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Value Based Medicare Reimbursement
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Book Synopsis Value-Based Medicare Reimbursement by : J. Duncan Moore, Jr.
Download or read book Value-Based Medicare Reimbursement written by J. Duncan Moore, Jr. and published by . This book was released on 2014-04-01 with total page 660 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Provider's Guide to Value-Based Medicare Reimbursement is organized into groupings of chapters of related programs and initiatives most pertinent to a specific provider type. Parts I and II cover Medicare value-based programs for hospitals and physicians respectively. Part III is dedicated to new and emerging care-coordination healthcare delivery models contained in the PPACA which impact both hospitals and physicians.
Book Synopsis Value-Based Medicare Reimbursement for Hospitals by : Duncan Moore
Download or read book Value-Based Medicare Reimbursement for Hospitals written by Duncan Moore and published by . This book was released on 2015-05-31 with total page 106 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :National Academies of Sciences Engineering and Medicine Publisher : ISBN 13 :9780309685061 Total Pages : pages Book Rating :4.6/5 (85 download)
Book Synopsis The Future of Nursing 2020-2030 by : National Academies of Sciences Engineering and Medicine
Download or read book The Future of Nursing 2020-2030 written by National Academies of Sciences Engineering and Medicine and published by . This book was released on 2021-09-30 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.
Author :National Academies of Sciences, Engineering, and Medicine Publisher :National Academies Press ISBN 13 :0309448042 Total Pages :83 pages Book Rating :4.3/5 (94 download)
Book Synopsis Accounting for Social Risk Factors in Medicare Payment by : National Academies of Sciences, Engineering, and Medicine
Download or read book Accounting for Social Risk Factors in Medicare Payment written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2016-10-14 with total page 83 pages. Available in PDF, EPUB and Kindle. Book excerpt: Recent health care payment reforms aim to improve the alignment of Medicare payment strategies with goals to improve the quality of care provided, patient experiences with health care, and health outcomes, while also controlling costs. These efforts move Medicare away from the volume-based payment of traditional fee-for-service models and toward value-based purchasing, in which cost control is an explicit goal in addition to clinical and quality goals. Specific payment strategies include pay-for-performance and other quality incentive programs that tie financial rewards and sanctions to the quality and efficiency of care provided and accountable care organizations in which health care providers are held accountable for both the quality and cost of the care they deliver. Accounting For Social Risk Factors in Medicare Payment: Data is the fourth in a series of five brief reports that aim to inform ASPE analyses that account for social risk factors in Medicare payment programs mandated through the IMPACT Act. This report provides guidance on data sources for and strategies to collect data on indicators of social risk factors that could be accounted for Medicare quality measurement and payment programs.
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.
Book Synopsis The Healthcare Imperative by : Institute of Medicine
Download or read book The Healthcare Imperative written by Institute of Medicine and published by National Academies Press. This book was released on 2011-01-17 with total page 852 pages. Available in PDF, EPUB and Kindle. Book excerpt: The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.
