The Centers for Medicare & Medicaid Services (CMS) announced a call for applications for a new Affordable Care Act initiative designed to strengthen primary care in the United States.
Under the Graduate Nurse Education Demonstration, CMS will provide hospitals working with nursing schools to train advanced practice registered nurses (APRNs) with payments of up to $50 million annually over four years to cover the costs of APRNs’ clinical training.
Growing the ranks of APRNs is an important way to increase the base of primary care providers in this country. In the past, the cost of clinical training has limited the ability of hospitals and other healthcare providers to accept more APRN students into their settings for clinical training.
Under the Graduate Nurse Education Demonstration, CMS will provide reimbursement to up to five eligible hospitals for the reasonable cost of providing clinical training to APRN students added as a result of the demonstration. Hospitals participating in the demonstration must partner with accredited schools of nursing and non-hospital community-based care settings.
Payments to the participating hospitals will be linked directly to the number of additional APRNs that the hospitals and their partnering entities are able to train as a result of their participation in the demonstration. The payment will be calculated on a per-student basis, comparing previous enrollment levels in APRN training programs with enrollment under the demonstration.
For more information, or to view the solicitation, visit: innovation.cms.gov/initiatives/gne.
Source: CMS News Release
Showing posts with label Primary Care. Show all posts
Showing posts with label Primary Care. Show all posts
Monday, March 26, 2012
Tuesday, March 13, 2012
Walgreens Uses e-Delivery of Patient Info to Physicians
Walgreens announced that it will use Surescripts’ Clinical Interoperability services to electronically deliver patient data directly to primary care providers to improve the coordination of care. In the coming months, all of the 7,800 Walgreens and Duane Reade pharmacies and 350 Take Care Clinics nationwide will use the Surescripts network to deliver immunization records to the patient’s primary care provider. Later this year, Walgreens will also use the Surescripts network to provide immunization reporting to state and local public health agencies, and Take Care Clinic patient summaries to the patient’s primary care provider.
A recent survey of 400 physicians by Surescripts illustrated the challenge of compiling more complete medical records: 39 percent responded that they are frequently missing immunization records during patient visits; 35 percent are often missing patient summaries.
Source: Walgreens News Release
A recent survey of 400 physicians by Surescripts illustrated the challenge of compiling more complete medical records: 39 percent responded that they are frequently missing immunization records during patient visits; 35 percent are often missing patient summaries.
Source: Walgreens News Release
Monday, March 12, 2012
Study: Consumers Choose High-Value Health Care Providers When Given Good Cost, Quality Info
When asked to choose a health care provider based only on cost, consumers choose the more expensive option, according to a new study funded by HHS' Agency for Healthcare Research and Quality (AHRQ) that appears in the March issue of Health Affairs.
The study found that consumers equate cost with quality and worry that lower cost means lower quality care. But higher costs may indicate unnecessary services or inefficiencies, so cost information alone does not help consumers get the best value for their health care dollar, according to the study.
The study, entitled "An Experiment Shows That a Well-Designed Report on Costs and Quality Can Help Consumers Choose High-Value Health Care," found that when consumers were shown the right mix of cost and quality information, they were better able to choose high-value health care providers—defined as those who deliver high-quality care at a lower cost.
Health care consumers want to visit high-quality doctors and hospitals, and many public report cards are available to help them compare providers. However, few report cards include information on cost, and there has been little scientific evidence to guide the presentation of that information to help consumers choose high value providers.
A team of researchers, led by Judith H. Hibbard, Dr. P.H., at the University of Oregon in Eugene, studied 1,400 employees in a randomized experiment to find out how they responded to different presentations of quality and cost information. When providers were clearly identified as high quality, cost had less influence on consumers' decisions and consumers were more likely to choose a provider with lower cost but better quality than a high-cost provider.
"This study has important implications for the more than 150 public reports on physician and hospital care," said AHRQ Director Carolyn M. Clancy, M.D. "It's not simply a question of providing information on cost, but providing it in a way that is integrated with quality scores."
The study explored a number of ways to present cost and quality information effectively, using combinations of symbols such as dollar signs and stars, specific information such as dollar amounts and percentages, and labels such as "appropriate use" or "better." Consumers were more likely to choose high-value providers when presented with strong, unambiguous quality and cost information. In addition, a check mark indicating a "high-value" provider, along with the cost and quality information, also helped consumers use the information to make high-value choices. Given strong quality signals, consumers were also more confident in their choices.
