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Leveraging ACA powers: paying for value over volume

The Obama administration has deployed a new power conferred by the Affordable Care Act: Paying providers based solely on their quality of care, The New York Times reports. Two such programs were introduced this week. One requires all hospitals in 75 metropolitan areas to accept a flat fee for costs associated with a hip or knee replacement. If the quality of the care is not adjudged good, Medicare will take back some of the money. Another program increases or decreases payments to home health agencies in nine states, depending on how they perform on certain quality measurements. (The New York Times) 

 

 

Medicare proposes paying for end-of-life counseling 

In a sweeping new rule, CMS proposes paying for end-of-life counseling and revises several quality incentives, Modern Healthcare reports. The American Academy of Family Physicians, among others, has endorsed the proposal. CMS is accepting public comments on the proposed rule until Sept. 8. Politico notes many states have already passed laws making it easier to document end-of-life care goals in medical records, but no federal legislation has made it to the floor for a vote. (Politico; Modern Healthcare)

 
 

High levels of breast cancer screening may be associated with overdiagnosis with no effect on breast cancer mortality, according to research published in JAMA Internal Medicine. "When analyzed at the county level, the clearest result of mammography screening is the diagnosis of additional small cancers. Furthermore, there is no concomitant decline in the detection of larger cancers, which might explain the absence of any significant difference in the overall rate of death from the disease. Together, these findings suggest widespread overdiagnosis," the researchers conclude. (JAMA Internal Medicine)

 

Innovation & Transformation 

PC continuity associated with reduced ED use and fewer hospitalizations 

Patients treated by the same primary care doctor on a regular basis go to the emergency department and are hospitalized less frequently, according to research published in Health Affairs. "Changing providers' approach to care delivery and patients' care-seeking behaviors is fundamental to improving care and health outcomes while reducing costs. These approaches are particularly critical for populations that are newly insured under the ACA and for reducing future health care expenditures," researchers conclude. (Health Affairs)

 

 

S.C.'s PART significantly reduced readmissions, improved transitions 

The Preventing Avoidable Readmissions Together (PART) initiative, a statewide quality improvement learning collaborative in South Carolina, helped providers significantly reduce readmissions and improve care transition quality, according to research published in Population Health Management. The initiative, which included about 90 percent of acute care hospitals in the state, began with a learning session followed by three months for planning, forming multidisciplinary teams, discharge strategies and root cause analysis. These were followed by action phases dedicated to implementing transitional records; educating patients; providing timely, high-quality discharge summaries; and improving the follow-up and post-discharge processes. (FierceHealthCare; Population Health Management) 

  

 

Electronic reminders improve adherence in type 2 diabetes 

Patients with type 2 diabetes are more likely to receive recommended laboratory tests at practices that use diabetes registries to generate reminders. Use of the registry reminders also was associated with reduced rates of hospitalization, according to research published in the Journal of the Medical Informatics Association. Researchers also noted, however, that the use of a diabetes registry did not have a significant impact on the quality of care or hospital utilization for patients with type 1 diabetes. (Journal of the Medical Informatics Association; Health Data Management)

  
Consumers & Providers

Study: Knowing risks to patients, clinicians still work while ill

More than 75 percent of clinicians in a recent survey say they have worked while ill--even while acknowledging the potential risk for patients. Among the reasons: continuity of care, concern about letting patients down and fears of professional ostracism. "These results may inform efforts to design systems at our hospitals to provide support for attending physicians and APC [advanced practice clinicians] and help them make the right choice to keep their patients and colleagues safe while caring for themselves. In addition to reducing health care-associated infections, such systems help improve physician and APC health and wellness while reducing burnout," researchers conclude. (UPI; JAMA Pediatrics)

   

 

In a new position paper, the American College of Physicians identifies strategies to integrate mental health and substance abuse care into primary care to better treat each patient as "a whole person." ACP notes that mental and behavioral health issues--such as inappropriate eating behaviors and patterns of social isolation--are common and have been linked to increased morbidly and mortality. "Patients who exhibit physical ailments--such as chronic diseases like diabetes--often have behavioral health problems that may affect their physical care needs," says Ryan A. Crowley, senior health policy analyst for the ACP. (Reuters; Annals of Internal Medicine)

 

 

Patients want online access to clinicians and information

Patients want to be able to contact doctors via email or Facebook--and to access their health data via the physician's website--according to a survey of retail pharmacy users published in the Journal of General Internal Medicine. In the six months prior to the survey, 37 percent of patients did, in fact, contact their doctors via email, and another 18 percent through Facebook. The survey also shows that up to 57 percent of patients want to use their physician's websites to access health information, but only seven percent do. (Journal of General Internal Medicine; announcement)

 

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New & Noted   

Teens getting more antipsychotics: Antipsychotic drug use has been on the rise among adolescents, but most of these teens haven't been diagnosed with a mental disorder, according to research published in JAMA Psychiatry. (The Washington Post; JAMA Psychiatry)

 

 

CVS: No smoking, no chamber: CVS Health is quitting the U.S. Chamber of Commerce over its pro-tobacco lobbying. It made the announcement amid revelations that the chamber and its foreign affiliates were lobbying against antismoking laws. (The New York Times)

 

    

PCPs get a raise: Primary care physicians saw an average 3.6 percent increase in pay last year to $241,273, according to the Medical Group Management Association. (Forbes)
  
Multi-media

Discussion: No standard med school training on EHRs

There's no national standard for how medical students should be trained on EHRs. That's the focus of this iHealthBeat audio piece. A medical student, a med school professor and others discuss the variations in how medical schools are training students to use EHRs. (iHealthBeat)

 

MarketVoices...quotes worth reading

     

"The findings highlight the gap between patient interest for online communication and what physicians may currently provide. Improving and accelerating the adoption of secure Web-messaging systems is a possible solution that addresses both institutional concerns and patient demand." -- Dr. Joy Lee of the Johns Hopkins Bloomberg School of Public Health, discussing research she led that was published in the Journal of General Internal Medicine


 
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Wednesday, July 15, 2015













 

 

 

 

 

 

 

 

 

 

 

 

 

 

    

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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