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Abstract
BACKGROUND US hospitals are penalized for excess 30-day readmissions and mortality for select conditions. Under the Centers for Medicare and Medicaid Services policy, readmission prevention is incentivized to a greater extent than mortality reduction. A strategy to potentially improve hospital performance on either measure is by improving nursing care, as nurses provide the largest amount of direct patient care. However, little is known as to whether achieving nursing excellence, such as Magnet status, is associated with improved hospital performance on readmissions and mortality. OBJECTIVE The purpose of this study was to examine the relationship between hospitals' Magnet status and performance on readmission and mortality rates for Medicare beneficiaries. RESEARCH DESIGN This is a cross-sectional analysis of Medicare readmissions and mortality reduction programs from 2013 to 2016. A propensity score-matching approach was used to take into account differences in baseline characteristics when comparing Magnet and non-Magnet hospitals. SUBJECTS The sample was comprised of 3877 hospitals. MEASURES The outcome measures were 30-day risk-standardized readmission and mortality rates. RESULTS Following propensity score matching on hospital characteristics, we found that Magnet hospitals outperformed non-Magnet hospitals in reducing mortality; however, Magnet hospitals performed worse in reducing readmissions for acute myocardial infarction, coronary artery bypass grafting, and stroke. CONCLUSIONS Magnet hospitals performed better on the Hospital Value-Based Purchasing Mortality Program than the Hospital Readmissions Reduction Program. The results of this study suggest the need for The Magnet Recognition Program to examine the role of nurses in postdischarge activities as a component of its evaluation criteria.
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Affiliation(s)
- Hanadi Y Hamadi
- Department of Health Administration, Brooks College of Health, University of North Florida
| | - Dayana Martinez
- Department of Health Administration, Brooks College of Health, University of North Florida
| | - Julia Palenzuela
- Department of Health Administration, Brooks College of Health, University of North Florida
| | - Aaron C Spaulding
- Department of Health Sciences Research, Division of Health Care Policy and Research, Mayo Clinic Robert D. and Patricia E. Kern, Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL
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Naessens JM, Van Such MB, Nesse RE, Dilling JA, Swensen SJ, Thompson KM, Orlowski JM, Santrach PJ. Looking Under the Streetlight? A Framework for Differentiating Performance Measures by Level of Care in a Value-Based Payment Environment. Acad Med 2017; 92:943-950. [PMID: 28353502 PMCID: PMC5483980 DOI: 10.1097/acm.0000000000001654] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The majority of quality measures used to assess providers and hospitals are based on easily obtained data, focused on a few dimensions of quality, and developed mainly for primary/community care and population health. While this approach supports efforts focused on addressing the triple aim of health care, many current quality report cards and assessments do not reflect the breadth or complexity of many referral center practices.In this article, the authors highlight the differences between population health efforts and referral care and address issues related to value measurement and performance assessment. They discuss why measures may need to differ across the three levels of care (primary/community care, secondary care, complex care) and illustrate the need for further risk adjustment to eliminate referral bias.With continued movement toward value-based purchasing, performance measures and reimbursement schemes need to reflect the increased level of intensity required to provide complex care. The authors propose a framework to operationalize value measurement and payment for specialty care, and they make specific recommendations to improve performance measurement for complex patients. Implementing such a framework to differentiate performance measures by level of care involves coordinated efforts to change both policy and operational platforms. An essential component of this framework is a new model that defines the characteristics of patients who require complex care and standardizes metrics that incorporate those definitions.