The study's findings have implications for the design of public report cards that offer consumers information on the quality and cost of health care providers. Although report producers have been adopting strategies to help consumers process and use comparative information on quality and cost, many reporting websites still use overly technical information or present other barriers to easy comprehension, according to the study.
For additional AHRQ information about public reporting, please visit http://www.ahrq.gov/path/publicreporting.htm.
Source: AHRQ News Release
The study found that consumers equate cost with quality and worry that lower cost means lower quality care. But higher costs may indicate unnecessary services or inefficiencies, so cost information alone does not help consumers get the best value for their health care dollar, according to the study.
The study, entitled "An Experiment Shows That a Well-Designed Report on Costs and Quality Can Help Consumers Choose High-Value Health Care," found that when consumers were shown the right mix of cost and quality information, they were better able to choose high-value health care providers—defined as those who deliver high-quality care at a lower cost.
Health care consumers want to visit high-quality doctors and hospitals, and many public report cards are available to help them compare providers. However, few report cards include information on cost, and there has been little scientific evidence to guide the presentation of that information to help consumers choose high value providers.
A team of researchers, led by Judith H. Hibbard, Dr. P.H., at the University of Oregon in Eugene, studied 1,400 employees in a randomized experiment to find out how they responded to different presentations of quality and cost information. When providers were clearly identified as high quality, cost had less influence on consumers' decisions and consumers were more likely to choose a provider with lower cost but better quality than a high-cost provider.
"This study has important implications for the more than 150 public reports on physician and hospital care," said AHRQ Director Carolyn M. Clancy, M.D. "It's not simply a question of providing information on cost, but providing it in a way that is integrated with quality scores."
The study explored a number of ways to present cost and quality information effectively, using combinations of symbols such as dollar signs and stars, specific information such as dollar amounts and percentages, and labels such as "appropriate use" or "better." Consumers were more likely to choose high-value providers when presented with strong, unambiguous quality and cost information. In addition, a check mark indicating a "high-value" provider, along with the cost and quality information, also helped consumers use the information to make high-value choices. Given strong quality signals, consumers were also more confident in their choices.
The study's findings have implications for the design of public report cards that offer consumers information on the quality and cost of health care providers. Although report producers have been adopting strategies to help consumers process and use comparative information on quality and cost, many reporting websites still use overly technical information or present other barriers to easy comprehension, according to the study.
For additional AHRQ information about public reporting, please visit http://www.ahrq.gov/path/publicreporting.htm.
Source: AHRQ News Release
Tuesday, March 6, 2012
AHRQ Quality Indicators Toolkit for Hospitals
The Agency for Healthcare Research and Quality (AHRQ) has developed an array of health care decision making and research tools that can be used by program managers, researchers, and others at the Federal, State and local levels. The Quality Indicators (QIs) are measures of health care quality that make use of readily available hospital inpatient administrative data. The current AHRQ QI modules expand HCUP QIs. The QIs can be used to highlight potential quality concerns, identify areas that need further study and investigation, and track changes over time.
In response to high demand for a recent Webinar about the AHRQ Quality IndicatorsTM Toolkit for Hospitals, AHRQ is repeating this popular event. Participants will hear live presentations about the toolkit from its developers and learn from a quality expert at a hospital that tested it.
The toolkit is a free resource to guide hospitals through the process of using the AHRQ Inpatient Quality Indicators (IQIs) and Patient Safety Indicators (PSIs) to improve care.
Webinar information:
Date: Tuesday, March 13
Time: 3:00-4:30 pm Eastern Standard Time
Register at: http://meet63385651.adobeconnect.com/hospitaltoolkitregistration2/event/event_info.html
(Note: If you registered for the first Webinar but could not participate, you can register for the repeat Webinar by simply entering your email address and password.)
The Webinar will cover:
-The purpose of the toolkit.
-How it was developed.
-How it is organized for easy use.
-How a hospital has used it to assess performance on the indicators, identify priorities, and implement changes to improve quality and safety.
