Download or read book Accounting for Social Risk Factors in Medicare Payment written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2016-10-14 with total page 83 pages. Available in PDF, EPUB and Kindle. Book excerpt: Recent health care payment reforms aim to improve the alignment of Medicare payment strategies with goals to improve the quality of care provided, patient experiences with health care, and health outcomes, while also controlling costs. These efforts move Medicare away from the volume-based payment of traditional fee-for-service models and toward value-based purchasing, in which cost control is an explicit goal in addition to clinical and quality goals. Specific payment strategies include pay-for-performance and other quality incentive programs that tie financial rewards and sanctions to the quality and efficiency of care provided and accountable care organizations in which health care providers are held accountable for both the quality and cost of the care they deliver. Accounting For Social Risk Factors in Medicare Payment: Data is the fourth in a series of five brief reports that aim to inform ASPE analyses that account for social risk factors in Medicare payment programs mandated through the IMPACT Act. This report provides guidance on data sources for and strategies to collect data on indicators of social risk factors that could be accounted for Medicare quality measurement and payment programs.
Download or read book The Future of Nursing 2020 2030 written by National Academies of Sciences Engineering and Medicine and published by . This book was released on 2021-09-30 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.
Download or read book The Role of Telehealth in an Evolving Health Care Environment written by Institute of Medicine and published by National Academies Press. This book was released on 2012-12-20 with total page 159 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.
Download or read book Rewarding Provider Performance written by Institute of Medicine and published by National Academies Press. This book was released on 2007-02-17 with total page 273 pages. Available in PDF, EPUB and Kindle. Book excerpt: The third installment in the Pathways to Quality Health Care series, Rewarding Provider Performance: Aligning Incentives in Medicare, continues to address the timely topic of the quality of health care in America. Each volume in the series effectively evaluates specific policy approaches within the context of improving the current operational framework of the health care system. The theme of this particular book is the staged introduction of pay for performance into Medicare. Pay for performance is a strategy that financially rewards health care providers for delivering high-quality care. Building on the findings and recommendations described in the two companion editions, Performance Measurement and Medicare's Quality Improvement Organization Program, this book offers options for implementing payment incentives to provide better value for America's health care investments. This book features conclusions and recommendations that will be useful to all stakeholders concerned with improving the quality and performance of the nation's health care system in both the public and private sectors.
Download or read book The Healthcare Imperative written by Institute of Medicine and published by National Academies Press. This book was released on 2011-01-17 with total page 852 pages. Available in PDF, EPUB and Kindle. Book excerpt: The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.
Download or read book Valuebased purchasing for physicians under Medicare hearing before the Subcommittee on Health of the Committee on Ways and Means U S House of Representatives One Hundred Ninth Congress first session July 21 2005 written by United States. Congress. House. Committee on Ways and Means. Subcommittee on Health and published by DIANE Publishing. This book was released on 2006 with total page 112 pages. Available in PDF, EPUB and Kindle. Book excerpt:
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
Download or read book Report to the Congress Medicare Payment Policy written by Medicare Payment Advisory Commission (U.S.) and published by . This book was released on 1998 with total page 184 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Paying for Performance in Healthcare Implications for Health System Performance and Accountability written by Cheryl Cashin and published by McGraw-Hill Education (UK). This book was released on 2014-09-16 with total page 338 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health spending continues to grow faster than the economy in most OECD countries. In 2010, the OECD published a study of strategies to increase value for money in health care, in which pay for performance (P4P) was identified as an innovative tool to improve health system efficiency in several OECD countries. However, evidence that P4P increases value for money, boosts quality of processes in health care, or improves health outcomes is limited.This book explores the many questions surrounding P4P such as whether the potential power of P4P has been over-sold, or whether the disappointing results to date are more likely rooted in problems of design and implementation or inadequate monitoring and evaluation. The book also examines the supporting systems and process, in addition to incentives, that are necessary for P4P to improve provider performance and to drive and sustain improvement. The book utilises a substantial set of case studies from 12 OECD countries to shed light on P4P programs in practice.Featuring both high and middle income countries, cases from primary and acute care settings, and a range of both national and pilot programmes, each case study features: Analysis of the design and implementationdecisions, including the role of stakeholders Critical assessment of objectives versus results Examination of the of 'net' impacts, includingpositive spillover effects and unintended consequences The detailed analysis of these 12 case studies together with the rest of this critical text highlight the realities of P4P programs and their potential impact on the performance of health systems in a diversity of settings. As a result, this book provides critical insights into the experience to date with P4P and how this tool may be better leveraged to improve health system performance and accountability. This title is in the European Observatory on Health Systems and Policies Series.