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Affiliation(s)
- James M. Naessens
- 1 J.M. Naessens is professor of health services research, Mayo Clinic, and scientific director, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, Florida
| | - Monica B. Van Such
- 2 M.B. Van Such is principal analyst, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Robert E. Nesse
- 3 R.E. Nesse is senior medical director for payment reform and professor of family medicine, Mayo Clinic, Rochester, Minnesota
| | - James A. Dilling
- 4 J.A. Dilling is chief operating officer for quality, Baylor, Scott & White Health, Dallas, Texas
| | - Stephen J. Swensen
- 5 S.J. Swensen is professor of radiology and past director of quality, Mayo Clinic, Rochester, Minnesota
| | - Kristine M. Thompson
- 6 K.M. Thompson is assistant professor of emergency medicine and performance improvement officer, Mayo Clinic, Jacksonville, Florida
| | - Janis M. Orlowski
- 7 J.M. Orlowski is chief health care officer, Association of American Medical Colleges, Washington, DC
| | - Paula J. Santrach
- 8 P.J. Santrach is associate professor of laboratory medicine and pathology and chief quality officer, Mayo Clinic, Rochester, Minnesota
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3
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Abstract
The US healthcare system is rapidly moving toward rewarding value. Recent legislation, such as the Affordable Care Act and the Medicare Access and CHIP Reauthorization Act, solidified the role of value-based payment in Medicare. Many private insurers are following Medicare's lead. Much of the policy attention has been on programs such as accountable care organizations and bundled payments; yet, value-based purchasing (VBP) or pay-for-performance, defined as providers being paid fee-for-service with payment adjustments up or down based on value metrics, remains a core element of value payment in Medicare Access and CHIP Reauthorization Act and will likely remain so for the foreseeable future. This review article summarizes the current state of VBP programs and provides analysis of the strengths, weaknesses, and opportunities for the future. Multiple inpatient and outpatient VBP programs have been implemented and evaluated; the impact of those programs has been marginal. Opportunities to enhance the performance of VBP programs include improving the quality measurement science, strengthening both the size and design of incentives, reducing health disparities, establishing broad outcome measurement, choosing appropriate comparison targets, and determining the optimal role of VBP relative to alternative payment models. VBP programs will play a significant role in healthcare delivery for years to come, and they serve as an opportunity for providers to build the infrastructure needed for value-oriented care.
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Affiliation(s)
- Tingyin T Chee
- From Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC (T.T.C., W.B.B.); Department of Health Policy, University of Michigan, Ann Arbor (A.M.R.); and Cardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (J.H.W.)
| | - Andrew M Ryan
- From Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC (T.T.C., W.B.B.); Department of Health Policy, University of Michigan, Ann Arbor (A.M.R.); and Cardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (J.H.W.)
| | - Jason H Wasfy
- From Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC (T.T.C., W.B.B.); Department of Health Policy, University of Michigan, Ann Arbor (A.M.R.); and Cardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (J.H.W.)
| | - William B Borden
- From Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC (T.T.C., W.B.B.); Department of Health Policy, University of Michigan, Ann Arbor (A.M.R.); and Cardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (J.H.W.)
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Figueroa JF, Tsugawa Y, Zheng J, Orav EJ, Jha AK. Association between the Value-Based Purchasing pay for performance program and patient mortality in US hospitals: observational study. BMJ 2016; 353:i2214. [PMID: 27160187 PMCID: PMC4861084 DOI: 10.1136/bmj.i2214] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To determine the impact of the Hospital Value-Based Purchasing (HVBP) program-the US pay for performance program introduced by Medicare to incentivize higher quality care-on 30 day mortality for three incentivized conditions: acute myocardial infarction, heart failure, and pneumonia. DESIGN Observational study. SETTING 4267 acute care hospitals in the United States: 2919 participated in the HVBP program and 1348 were ineligible and used as controls (44 in general hospitals in Maryland and 1304 critical access hospitals across the United States). PARTICIPANTS 2 430 618 patients admitted to US hospitals from 2008 through 2013. MAIN OUTCOME MEASURES 30 day risk adjusted mortality for acute myocardial infarction, heart failure, and pneumonia using a patient level linear spline analysis to examine the association between the introduction of the HVBP program and 30 day mortality. Non-incentivized, medical conditions were the comparators. A secondary outcome measure was to determine whether the introduction of the HVBP program was particularly beneficial for a subgroup of hospital-poor performers at baseline-that may benefit the most. RESULTS Mortality rates of incentivized conditions in hospitals participating in the HVBP program declined at -0.13% for each quarter during the preintervention period and -0.03% point difference for each quarter during the post-intervention period. For non-HVBP hospitals, mortality rates declined at -0.14% point difference for each quarter during the preintervention period and -0.01% point difference for each quarter during the post-intervention period. The difference in the mortality trends between the two groups was small and non-significant (difference in difference in trends -0.03% point difference for each quarter, 95% confidence interval -0.08% to 0.13% point difference, P=0.35). In no subgroups of hospitals was HVBP associated with better outcomes, including poor performers at baseline. CONCLUSIONS Evidence that HVBP has led to lower mortality rates is lacking. Nations considering similar pay for performance programs may want to consider alternative models to achieve improved patient outcomes.