Download the AHRQ Quality IndicatorsTM Toolkit for Hospitals at: http://www.ahrq.gov/qual/qitoolkit
More information on the AHRQ Quality Indicators is available at: http://www.qualityindicators.ahrq.gov/
In response to high demand for a recent Webinar about the AHRQ Quality IndicatorsTM Toolkit for Hospitals, AHRQ is repeating this popular event. Participants will hear live presentations about the toolkit from its developers and learn from a quality expert at a hospital that tested it.
The toolkit is a free resource to guide hospitals through the process of using the AHRQ Inpatient Quality Indicators (IQIs) and Patient Safety Indicators (PSIs) to improve care.
Webinar information:
Date: Tuesday, March 13
Time: 3:00-4:30 pm Eastern Standard Time
Register at: http://meet63385651.adobeconnect.com/hospitaltoolkitregistration2/event/event_info.html
(Note: If you registered for the first Webinar but could not participate, you can register for the repeat Webinar by simply entering your email address and password.)
The Webinar will cover:
-The purpose of the toolkit.
-How it was developed.
-How it is organized for easy use.
-How a hospital has used it to assess performance on the indicators, identify priorities, and implement changes to improve quality and safety.
Download the AHRQ Quality IndicatorsTM Toolkit for Hospitals at: http://www.ahrq.gov/qual/qitoolkit
More information on the AHRQ Quality Indicators is available at: http://www.qualityindicators.ahrq.gov/
Thursday, March 1, 2012
SAFE CARE Patient Safety Education Program Launched
In celebration of Patient Safety Awareness Week, March 4-10, 2012, a unique patient safety education program was launched to provide patients and their families with instant access to current patient safety videos at their bedside and while receiving care.
The 2012 SAFE CARE Patient Safety Education Program is a free offering developed to assist health care organizations in educating patients to help prevent medical errors. The campaign features videos from The Joint Commission’s Speak Up™ campaign, the Centers for Disease Control and Prevention (CDC), Kimberly-Clark, the Patient Channel® from The Wellness Network, and Safe Care Campaign. The goal of the SAFE CARE Patient Safety Education Program is to save lives, prevent harm and help patients receive safer care.
The SAFE CARE Program utilizes free posters that hospitals can hang in patient rooms which allows patients and families to instantly access and watch safety videos by topic on their own smart phones by simply pointing a smart phone at a QR code on the poster, or texting the word “SAFE” to 411247 to receive a link to Safe Care’s safety video library. The nine short videos address the most common patient safety issues in hospitals such as hand hygiene, preventing infections, avoiding medication errors, patient falls, and more. Organizations are also able to customize the videos for a nominal fee.
“We are making important safety information available to patients and their families 24/7 with no training or time obligation whatsoever from the hospital care staff,” says Victoria Nahum, executive director, SAFE CARE Campaign. “These videos show how to receive the safest care possible and we put it right into the hands of the patients and their families’ right when they need it most - while they're at the bedside.”
“We know that the more patients are involved in their care the less likely there will be a bad outcome such as a medication mix-up or a health care-associated infection,” says Cathy Barry-Ipema, chief communications officer, The Joint Commission. “This campaign gives patients the information they need to speak up and be active participants in their health care.”
"Patients have a right to know that they are receiving safe care," said Arjun Srinivasan, M.D., associate director of Healthcare-Associated Infection Prevention Programs, Centers for Disease Control and Prevention. "We hope that educational materials, like these, will empower patients to start a discussion with their healthcare provider about what can be done to prevent infections during their medical care."
Source: TJC News Release
The 2012 SAFE CARE Patient Safety Education Program is a free offering developed to assist health care organizations in educating patients to help prevent medical errors. The campaign features videos from The Joint Commission’s Speak Up™ campaign, the Centers for Disease Control and Prevention (CDC), Kimberly-Clark, the Patient Channel® from The Wellness Network, and Safe Care Campaign. The goal of the SAFE CARE Patient Safety Education Program is to save lives, prevent harm and help patients receive safer care.
The SAFE CARE Program utilizes free posters that hospitals can hang in patient rooms which allows patients and families to instantly access and watch safety videos by topic on their own smart phones by simply pointing a smart phone at a QR code on the poster, or texting the word “SAFE” to 411247 to receive a link to Safe Care’s safety video library. The nine short videos address the most common patient safety issues in hospitals such as hand hygiene, preventing infections, avoiding medication errors, patient falls, and more. Organizations are also able to customize the videos for a nominal fee.
