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Is the QALY Fit for Purpose?The quality-adjusted life-year (QALY) is a popular tool for value assessment but is flawed. This paper highlights potential solutions.
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The New CMS Bundle Model: Understanding Key Decision Points for Program ParticipationThere's only a month until the application portal closes for the Bundled Payment for Care Improvement Advanced initiative, the first value-based model launched under the Trump administration.
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How Will FY2020 IPPS Proposed Rule Affect Hospital CDI Programs?The fiscal year 2020 (FY2020) Inpatient Prospective Payment Systems (IPPS) proposed rule notably includes approximately 1500 complications or comorbidities (CC)/major complications or comorbidities (MCC) designation changes and 324 changes to International Classification of Diseases, Tenth Revision, Clinical Modification codes, along with several other updates. The designation changes are an effort to respond to the notion that the CC/MCC assignment are no longer appropriate as conditions and factors have shifted.
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The Whole Patient and Nothing but the PatientChronic care management is available under Medicare but has been underused thus far.
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Take an App and (Don't) Call Me in the MorningHow can perioperative mobile apps can increase patient compliance while saving money?
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Having Cancer Saved My LifeA Samfund grant recipient narrates her experience of being diagnosed young with cancer and how the support from The Samfund "made everyday school and life manageable."
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Population Health Starts With Access to CareAccess and quality are inseparable, so providers prioritizing population health goals can find success by starting from a solid foundation of patient access. So how can providers streamline access to care and directly influence population health? The answer lies with sophisticated patient engagement technology.
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Will Your State Have a Shortage of Nurses in the Next Decade?Overall, the United States is predicted to see a shortage of 193,000 nursing professionals by 2020, according to a 2015 report.
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Pharmacoeconomics Refresher: The CVS $100k/QALY Announcement (Part 3)In this series, we have used the recent announcement by CVS Health regarding a strategy to lower drug prices as an example to review basic pharmacoeconomic principles. For Part 3, we are going to discuss various stakeholders and how each might view the results of decisions based off of pharmacoeconomic analyses.
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Barriers to ACA's Contraception Mandate Remain: Part IIIFor millions, the Affordable Care Act promised relief from the expenses of contraception. So why are many still not feeling it?
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Innovation in Medicare Advantage Begins With DoctorsTo drive real innovation in Medicare Advantage—improvements that will result in better health outcomes and reduce costs—CMS should start with doctors.
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Trends in Healthcare Payments: Opportunities Are Endless for ProvidersProviders are using outdated practices to connect with patients for their bills.
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What Is a Complication, Anyway?When asked “what is your surgical site infection rate?” one will get an answer that is almost certainly removed from reality.
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Closing the Gap on Health InequalityAccess to testing for early diagnosis of chronic conditions, and use of data to find care gaps, will reduce health disparities.
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Recognizing Diversity and Cultural Differences in Healthcare OrganizationsIt is imperative for organizations to support diversity and acknowledge individuals’ differences in order to foster better morale, promote creativity and innovations, improve decision making, and create social justice that advocates equity.
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Contributor: Eating Disorder Claim Lines Rose 65% Across Nation From 2018 to 2022A white paper from FAIR Health found that claim lines and telehealth usage for eating disorders had increased in a span of 4 years.
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A Better Emergency Department Patient Access StrategyImproving patient collections in fast-paced, high-volume clinical environments.
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Expect Reference-Based Pricing to Get a Serious RebootReference-based pricing is about to get a serious reboot, with even more healthcare purchasers engaging in the practice and those that are already using it reviewing existing contracts with increased scrutiny.
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Contributor: Do Health Plans Have a Plan to Help Employer-Purchasers Get Better Value?This article is co-written by Suzanne Delbanco, PhD, MPH, executive director, Andréa Caballero, MPA, program director, and Julianne McGarry, MPP, director of projects and research, for Catalyst for Payment Reform, and Robert S. Galvin, MD, chief executive officer, Equity Healthcare, LLC.
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The Legal Landscape of TeledermatologyTeledermatology is advertised a major breakthrough in telehealth. But, is the tort system ready for widespread adoption?
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Most Hospitals Receive Failing Score in at Least 1 Quality Dimension of Their Community Health Needs AssessmentDeveloping clearer guidelines for measuring a hospital's orientation toward population health would be a big step towards fundamentally improving population health and changing the relationship between a hospital and its community.
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Need Healthcare? Let's Go Shopping or NotWe all shop. Every day we decide which products and services to buy. But shopping for medical care, typically, has been different.
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Three Proposals That Would Kill the 340B ProgramThe 3 prescriptions for reforming the 340B Drug Discount Program proposed by authors in the December issue of Evidence-Based Oncology would limit safety net hospitals' abilities to treat vulnerable patients.