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Affiliation(s)
- Jose F Figueroa
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Yusuke Tsugawa
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Jie Zheng
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - E John Orav
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Ashish K Jha
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA Section of General Internal Medicine, VA Boston Healthcare System, Boston, MA, USA
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Beveridge RA. The path to value through the use of holistic care. Am J Manag Care 2015; 21:674b-c. [PMID: 26633098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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McFarland DC, Ornstein KA, Holcombe RF. Demographic factors and hospital size predict patient satisfaction variance--implications for hospital value-based purchasing. J Hosp Med 2015; 10:503-9. [PMID: 25940305 PMCID: PMC4790720 DOI: 10.1002/jhm.2371] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 03/17/2015] [Accepted: 04/03/2015] [Indexed: 11/05/2022]
Abstract
BACKGROUND Hospital Value-Based Purchasing (HVBP) incentivizes quality performance-based healthcare by linking payments directly to patient satisfaction scores obtained from Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. Lower HCAHPS scores appear to cluster in heterogeneous population-dense areas and could bias Centers for Medicare & Medicaid Services (CMS) reimbursement. OBJECTIVE Assess nonrandom variation in patient satisfaction as determined by HCAHPS. DESIGN Multivariate regression modeling was performed for individual dimensions of HCAHPS and aggregate scores. Standardized partial regression coefficients assessed strengths of predictors. Weighted Individual (hospital) Patient Satisfaction Adjusted Score (WIPSAS) utilized 4 highly predictive variables, and hospitals were reranked accordingly. SETTING A total of 3907 HVBP-participating hospitals. PATIENTS There were 934,800 patient surveys by the most conservative estimate. MEASUREMENTS A total of 3144 county demographics (US Census) and HCAHPS surveys. RESULTS Hospital size and primary language (non-English speaking) most strongly predicted unfavorable HCAHPS scores, whereas education and white ethnicity most strongly predicted favorable HCAHPS scores. The average adjusted patient satisfaction scores calculated by WIPSAS approximated the national average of HCAHPS scores. However, WIPSAS changed hospital rankings by variable amounts depending on the strength of the predictive variables in the hospitals' locations. Structural and demographic characteristics that predict lower scores were accounted for by WIPSAS that also improved rankings of many safety-net hospitals and academic medical centers in diverse areas. CONCLUSIONS Demographic and structural factors (eg, hospital beds) predict patient satisfaction scores even after CMS adjustments. CMS should consider WIPSAS or a similar adjustment to account for the severity of patient satisfaction inequities that hospitals could strive to correct.
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Affiliation(s)
- Daniel C McFarland
- Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, New York, New York
| | - Katherine A Ornstein
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, New York, New York
| | - Randall F Holcombe
- Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, New York, New York
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7
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Rice RT. Practitioner application. J Healthc Manag 2015; 60:231-232. [PMID: 26554268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Rangnekar A, Johnson T, Garman A, O'Neil P. The Relationship Between Hospital Value-Based Purchasing Program Scores and Hospital Bond Ratings. J Healthc Manag 2015; 60:220-231. [PMID: 26554267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Tax-exempt hospitals and health systems often borrow long-term debt to fund capital investments. Lenders use bond ratings as a standard metric to assess whether to lend funds to a hospital. Credit rating agencies have historically relied on financial performance measures and a hospital's ability to service debt obligations to determine bond ratings. With the growth in pay-for-performance-based reimbursement models, rating agencies are expanding their hospital bond rating criteria to include hospital utilization and value-based purchasing (VBP) measures. In this study, we evaluated the relationship between the Hospital VBP domains--Clinical Process of Care, Patient Experience of Care, Outcome, and Medicare Spending per Beneficiary (MSPB)--and hospital bond ratings. Given the historical focus on financial performance, we hypothesized that hospital bond ratings are not associated with any of the Hospital VBP domains. This was a retrospective, cross-sectional study of all hospitals that were rated by Moody's for fiscal year 2012 and participated in the Centers for Medicare & Medicaid Services' VBP program as of January 2014 (N = 285). Of the 285 hospitals in the study, 15% had been assigned a bond rating of Aa, and 46% had been assigned an A rating. Using a binary logistic regression model, we found an association between MSPB only and bond ratings, after controlling for other VBP and financial performance scores; however, MSPB did not improve the overall predictive accuracy of the model. Inclusion of VBP scores in the methodology used to determine hospital bond ratings is likely to affect hospital bond ratings in the near term.
