system appears to be related to patient care and outcomes, can specific organizational, financial, or other variables be identified that account for the relationships? If not, what type of research should be pursued to provide the information needed about the relationship between types of health care systems and the processes and outcomes of care provided to people with serious chronic conditions?

Best Care at Lower Cost

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Author :
Publisher : National Academies Press
ISBN 13 : 0309282810
Total Pages : 437 pages
Book Rating : 4.3/5 (92 download)

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Book Synopsis Best Care at Lower Cost by : Institute of Medicine

Download or read book Best Care at Lower Cost written by Institute of Medicine and published by National Academies Press. This book was released on 2013-05-10 with total page 437 pages. Available in PDF, EPUB and Kindle. Book excerpt: America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost. The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009-roughly $750 billion-was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances. About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care. This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.

Rewarding Provider Performance

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Publisher : National Academies Press
ISBN 13 : 0309102162
Total Pages : 273 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Rewarding Provider Performance by : Institute of Medicine

Download or read book Rewarding Provider Performance written by Institute of Medicine and published by National Academies Press. This book was released on 2007-02-17 with total page 273 pages. Available in PDF, EPUB and Kindle. Book excerpt: The third installment in the Pathways to Quality Health Care series, Rewarding Provider Performance: Aligning Incentives in Medicare, continues to address the timely topic of the quality of health care in America. Each volume in the series effectively evaluates specific policy approaches within the context of improving the current operational framework of the health care system. The theme of this particular book is the staged introduction of pay for performance into Medicare. Pay for performance is a strategy that financially rewards health care providers for delivering high-quality care. Building on the findings and recommendations described in the two companion editions, Performance Measurement and Medicare's Quality Improvement Organization Program, this book offers options for implementing payment incentives to provide better value for America's health care investments. This book features conclusions and recommendations that will be useful to all stakeholders concerned with improving the quality and performance of the nation's health care system in both the public and private sectors.