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Payment Reform To Support High Performing Practice
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Book Synopsis Payment Reform to Support High-performing Practice by :
Download or read book Payment Reform to Support High-performing Practice written by and published by . This book was released on 2010 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt: At the heart of the U.S. crisis in primary care sits a dysfunctional payment system for health care services. It richly rewards expensive procedures and grossly underpays for evaluation and management (E & M) services. It incents high volumes of high-cost care and largely ignores considerations of value. Although designed more than two decades ago to correct the imbalances in reimbursement between procedures and E & M services, it has come to exacerbate them. Access to high-quality primary care is becoming increasingly problematic in many parts of the country.
Book Synopsis Workforce Issues in Health Care Reform by : United States. Congress. Senate. Committee on Finance
Download or read book Workforce Issues in Health Care Reform written by United States. Congress. Senate. Committee on Finance and published by . This book was released on 2009 with total page 256 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Payment Reform for Primary Care Within the Accountable Care Organization by : Allan Goroll
Download or read book Payment Reform for Primary Care Within the Accountable Care Organization written by Allan Goroll and published by . This book was released on 2016 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Physicians in Accountable Care Organizations (ACOs) are being paid primarily fee-for-service, a practice that does not align them with the goals of the ACO. This paper provides a set of issues related to the current payment system and changing to a more global form of payment for primary care. The bottom line is that physicians must have confidence in, a commitment by new organizations such as ACOs to provide practices with the supports necessary for them to do their jobs well and to pay commensurately with the value they create. Such payment reform can provide the basis for a new social contract between the profession and society and help achieve the goal needed by the nation of better health care at lower cost.
Book Synopsis Pay for Innovation Or Pay for Standardization by :
Download or read book Pay for Innovation Or Pay for Standardization written by and published by . This book was released on 2009 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This primer published by the Network for Regional Healthcare Improvement (NRHI) urges major reforms in the way Medicare, Medicaid and private health insurance plans pay primary care physicians. Pay for Innovation or Pay for Standardization cautions that higher payments to primary care practices should be based primarily on whether they improve outcomes for their patients, rather than whether they meet detailed accreditation standards. The recommendations in the report were developed by more than 100 health care leaders from across the country who participated in NRHIâ€TMs 2008 national Summit on Healthcare Payment Reform. Summit participants developed recommendations regarding the type of payment changes needed and which primary care providers should be able to participate. The recommendation highlight that we should encourage and assist small physician practices to participate in medical home initiatives, since that is where the majority of primary care physicians in the nation practice. This is the third in a series of reports from NRHI examining ways to reform payment systems in order to improve quality and reduce costs in the health care system, supported by the Robert Wood Johnson Foundation.
Book Synopsis Health Reform Policy to Practice by : Ronald Stock
Download or read book Health Reform Policy to Practice written by Ronald Stock and published by Academic Press. This book was released on 2017-08-04 with total page 363 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health Reform Policy to Practice: Oregon as a Case Study for a Path to a Comprehensive and Sustainable Health Delivery Model offers a real world example of an innovative, successful and comprehensive program conducted by the U.S. State of Oregon. In 1991, Oregon embarked on a journey to improve health for all its citizens by radically re-thinking how to approach health care for long-term benefits. Over more than two decades, Oregonians have participated in a dialogue to create a new approach to solve the dilemma of providing high quality health care that is affordable and effective. Traditionally, health care reform looked at cutting people from care, cutting provider rates or cutting services. Oregon's approach is unique in that it built a new system of delivery from the ground (community) up. The Oregon model took a "Fourth Path to health care by redesigning the clinical delivery system through reducing waste, improving individual health and prevention, and therefore reducing utilization of services, creating local accountability, aligning financial incentives and creating fiscal accountability. This is not only an Oregon story, but a national one as other states, payers and purchasers implement health care reform. - Written by content experts who have been actively involved in health care reform efforts - Provides clear translation of current information and experience to implementation - Explores the potential impact of the Oregon experience on national and international health care reform efforts
Book Synopsis Provider Payment Reforms for Improved Primary Health Care in Romania by : Adanna Chukwuma
Download or read book Provider Payment Reforms for Improved Primary Health Care in Romania written by Adanna Chukwuma and published by . This book was released on with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Romania faces high levels of amenable mortality reflecting, in part, the relatively low utilization rates of high-quality primary health care (PHC), particularly for non-communicable disease (NCD) prevention and treatment. Provider payment mechanisms do not reward the high-quality care provision and may incentivize bypassing of PHC for hospitals, exacerbating challenges presented by physical, financial, and social barriers to accessing essential care. This paper assesses provider payment mechanisms at the PHC level, by examining their design features and implementation arrangements, and exploring their implications for PHC performance in terms of access and quality of care. The authors conclude with policy recommendations to address the constraints identified. To increase the supply of preventative care and case management, the authors recommend that volume thresholds for fee-for-service payments reflect both the number of enrollees and physicians in a practice; laboratory tests required for case management be reduced in scope and their costs be reimbursed; and the law on health care reform be amended to enable the introduction of new payment mechanisms, such as performance-based payments. To expand the scope of PHC and strengthen care coordination with hospitals, periodic reviews by physician commissions should aim to expand the scope of PHC care in line with provisions in other European Union (EU) countries for ambulatory-care sensitive conditions; capitation payments should be adjusted for gender and historical service use to reduce incentive for over-referrals; and payment mechanisms that reward coordination of care, including bundled payments, should be introduced. To establish an enabling environment for provider payment reforms, health information systems should be strengthened by unifying diagnosis coding, establishing quality standards, and ensuring referral module functionality; payment reforms should be informed by extensive consultations with providers at all service delivery levels; and PHC spending should be increased to support higher reimbursement levels for providers and match expenditure levels in high-performing EU health systems.