“We are making important safety information available to patients and their families 24/7 with no training or time obligation whatsoever from the hospital care staff,” says Victoria Nahum, executive director, SAFE CARE Campaign. “These videos show how to receive the safest care possible and we put it right into the hands of the patients and their families’ right when they need it most - while they're at the bedside.”
“We know that the more patients are involved in their care the less likely there will be a bad outcome such as a medication mix-up or a health care-associated infection,” says Cathy Barry-Ipema, chief communications officer, The Joint Commission. “This campaign gives patients the information they need to speak up and be active participants in their health care.”
"Patients have a right to know that they are receiving safe care," said Arjun Srinivasan, M.D., associate director of Healthcare-Associated Infection Prevention Programs, Centers for Disease Control and Prevention. "We hope that educational materials, like these, will empower patients to start a discussion with their healthcare provider about what can be done to prevent infections during their medical care."
Source: TJC News Release
Thursday, February 23, 2012
Health Reform Law Provides Coverage for Nearly 50,000 Americans With Pre-existing Conditions
U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced that the new health care law’s Pre-Existing Condition Insurance Plan (PCIP) program is providing insurance to nearly 50,000 people with high-risk pre-existing conditions nationwide.
The Department released a new report demonstrating how PCIP is helping to fill a void in the insurance market for consumers with pre-existing conditions who are denied insurance coverage and are ineligible for Medicare or Medicaid coverage.
“For too long, Americans with pre-existing conditions were locked out of the health care system and their health suffered,” said HHS Secretary Kathleen Sebelius. “Thanks to health reform, our most vulnerable Americans across the country have the care they need.”
Under the Affordable Care Act, in 2014, insurers will be prohibited from denying coverage to any American with a pre-existing condition. Until then, the PCIP program will continue to provide enrollees with affordable insurance coverage.
In many cases, PCIP participants have been diagnosed with and need treatment for serious health care conditions such as cancer, ischemic heart disease, degenerative bone diseases and hemophilia. As a result of the new law, PCIP enrollees are receiving health services for their conditions on the first day their insurance coverage begins. Their critical need for treatment, combined with their lack of prior health coverage has led to higher overall per-member claims costs in state-based PCIPs of approximately $29,000 per year, which is more than double the per member cost that traditional State High Risk Pools have experienced in recent years.
Enrollment in PCIP has seen a nearly 400 percent increase from November 2010 to November 2011. PCIP enrollment is anticipated to trend upwards of 50,000 enrollees within the coming month.
People who enroll in the PCIP program are not charged a higher premium because of their medical condition. Program participants pay comparable premium rates to healthy people in the individual insurance market. By law, premiums may vary only on the basis of age, geographic area and tobacco use.
PCIP provides comprehensive health coverage, including primary and specialty care, hospital care, prescription drugs, home health and hospice care, skilled nursing care, preventive health and maternity care. The program is available in 50 states and the District of Columbia and open to U.S. citizens and people who reside in the U.S. legally (regardless of income) who have been without insurance coverage for at least six months, and have a pre-existing condition, or have been denied health insurance coverage because of a health condition.
The Affordable Care Act directed the Secretary of HHS to carry out PCIP either directly or through a contract with a state or nonprofit entity. In 27 states, a state or nonprofit entity elected to administer PCIP, while HHS operates the program in the remaining 23 states and the District of Columbia.
The new report can be found at: http://www.cciio.cms.gov/resources/files/Files2/02242012/pcip-annual-report.pdf
For more information, including eligibility, plan benefits and rates, as well as information on how to apply, visit www.pcip.gov and click on “Find Your State.” Then select your state from a map of the United States or from the drop-down menu.
The PCIP call center is open from 8 a.m. to 11 p.m. Eastern Time. Call toll-free 1-866-717-5826 (TTY 1-866-561-1604).
Source: HHS News Release
The Department released a new report demonstrating how PCIP is helping to fill a void in the insurance market for consumers with pre-existing conditions who are denied insurance coverage and are ineligible for Medicare or Medicaid coverage.