Book Synopsis Promising Care by : Donald M. Berwick
Download or read book Promising Care written by Donald M. Berwick and published by John Wiley & Sons. This book was released on 2013-11-25 with total page 323 pages. Available in PDF, EPUB and Kindle. Book excerpt: Promising Care: How We Can Rescue Health Care by Improving It collects 16 speeches given over a period of 10 years by Donald M. Berwick, an internationally acclaimed champion of health care improvement throughout the course of his long and storied career as a physician, health care educator and policy expert, leader of the Institute for Healthcare Improvement (IHI), and administrator of the Centers for Medicare & Medicaid Services. These landmark speeches (including all of Berwick’s speeches delivered at IHI’s annual National Forum on Quality Improvement in Health Care from 2003 to 2012) clearly show why our medical systems don’t reliably contribute to our overall health. As a remedy he offers a vision for making our systems better – safer, more effective, more efficient, and more humane. Each of Berwick’s compelling speeches is preceded by a brief commentary by a prominent figure in health care, policy, or politics who has a unique connection to that particular speech. Contributors include such notables as Tom Daschle, Paul Batalden, and Lord Nigel Crisp. Their commentaries reflect on how it felt to hear the speech in the context in which it was delivered, and assess its relevance in today’s health care environment. The introduction is by Maureen Bisognano, CEO of Institute for Healthcare Improvement, and author of Pursuing the Triple Aim. Praise for previous books by Don Berwick Curing Health Care: "The book is an easy and affirming read for anyone who is familiar with and has used the TQM teachings of Dr. Joseph M. Juran and Dr. W. Edwards Deming and would be a simple and informative introduction to the concepts for anyone who has been hearing about TQM but has no idea what it is all about and wants to know more." —Permanent Fixes (blog) "Donald Berwick is the most clearly heard evangelist of applying industrial methods of continuous quality improvement in health care." —Annals of Internal Medicine Escape Fire: "With an effective blend of common sense, real-life stories, persuasive metaphors, and out-of-the-box thinking, Dr. Berwick’s presentations make for fascinating reading for anyone interested in improving America’s $1.7 trillion health care system." —Piper Report "Anyone interested in change in the healthcare system would enjoy this book. In degree programs, the various speeches would be useful for discussion in a health policy readings course." —The Annals of Pharmacotherapy
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.
Book Synopsis Medicaid Hospital Payment by : Jennifer Baldwin
Download or read book Medicaid Hospital Payment written by Jennifer Baldwin and published by . This book was released on 1991 with total page 110 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Medicare Handbook written by and published by . This book was released on 1992 with total page 12 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicare Prospective Payment and the Shaping of U.S. Health Care by : Rick Mayes
Download or read book Medicare Prospective Payment and the Shaping of U.S. Health Care written by Rick Mayes and published by JHU Press. This book was released on 2006-12-20 with total page 274 pages. Available in PDF, EPUB and Kindle. Book excerpt: This is the definitive work on Medicare’s prospective payment system (PPS), which had its origins in the 1972 Social Security Amendments, was first applied to hospitals in 1983, and came to fruition with the Balanced Budget Act of 1997. Here, Rick Mayes and Robert A. Berenson, M.D., explain how Medicare’s innovative payment system triggered shifts in power away from the providers (hospitals and doctors) to the payers (government insurers and employers) and how providers have responded to encroachments on their professional and financial autonomy. They conclude with a discussion of the problems with the Medicare Modernization Act of 2003 and offer prescriptions for how policy makers can use Medicare payment policy to drive improvements in the U.S. health care system. Mayes and Berenson draw from interviews with more than sixty-five major policy makers—including former Treasury secretary Robert Rubin, U.S. Representatives Pete Stark and Henry Waxman, former White House chief of staff Leon Panetta, and former administrators of the Health Care Financing Administration Gail Wilensky, Bruce Vladeck, Nancy-Ann DeParle, and Tom Scully—to explore how this payment system worked and its significant effects on the U.S. medical landscape in the past twenty years. They argue that, although managed care was an important agent of change in the 1990s, the private sector has not been the major health care innovator in the United States; rather, Medicare’s transition to PPS both initiated and repeatedly intensified the economic restructuring of the U.S. health care system.
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 2001-07-19 with total page 359 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.