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9
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Herman B. Value-based care not likely to end financial squabbles between insurers, providers. Mod Healthc 2015; 45:10. [PMID: 25671911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Abstract
Claims, justifying the acceptance and placement of new products on health system formularies, are all too often presented in terms that are either unverifiable or only verifiable in a timeframe that is of no practical benefit to formulary committees. One solution is for formulary committees to request that (i) all predictive claims made should be capable of empirical testing and (ii) manufacturers in making submissions should be asked to submit a protocol that details how their claims are to be assessed. Evaluation of claims can provide not only a significant input to ongoing disease area and therapeutic reviews, but can also provide a needed link to comparative effectiveness research and value-based healthcare. This paper presents a set of protocol standards (PROST) together will questions that should be addressed in a protocol review.
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Affiliation(s)
- Jon C Schommer
- a a College of Pharmacy, University of Minnesota , Minneapolis , MN , USA
| | - Angeline M Carlson
- b b College of Pharmacy and School of Public Health, University of Minnesota , Minneapolis , MN , USA , and Data Intelligence Consultants LLC , Eden Prairie , MN , USA
| | - Taeho Greg Rhee
- a a College of Pharmacy, University of Minnesota , Minneapolis , MN , USA
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Discharge planning takes spotlight as VBP focuses on efficiency. Hosp Case Manag 2014; 22:89-91. [PMID: 24946379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Hospital efficiency of care, a new domain in the Centers for Medicare & Medicaid Services Value-based Purchasing Program, bases hospital scores on spending three days before admission through 30 days after discharge. Case managers need to take the time to develop a discharge plan that works and look at cost-effectiveness as well as appropriateness of the level of care, experts say. Because the data used for this measure is risk-adjusted, it's crucial for the documentation in the medical record to clearly and accurately reflect the patient's severity of illness. Become familiar with all the potential discharge destinations and spend time with each provider, experts recommend.
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Look ahead to succeed under VBP. Hosp Case Manag 2014; 22:92-3. [PMID: 24946380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The Centers for Medicare & Medicaid Services (CMS) is adding new metrics to its Value-based Purchasing Program each year, and case managers should look ahead to ensure that their hospital performs well on the measures. CMS automatically withholds a percentage of the Medicare base operating payment each year (1.5% in fiscal 2015), and hospitals can earn back what was deducted or more by performing well. Value-based purchasing for 2015 includes four domains: clinical processes of care, outcomes, Hospital Consumer Assessment of Healthcare Programs and Systems (HCAHPS), and hospital efficiency of care. Any measure that is in the Inpatient Quality Reporting Program is considered to be on deck for value-based purchasing.
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13
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CMS emphasizes quality patient care. Hosp Case Manag 2014; 22:94-5. [PMID: 24946382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The Inpatient Prospective Payment System proposed rule for fiscal 2015 continues the Centers for Medicare & Medicaid Services' move toward basing reimbursement on quality of care, not quantity. The rule also asks for public input on the two-midnight rule and a policy to address short-stay patients. CMS is implementing the Hospital-Acquired Condition Reduction Program, which penalizes hospitals that perform poorly. The agency proposes to add two safety measures to value-based purchasing in the future.
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Goozner M. Insuring against the future. Mod Healthc 2014; 44:24. [PMID: 25134409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Kaplan G, Robeznieks A. Prospering by standardizing processes and improving the patient experience. Mod Healthc 2014; 44:28-29. [PMID: 24693751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Byock I. We must--and we can--do better. Health Prog 2014; 95:55-59. [PMID: 24624562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Szablowski KM. Hospital value-based purchasing (VBP) program: measurement of quality and enforcement of quality improvement. Conn Med 2014; 78:49-51. [PMID: 24600783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
VBP program is a novel medicare payment estimatin tool used to encourage clinical care quality improvement as well as improvement of patient experience as a customer of a health care system. The program utilizes well established tools of measuring clinical care quality and patient satisfaction such as the hospital IQR program and HCAHPS survey to estimate Medicare payments and encourage hospitals to continuosly improve the level of care they provide.
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Drell L. Sticker shock! Mark Health Serv 2014; 34:28-31. [PMID: 24741766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Rewarding quality--the 10 most- and least-improved hospitals. Mod Healthc 2013; 43:30. [PMID: 24437036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Simple but thoughtful process changes can improve patient satisfaction. OR Manager 2013; 29:14-6. [PMID: 24527512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Stempniak M. Separately together. Systems work jointly on managing population health. Hosp Health Netw 2013; 87:19. [PMID: 24303628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Aston G. Diabetes: the right care and the right reimbursement. Hosp Health Netw 2013; 87:40-2. [PMID: 24303636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Managing patients with diabetes or other chronic diseases is suddenly a major focus for hospitals. They're working with insurers to develop fair, effective reimbursement models.