“For too long, Americans with pre-existing conditions were locked out of the health care system and their health suffered,” said HHS Secretary Kathleen Sebelius. “Thanks to health reform, our most vulnerable Americans across the country have the care they need.”
Under the Affordable Care Act, in 2014, insurers will be prohibited from denying coverage to any American with a pre-existing condition. Until then, the PCIP program will continue to provide enrollees with affordable insurance coverage.
In many cases, PCIP participants have been diagnosed with and need treatment for serious health care conditions such as cancer, ischemic heart disease, degenerative bone diseases and hemophilia. As a result of the new law, PCIP enrollees are receiving health services for their conditions on the first day their insurance coverage begins. Their critical need for treatment, combined with their lack of prior health coverage has led to higher overall per-member claims costs in state-based PCIPs of approximately $29,000 per year, which is more than double the per member cost that traditional State High Risk Pools have experienced in recent years.
Enrollment in PCIP has seen a nearly 400 percent increase from November 2010 to November 2011. PCIP enrollment is anticipated to trend upwards of 50,000 enrollees within the coming month.
People who enroll in the PCIP program are not charged a higher premium because of their medical condition. Program participants pay comparable premium rates to healthy people in the individual insurance market. By law, premiums may vary only on the basis of age, geographic area and tobacco use.
PCIP provides comprehensive health coverage, including primary and specialty care, hospital care, prescription drugs, home health and hospice care, skilled nursing care, preventive health and maternity care. The program is available in 50 states and the District of Columbia and open to U.S. citizens and people who reside in the U.S. legally (regardless of income) who have been without insurance coverage for at least six months, and have a pre-existing condition, or have been denied health insurance coverage because of a health condition.
The Affordable Care Act directed the Secretary of HHS to carry out PCIP either directly or through a contract with a state or nonprofit entity. In 27 states, a state or nonprofit entity elected to administer PCIP, while HHS operates the program in the remaining 23 states and the District of Columbia.
The new report can be found at: http://www.cciio.cms.gov/resources/files/Files2/02242012/pcip-annual-report.pdf
For more information, including eligibility, plan benefits and rates, as well as information on how to apply, visit www.pcip.gov and click on “Find Your State.” Then select your state from a map of the United States or from the drop-down menu.
The PCIP call center is open from 8 a.m. to 11 p.m. Eastern Time. Call toll-free 1-866-717-5826 (TTY 1-866-561-1604).
Source: HHS News Release
Monday, January 30, 2012
ONC Launches Health IT Challenge to Improve Hospital Discharge Care
The National Coordinator for Health Information Technology announced a Discharge Follow-Up Appointment care transitions challenge – the second as part of the Office of the National Coordinator for Health Information Technology (ONC) Investing in Innovation (i2) Initiative. With the support of Health 2.0 and Partnership for Patients, ONC launched the Discharge Follow-Up Appointment challenge in support of ONC’s Investing in Innovation (i2) program.
The i2 Initiative is a bold new effort to spur innovations in health IT. The program utilizes prizes and challenges to facilitate innovation and obtain solutions to intractable health IT problems. Aligned with the Obama administration’s innovation agenda, i2 is the first federal program to operate under the authority of the America COMPETES Reauthorization Act of 2010.
The challenge aims to stimulate the use of simple, information technology-enabled processes and tools to make transitions easier and safer for patients, caregivers and providers, particularly when a patient is discharged from a hospital. The first health IT challenge, Ensuring Safe Transitions from Hospital to Home , called upon developers to create a web-based application that could empower patients and caregivers to better navigate and manage a transition from a hospital.
The scheduling of follow-up appointments and post-discharge testing before leaving the hospital helps ensure safer and more effective transitions. Unfortunately, most patients across the country continue to leave the hospital without confirmed appointments and many providers remain frustrated by a highly manual and unreliable system. The Discharge Follow-Up Appointment challenge will focus on promoting effective care transitions.
“This challenge is an enormous opportunity for software developers to develop solutions, and pursue models that can be adopted across a community,” said Farzad Mostashari, M.D., Sc.M., national coordinator for health information technology. “Scheduling post-discharge follow-up appointments is critical, but not easy for patients or providers and we’re excited by the possibilities that will stem from this challenge.”