Book Synopsis Understanding Value Based Healthcare by : Vineet Arora
Download or read book Understanding Value Based Healthcare written by Vineet Arora and published by McGraw Hill Professional. This book was released on 2015-04-03 with total page 417 pages. Available in PDF, EPUB and Kindle. Book excerpt: Provide outstanding healthcare while keeping within budget with this comprehensive, engagingly written guide Understanding Value-Based Healthcare is a succinct, interestingly written primer on the core issues involved in maximizing the efficacy and outcomes of medical care when cost is a factor in the decision-making process. Written by internationally recognized experts on cost- and value-based healthcare, this timely book delivers practical and clinically focused guidance on one of the most debated topics in medicine and medicine administration today. Understanding Value-Based Healthcare is divided into three sections: Section 1 Introduction to Value in Healthcare lays the groundwork for understanding this complex topic. Coverage includes the current state of healthcare costs and waste in the USA, the challenges of understanding healthcare pricing, ethics of cost-conscious care, and more. Section 2 Causes of Waste covers important issues such as variation in resource utilization, the role of technology diffusion, lost opportunities to deliver value, and barriers to providing high-value care. Section 3 Solutions and Tools discusses teaching cost awareness and evidence-based medicine, the role of patients, high-value medication prescribing, screening and prevention, incentives, and implementing value-based initiatives. The authors include valuable case studies within each chapter to demonstrate how the material relates to real-world situations faced by clinicians on a daily basis. .
Book Synopsis Principles of Reimbursement for Services by Hospital-based Physicians by : United States. Social Security Administration
Download or read book Principles of Reimbursement for Services by Hospital-based Physicians written by United States. Social Security Administration and published by . This book was released on 1967 with total page 20 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Vital Signs by : Institute of Medicine
Download or read book Vital Signs written by Institute of Medicine and published by National Academies Press. This book was released on 2015-08-26 with total page 245 pages. Available in PDF, EPUB and Kindle. Book excerpt: Thousands of measures are in use today to assess health and health care in the United States. Although many of these measures provide useful information, their usefulness in either gauging or guiding performance improvement in health and health care is seriously limited by their sheer number, as well as their lack of consistency, compatibility, reliability, focus, and organization. To achieve better health at lower cost, all stakeholders - including health professionals, payers, policy makers, and members of the public - must be alert to what matters most. What are the core measures that will yield the clearest understanding and focus on better health and well-being for Americans? Vital Signs explores the most important issues - healthier people, better quality care, affordable care, and engaged individuals and communities - and specifies a streamlined set of 15 core measures. These measures, if standardized and applied at national, state, local, and institutional levels across the country, will transform the effectiveness, efficiency, and burden of health measurement and help accelerate focus and progress on our highest health priorities. Vital Signs also describes the leadership and activities necessary to refine, apply, maintain, and revise the measures over time, as well as how they can improve the focus and utility of measures outside the core set. If health care is to become more effective and more efficient, sharper attention is required on the elements most important to health and health care. Vital Signs lays the groundwork for the adoption of core measures that, if systematically applied, will yield better health at a lower cost for all Americans.
Book Synopsis Improving Quality in Medicare by : United States. Congress. Senate. Committee on Finance
Download or read book Improving Quality in Medicare written by United States. Congress. Senate. Committee on Finance and published by . This book was released on 2005 with total page 224 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Redefining Health Care by : Michael E. Porter
Download or read book Redefining Health Care written by Michael E. Porter and published by Harvard Business Press. This book was released on 2006-04-24 with total page 540 pages. Available in PDF, EPUB and Kindle. Book excerpt: The U.S. health care system is in crisis. At stake are the quality of care for millions of Americans and the financial well-being of individuals and employers squeezed by skyrocketing premiums—not to mention the stability of state and federal government budgets. In Redefining Health Care, internationally renowned strategy expert Michael Porter and innovation expert Elizabeth Teisberg reveal the underlying—and largely overlooked—causes of the problem, and provide a powerful prescription for change. The authors argue that competition currently takes place at the wrong level—among health plans, networks, and hospitals—rather than where it matters most, in the diagnosis, treatment, and prevention of specific health conditions. Participants in the system accumulate bargaining power and shift costs in a zero-sum competition, rather than creating value for patients. Based on an exhaustive study of the U.S. health care system, Redefining Health Care lays out a breakthrough framework for redefining the way competition in health care delivery takes place—and unleashing stunning improvements in quality and efficiency. With specific recommendations for hospitals, doctors, health plans, employers, and policy makers, this book shows how to move health care toward positive-sum competition that delivers lasting benefits for all.