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Care integration and network models: how to become a player. Caring 2013; 32:24-5. [PMID: 24312971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Turrell A. Procurement. Challenging traditional methods of procurement. Health Serv J 2013; 123:19-21. [PMID: 23944006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Kutscher B. Patients and price. HFMA looks at costs, transparency. Mod Healthc 2013; 43:13. [PMID: 23878866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Fifer J. Steps toward transparency. Health organizations need to be open with consumers about pricing. Mod Healthc 2013; 43:28. [PMID: 23875238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Joseph Fifer
- Healthcare Financial Management Association, USA
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Abstract
As health care expenditures increase, payers, including the Centers for Medicare and Medicaid Services, are moving away from reimbursement based on types and volume of services to an emphasis on quality of provided care, an approach called value-based purchasing (VBP). Because it is tied to reimbursement, VBP creates economic motivation to measure and improve care. VBP is proceeding without high-level evidence supporting its effectiveness in improving health care quality. Rising health care costs, however, make VBP an attractive approach for curtailing costs and emphasizing improved quality, and VBP is likely to become a more prevalent mechanism of reimbursement for providers and facilities.
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Affiliation(s)
- James M O'Brien
- Quality and Patient Safety, Riverside Methodist Hospital, Columbus, OH 43214, USA.
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Bernd D. Managing risk in a population. The new economics of health care. Hosp Health Netw 2013; 87:63. [PMID: 23814959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Fifer J. Defining value: how will you quantify excellence? Hosp Health Netw 2013; 87:60. [PMID: 23814956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Joseph Fifer
- Healthcare Financial Management Association, Westchester, Ill, USA
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Umbdenstock R. A commitment to value, unleashed: hospitals step up. Hosp Health Netw 2013; 87:59. [PMID: 23814955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Hessler FA. Directing capital of value-makers: what investors want. Hosp Health Netw 2013; 87:62. [PMID: 23814958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Karash JA. Investing in value-based health care. Hosp Health Netw 2013; 87:54-58. [PMID: 23814954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Binder L. Focus on value. Hospitals, patients benefit when providers treat quality like a financial report. Mod Healthc 2013; 43:26. [PMID: 23944136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Burdick HJ. Deadlines for payments or penalties. W V Med J 2013; 109:4-5. [PMID: 23600097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Bendix J. Private payers re-examining reimbursement. A host of new payment models will bring pressure on PCPs to hold down costs, improve quality. Med Econ 2013; 90:48-54. [PMID: 23875282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Abstract
This paper and the three presentations it supports are drawn from the theme of the 2012 Cancer Center Business Summit (CCBS): "Transitioning to Value-Based Oncology: Strategies to Survive and Thrive." The CCBS is a forum on oncology business innovation, and the principal question the organizers address each year is "What are the creative, innovative, and best business models and practices that are being conceived or piloted today that may provide a responsible and sustainable platform for the delivery of cancer care tomorrow?" At this moment in health care-when so much is in flux and new business models and solutions abound-the oncology sector has a solemn responsibility: to forge the business models and relationships that will help to define a new cancer care value proposition and a sustainable health care system of tomorrow for the benefit of the patients it serves to get it "right."
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Affiliation(s)
- John V Cox
- From Texas Oncology, PA, Dallas, TX; Consultants in Medical Oncology & Hematology, Drexel Hill, PA; Cancer Center Business Development Group, Bedford, NH
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HFMA. Maximizing value from anesthesia services. Healthc Financ Manage 2012; 66:41-2. [PMID: 23173360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Frick KD. National Quality Forum guidelines for comparing outcomes and resource use. Virtual Mentor 2012; 14:877-879. [PMID: 23351901 DOI: 10.1001/virtualmentor.2012.14.11.pfor1-1211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Kevin D Frick
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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White SE, Taylor LB. Accountable care and data analytics emerging in healthcare. J AHIMA 2012; 83:56-58. [PMID: 23210300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Hoppes M. Embracing change…anticipating risk. J Healthc Risk Manag 2011; 31:1-2. [PMID: 21990196 DOI: 10.1002/jhrm.20081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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