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Collaborative Care Before Accountable Care: Achieving Low-Cost, High-Quality Care Through a Regional Collaborative in FloridaAs accountable care organizations proliferate across the nation, delivery systems still struggle to balance quality improvement, cost containment, and migration toward accountable care. This paper describes the phased approach where the University of Florida Health Science Center and Shands Teaching Hospital and Clinics, Inc, and Orlando Health have jointly developed a series of clinical and health services that are of the highest quality and are offered at the lowest cost. The result is a regional collaborative that will be the foundation for a regional accountable care organization, first leveraging clinical core competencies, then moving to a more integrated model.
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Scalable Hospital at Home With Virtual Physician Visits: Pilot StudyResults suggest that this scalable model of Hospital at Home is safe, feasible, highly satisfactory, and may be associated with substantial reductions in hospital readmissions.
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Unintended Consequences of a Quality Measure for Acute BronchitisA quality measure reduced antibiotic use for patients with acute bronchitis but led to use of an alternative diagnosis, offsetting most of the observed improvement.
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Electronic Health Record Adoption and Quality Improvement in US HospitalsA national study of electronic health record (EHR) adoption and hospital quality finds that existing measures may be inappropriate for assessing the effect of EHR adoption on quality.
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Documentation of the 5 As for Smoking Cessation by PCPs Across Distinct Health SystemsEvaluation of the 5 As of smoking cessation using patient electronic medical records across 6 distinct healthcare systems, stratified by comorbidity, gender, age, race ethnicity.
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CAH Staff Perceptions of a Clinical Information System ImplementationThis study examines staff perceptions of patient care quality and the processes before and after implementation of a comprehensive clinical information system in 7 critical access hospitals.
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Potential Benefits of Increased Access to Doula Support During ChildbirthIncreasing access to continuous labor support from a birth doula may facilitate decreases in non-indicated cesarean rates among women who desire doula care.
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A Cost-Effectiveness Analysis of Cardiology eConsults for Medicaid PatientsA randomized trial of eConsults for cardiology referrals from primary care resulted in significant reductions in total cost of care compared with traditional face-to-face consultations.
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Pattern of Statin Use Among 10 Cohorts of New Users From 1995 to 2004: A Register-Based Nationwide StudyOne-year persistence among new users of statins in Finland improved from 1995 to 1998, after which no substantial changes were observed up to 2004.
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Is There a Mathematical Resolution to the Cost-Versus-Value Debate?Solutions proposed by patient advocates and physicians to control costs provide approaches to valuing new drug/treatments compared with 1 or several prevailing standards of care. Increasingly, however, the debate over cost is transitioning to a debate over value.
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Association of Part D Coverage Gap With COPD Medication AdherenceUsing longitudinal Medicare claims data, this study quantified the association of the Medicare Part D coverage gap with medication adherence among beneficiaries with chronic obstructive pulmonary disease.
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Health Plan Resource Use Bringing Us Closer to Value-Based DecisionsThere is a critical need for comparative information about plan resource use to support value-based purchasing efforts.
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A Strategy to Promote Population-Wide Life Satisfaction While Advancing EquityThe authors used health care claims and survey data to identify a strategy that might promote life satisfaction while advancing equity in an insured population.
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Reducing Long-Term Cost by Transforming Primary Care: Evidence From Geisinger's Medical Home ModelProvenHealth Navigator, Geisinger's version of advanced patient-centered medical homes, is associated with significant savings in total cost of care over time.
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Patient Perceptions of In-home Urgent Care via Mobile Integrated HealthComparing patients’ experiences with in-home urgent care from community paramedics vs urgent care provided in emergency departments, we found higher satisfaction among patients receiving in-home treatment.
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Genetic Counselors Save Costs Across the Genetic Testing SpectrumGenetic counselors (GCs) increasingly serve a variety of roles across the healthcare spectrum, including test utilization management. Our data show that utilizing the expertise of GCs reduced test order errors, improved patient outcomes, and resulted in significant cost savings to the healthcare system.
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Impact of a Pharmacy-Based Transitional Care Program on Hospital ReadmissionsPatients receiving postdischarge care from pharmacists had a 28% lower risk of readmission at 30 days and a 31.9% lower risk at 180 days compared with usual care.
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IT-Enabled Systems Engineering Approach to Monitoring and Reducing ADEsSelf-empowering team resource management, when aided by information technology, appears to help reduce adverse drug events in primary care offices.