Download or read book Redefining Health Care written by Michael E. Porter and published by Harvard Business Press. This book was released on 2006-04-24 with total page 540 pages. Available in PDF, EPUB and Kindle. Book excerpt: The U.S. health care system is in crisis. At stake are the quality of care for millions of Americans and the financial well-being of individuals and employers squeezed by skyrocketing premiums—not to mention the stability of state and federal government budgets. In Redefining Health Care, internationally renowned strategy expert Michael Porter and innovation expert Elizabeth Teisberg reveal the underlying—and largely overlooked—causes of the problem, and provide a powerful prescription for change. The authors argue that competition currently takes place at the wrong level—among health plans, networks, and hospitals—rather than where it matters most, in the diagnosis, treatment, and prevention of specific health conditions. Participants in the system accumulate bargaining power and shift costs in a zero-sum competition, rather than creating value for patients. Based on an exhaustive study of the U.S. health care system, Redefining Health Care lays out a breakthrough framework for redefining the way competition in health care delivery takes place—and unleashing stunning improvements in quality and efficiency. With specific recommendations for hospitals, doctors, health plans, employers, and policy makers, this book shows how to move health care toward positive-sum competition that delivers lasting benefits for all.
Download or read book Medicare Primer written by Patricia A. Davis and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This report provides a general overview of the Medicare program including descriptions of the program's history, eligibility criteria, covered services, provider payment systems, and program administration and financing.
Download or read book Medicare Laboratory Payment Policy written by Institute of Medicine and published by National Academies Press. This book was released on 2000-12-04 with total page 261 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clinical laboratory tests play an integral role in helping physicians diagnose and treat patients. New developments in laboratory technology offer the prospect of improvements in diagnosis and care, but will place an increased burden on the payment system. Medicare, the federal program providing coverage of health-care services for the elderly and disabled, is the largest payer of clinical laboratory services. Originally designed in the early 1980s, Medicare's payment policy methodology for outpatient laboratory services has not evolved to take into account technology, market, and regulatory changes, and is now outdated. This report examines the current Medicare payment methodology for outpatient clinical laboratory services in the context of environmental and technological trends, evaluates payment policy alternatives, and makes recommendations to improve the system.
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.
Download or read book The Medicare Value Based Purchasing for Physicians Act written by United States. Congress. House. Committee on Ways and Means. Subcommittee on Health and published by . This book was released on 2006 with total page 96 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Value based Purchasing for Physicians Under Medicare written by United States. Congress. House. Committee on Ways and Means. Subcommittee on Health and published by . This book was released on 2006 with total page 112 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Vital Signs written by Institute of Medicine and published by National Academies Press. This book was released on 2015-08-26 with total page 245 pages. Available in PDF, EPUB and Kindle. Book excerpt: Thousands of measures are in use today to assess health and health care in the United States. Although many of these measures provide useful information, their usefulness in either gauging or guiding performance improvement in health and health care is seriously limited by their sheer number, as well as their lack of consistency, compatibility, reliability, focus, and organization. To achieve better health at lower cost, all stakeholders - including health professionals, payers, policy makers, and members of the public - must be alert to what matters most. What are the core measures that will yield the clearest understanding and focus on better health and well-being for Americans? Vital Signs explores the most important issues - healthier people, better quality care, affordable care, and engaged individuals and communities - and specifies a streamlined set of 15 core measures. These measures, if standardized and applied at national, state, local, and institutional levels across the country, will transform the effectiveness, efficiency, and burden of health measurement and help accelerate focus and progress on our highest health priorities. Vital Signs also describes the leadership and activities necessary to refine, apply, maintain, and revise the measures over time, as well as how they can improve the focus and utility of measures outside the core set. If health care is to become more effective and more efficient, sharper attention is required on the elements most important to health and health care. Vital Signs lays the groundwork for the adoption of core measures that, if systematically applied, will yield better health at a lower cost for all Americans.
Download or read book The Bogleheads Guide to Investing written by Taylor Larimore and published by John Wiley & Sons. This book was released on 2006-04-20 with total page 335 pages. Available in PDF, EPUB and Kindle. Book excerpt: Within this easy-to-use, need-to-know, no-frills guide to building financial well-being is advice for long-term wealth creation and happiness, without all the worries and fuss of stock pickers and day traders.