Book Synopsis Pay for Performance in Health Care by : Jerry Cromwell
Download or read book Pay for Performance in Health Care written by Jerry Cromwell and published by RTI Press. This book was released on 2011-02-28 with total page 388 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a balanced assessment of pay for performance (P4P), addressing both its promise and its shortcomings. P4P programs have become widespread in health care in just the past decade and have generated a great deal of enthusiasm in health policy circles and among legislators, despite limited evidence of their effectiveness. On a positive note, this movement has developed and tested many new types of health care payment systems and has stimulated much new thinking about how to improve quality of care and reduce the costs of health care. The current interest in P4P echoes earlier enthusiasms in health policy—such as those for capitation and managed care in the 1990s—that failed to live up to their early promise. The fate of P4P is not yet certain, but we can learn a number of lessons from experiences with P4P to date, and ways to improve the designs of P4P programs are becoming apparent. We anticipate that a “second generation” of P4P programs can now be developed that can have greater impact and be better integrated with other interventions to improve the quality of care and reduce costs.
Author :United States. Congress. Senate. Committee on Health, Education, Labor, and Pensions Publisher : ISBN 13 : Total Pages :88 pages Book Rating :4.:/5 (319 download)
Book Synopsis Improving Quality, Lowering Costs by : United States. Congress. Senate. Committee on Health, Education, Labor, and Pensions
Download or read book Improving Quality, Lowering Costs written by United States. Congress. Senate. Committee on Health, Education, Labor, and Pensions and published by . This book was released on 2014 with total page 88 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Integrating Behavioral Health and Primary Care by : Dr. Robert Feinstein
Download or read book Integrating Behavioral Health and Primary Care written by Dr. Robert Feinstein and published by Oxford University Press. This book was released on 2017-04-13 with total page 593 pages. Available in PDF, EPUB and Kindle. Book excerpt: Integrated care incorporates behavioral and physical health services into primary care and specialty medical environments. Integrated care models are patient-centered; delivered by teams of medical professionals, utilize care coordination, and a population-based approach. This book is practical, office-based, and comfortably accessible to students, residents, faculty, and all mental health professionals, primary care and medical specialists. We examine and recommend applying collaborative care and other existing models of integrated care based on existing literature. When there is no literature supporting a specific approach, our experts offer their ideas and take an aspirational approach about how to manage and treat specific behavioral disorder or problems We assume the use of integrated team staffing including a primary care or specialist provider(s), front desk staff, medical assistant(s), nurse(s), nurse practitioners, behavioral health specialist(s), health coaches, consulting psychiatrist, and care coordinator(s)/manager(s).
Book Synopsis Best practices DOD training can do more to help weapon system programs implement best practices : report to the chairman and ranking minority member, Subcommittee on Readiness and Management Support, Committee on Armed Services, U.S. Senate by :
Download or read book Best practices DOD training can do more to help weapon system programs implement best practices : report to the chairman and ranking minority member, Subcommittee on Readiness and Management Support, Committee on Armed Services, U.S. Senate written by and published by DIANE Publishing. This book was released on with total page 76 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :National Academies of Sciences, Engineering, and Medicine Publisher :National Academies Press ISBN 13 :0309391970 Total Pages :95 pages Book Rating :4.3/5 (93 download)
Book Synopsis Systems Practices for the Care of Socially At-Risk Populations by : National Academies of Sciences, Engineering, and Medicine
Download or read book Systems Practices for the Care of Socially At-Risk Populations written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2016-05-07 with total page 95 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Centers for Medicare & Medicaid Services (CMS) have been moving from volume-based, fee-for-service payment to value-based payment (VBP), which aims to improve health care quality, health outcomes, and patient care experiences, while also controlling costs. Since the passage of the Patient Protection and Affordable Care Act of 2010, CMS has implemented a variety of VBP strategies, including incentive programs and risk-based alternative payment models. Early evidence from these programs raised concerns about potential unintended consequences for health equity. Specifically, emerging evidence suggests that providers disproportionately serving patients with social risk factors for poor health outcomes (e.g., individuals with low socioeconomic position, racial and ethnic minorities, gender and sexual minorities, socially isolated persons, and individuals residing in disadvantaged neighborhoods) may be more likely to fare poorly on quality rankings and to receive financial penalties, and less likely to receive financial rewards. The drivers of these disparities are poorly understood, and differences in interpretation have led to divergent concerns about the potential effect of VBP on health equity. Some suggest that underlying differences in patient characteristics that are out of the control of providers lead to differences in health outcomes. At the same time, others are concerned that differences in outcomes between providers serving socially at-risk populations and providers serving the general population reflect disparities in the provision of health care. Systems Practices for the Care of Socially At-Risk Populations seeks to better distinguish the drivers of variations in performance among providers disproportionately serving socially at-risk populations and identifies methods to account for social risk factors in Medicare payment programs. This report identifies best practices of high-performing hospitals, health plans, and other providers that serve disproportionately higher shares of socioeconomically disadvantaged populations and compares those best practices of low-performing providers serving similar patient populations. It is the second in a series of five brief reports that aim to inform the Office of the Assistant Secretary of Planning and Evaluation (ASPE) analyses that account for social risk factors in Medicare payment programs mandated through the Improving Medicare Post-Acute Care Transformation (IMPACT) Act.
