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Value-Based Contracting Innovated Medicare Advantage Healthcare Delivery and Improved SurvivalElderly Medicare Advantage members with multiple chronic conditions attained a survival benefit from more cost-effective care when a private plan developed gainshare and monetary risk-bearing arrangements with its contracted providers.
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“Lean” Improvement in the Quality of Patient Care in the Hospital Admissions ProcessThe objective of this work is to improve the quality of patient care in the admission office service of the University Hospital Virgen del Rocío (HUVR) by standardizing and systematizing its procedures using Lean methodology. The results have allowed HUVR to achieve continuous improvement in the process, eliminating the elements that do not add value.
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Helping Cancer Patients and Caregivers Navigate Immunotherapy TreatmentPatients, caregivers, and providers need education on immunotherapy treatment, support in patient-provider communications as well as support in mitigating the financial impact of immunotherapy treatment.
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Primary Care Physician Resource Use Changes Associated With Feedback ReportsImplementing systemwide dissemination of feedback reports to primary care physicians in an integrated delivery system may be associated with changes in medical resource use.
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Disease Management Programs in Type 2 Diabetes: Quality of CareDisease management programs for diabetes can improve some processes of care, but they do not improve intermediate outcomes beyond doubt.
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Artificial Intelligence in Medicare: Utilization, Spending, and Access to AI-Enabled Clinical SoftwareThis study quantified the trends over time in utilization of, spending on, and access to CT fractional flow reserve, the first artificial intelligence (AI)–enabled clinical software reimbursed by Medicare.
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Quality of Anticoagulation Control Among Patients With Atrial FibrillationPatients with atrial fibrillation receiving routine medical care within a large managed care organization were found to have suboptimal anticoagulation control.
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What Performance Measures Do Consumers Find Useful When Selecting Marketplace Health Plans?Marketplace consumers desire more health plan measures on how well plans support long-term patient—physician relationships. Consumers are skeptical of measures about rewarding providers for high quality.
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Why Accounting for Our Differences Matter in Assessing Drug ValueThe authors discuss how more efforts need to ensure the methods used to measure the “value” of new therapies include factors that reflect patient heterogeneity.
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Access to Primary and Dental Care Among Adults Newly Enrolled in MedicaidNearby provider supply did not affect identification of usual sources of primary or dental care among new Medicaid enrollees. Strategies to improve access are needed.
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Why Palliative Care Is the Answer to the Serious Illness Question in Payment ReformWhether it is through enlisting primary providers, building a champion workforce, or hiring more specialist consultants, there is no question that palliative programming must be at the heart of our healthcare system’s quality transformation.
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Road Map to Success in the OCM: From Team Building to ImplementationWe learned that a true patient-centered approach would be a combination of objective, numerical, centripetal measures defined in the Oncology Care Model (OCM) and subjective centrifugal emotions, aspirations, and expectations. We created smart teams, enabling an efficient transition from volume to value. These exercises were similar to building a higher pyramid on top of what we already achieved during our journey toward Patient-Centered Speciality Practice (PCSP) accreditation by the the National Committee for Quality Assurance in 2015. Although the transition to being a PCSP was speciality agnostic and truly patient centric, the OCM gave us a blueprint that was specific to the needs of PCCC.
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Testing of a Tethered Personal Health Record Framework for Early End-of-Life DiscussionsPilot testing demonstrates the use of a novel, personal health record—based framework used in primary care settings may improve presence and quality of advance care planning documentation in the electronic health record.
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Cost Savings From Avoidance of Early Elective DeliveriesResearchers calculated savings available to healthcare insurers if providers of obstetrical services avoided the performance of early elective deliveries. The calculations illustrate a considerable savings.
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Measuring Concurrent Oral Hypoglycemic and Antidepressant Adherence and Clinical OutcomesSelf-reported adherence tended to overestimate medication adherence compared with electronic monitoring. Electronic monitoring of oral hypoglycemic agents but not self-reported adherence predicted glycemic control.
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Collection of Data on Race/Ethnicity and Language Proficiency of ProvidersHealth plans collect and use data on network providers' proficiency in languages other than English more commonly than race and ethnicity data on providers.