Book Synopsis Lifestyle Medicine by : Jeffrey I. Mechanick
Download or read book Lifestyle Medicine written by Jeffrey I. Mechanick and published by Springer. This book was released on 2016-03-18 with total page 367 pages. Available in PDF, EPUB and Kindle. Book excerpt: Lifestyle – the manner in which people live – is fundamental to health, wellness, and prevention of disease. It follows that attention to lifestyle is critically important to effective and successful health care. But here’s the challenge: health care professionals receive very little, if any, formal training about lifestyle counseling and therefore are ill equipped to incorporate lifestyle issues into clinical practice. In response, “Lifestyle Medicine” is evolving as a means to fill this knowledge gap. Lifestyle medicine approaches health and wellness by harnessing the power of lifestyle-related behaviors and influencing the environment we live in. It is a formal approach that promises to enhance and strengthen a re-invigorated health care system that is still outpaced by the epidemic proportions and complexity of chronic diseases like obesity, diabetes, depression, hypertension, and cancer, among others. Lifestyle Medicine: A Manual for Clinical Practice presents this formal approach in a pragmatic context. This unique and practical manual provides clear and succinct guidance on nearly all aspects of lifestyle medicine. The approach is both explanatory and pragmatic, providing case studies and bulleted translation of academic information into clinical practice recommendations. There is an emphasis on scientific evidence wherever possible as well as opinions by the expert chapter authors who practice lifestyle medicine. There is a “how-to” rationality to the book, consistent with a premise that any and all health care professionals should, and perhaps must, incorporate lifestyle medicine. A valuable checklist is included at the close of the book that summarizes key points and provides a practical tool for routine patient encounters.
Book Synopsis Using Physician Payment Reform to Enhance Health System Performance by : Marsha Gold
Download or read book Using Physician Payment Reform to Enhance Health System Performance written by Marsha Gold and published by . This book was released on 2008 with total page 17 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Culturally Responsive Teaching and The Brain by : Zaretta Hammond
Download or read book Culturally Responsive Teaching and The Brain written by Zaretta Hammond and published by Corwin Press. This book was released on 2014-11-13 with total page 290 pages. Available in PDF, EPUB and Kindle. Book excerpt: A bold, brain-based teaching approach to culturally responsive instruction To close the achievement gap, diverse classrooms need a proven framework for optimizing student engagement. Culturally responsive instruction has shown promise, but many teachers have struggled with its implementation—until now. In this book, Zaretta Hammond draws on cutting-edge neuroscience research to offer an innovative approach for designing and implementing brain-compatible culturally responsive instruction. The book includes: Information on how one’s culture programs the brain to process data and affects learning relationships Ten “key moves” to build students’ learner operating systems and prepare them to become independent learners Prompts for action and valuable self-reflection
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 Public Budgeting Reform in China: Theory and Practice by : Xiaonan Liu
Download or read book Public Budgeting Reform in China: Theory and Practice written by Xiaonan Liu and published by Springer. This book was released on 2015-10-30 with total page 238 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book introduces the theory and practice of Chinese public budget reform, including the manner and implications of public budget reform, the role and status of central government and local governments in budget reform, as well as the latest achievements of China’s local government public budget reform. The authors of this book are all researchers who have witnessed Chinese public budget reform.
Book Synopsis High-impact Educational Practices by : George D. Kuh
Download or read book High-impact Educational Practices written by George D. Kuh and published by . This book was released on 2008 with total page 50 pages. Available in PDF, EPUB and Kindle. Book excerpt: This publication¿the latest report from AAC&U¿s Liberal Education and America¿s Promise (LEAP) initiative¿defines a set of educational practices that research has demonstrated have a significant impact on student success. Author George Kuh presents data from the National Survey of Student Engagement about these practices and explains why they benefit all students, but also seem to benefit underserved students even more than their more advantaged peers. The report also presents data that show definitively that underserved students are the least likely students, on average, to have access to these practices.