For additional information about ONC or on the i2 program, visit http://HealthIT.HHS.gov.
For more information about Health 2.0, which helps support the i2 challenge program, visit www.Health2Con.com .
For more information about Partnership for Patients, which also supports the i2 challenge program, visit http://www.healthcare.gov/compare/partnership-for-patients/index.html .
F
or more information about U. S. Department of Health and Human Services’ Recovery Act programs, see www.hhs.gov/recovery.
Source: HHS News Release
The i2 Initiative is a bold new effort to spur innovations in health IT. The program utilizes prizes and challenges to facilitate innovation and obtain solutions to intractable health IT problems. Aligned with the Obama administration’s innovation agenda, i2 is the first federal program to operate under the authority of the America COMPETES Reauthorization Act of 2010.
The challenge aims to stimulate the use of simple, information technology-enabled processes and tools to make transitions easier and safer for patients, caregivers and providers, particularly when a patient is discharged from a hospital. The first health IT challenge, Ensuring Safe Transitions from Hospital to Home , called upon developers to create a web-based application that could empower patients and caregivers to better navigate and manage a transition from a hospital.
The scheduling of follow-up appointments and post-discharge testing before leaving the hospital helps ensure safer and more effective transitions. Unfortunately, most patients across the country continue to leave the hospital without confirmed appointments and many providers remain frustrated by a highly manual and unreliable system. The Discharge Follow-Up Appointment challenge will focus on promoting effective care transitions.
“This challenge is an enormous opportunity for software developers to develop solutions, and pursue models that can be adopted across a community,” said Farzad Mostashari, M.D., Sc.M., national coordinator for health information technology. “Scheduling post-discharge follow-up appointments is critical, but not easy for patients or providers and we’re excited by the possibilities that will stem from this challenge.”
For additional information about ONC or on the i2 program, visit http://HealthIT.HHS.gov.
For more information about Health 2.0, which helps support the i2 challenge program, visit www.Health2Con.com .
For more information about Partnership for Patients, which also supports the i2 challenge program, visit http://www.healthcare.gov/compare/partnership-for-patients/index.html .
F
or more information about U. S. Department of Health and Human Services’ Recovery Act programs, see www.hhs.gov/recovery.
Source: HHS News Release
Friday, January 13, 2012
Doctors Are Cautious, Patients Enthusiastic About Sharing Medical Notes
Patients are overwhelmingly interested in exploring the notes doctors write about them after an office visit, but doctors worry about the impact of such transparency on their patients and on their own workflow, a Beth Israel Deaconess Medical Center (BIDMC) study suggests.
In a study published in the Dec. 20 issue of the Annals of Internal Medicine, patient and doctor attitudes were surveyed extensively prior to the launch of the OpenNotes trial in which patients at BIDMC, Geisinger Health System of Danville, PA, and Harborview Medical Center in Seattle were offered online access to their doctors’ notes written after office visits. Such notes have long been primarily within the doctors’ domain, even though patients have the legal right to obtain them.
"Doctors were divided in many of their expectations, and the issues we highlight have important consequences for both their work life and quality of care," writes lead author Jan Walker, RN, MBA, of BIDMC’s Division of General Medicine and Primary Care.
While many of the more than 100 primary care doctors who volunteered to participate in this experiment predicted possible health benefits from allowing patients to read their notes, the majority of those who declined participation were doubtful about positive impacts. And among the 173 doctors completing surveys, the majority expressed concerns about confusing or worrying patients with the content. Doctors also anticipated that they would write their notes less candidly and that responding to patient questions might be exceedingly time-consuming.
In contrast to the doctors surveyed, the nearly 38,000 patients who completed the baseline survey were almost uniformly optimistic about OpenNotes, and few anticipated being confused or worried
"The enthusiasm of patients exceeded our expectations," wrote Walker. "Most of them were overwhelmingly positive about the prospect of reading visit notes, regardless of demographic or health characteristics."
More than 90 percent favored making the notes available. Well over half anticipated improved adherence to their medications, 90 percent expected to feel more in control of their care, and four out of five predicted they would take better care of themselves.
"We know a lot more about our cars than our own bodies," responded one patient. "We leave all of that to the clinicians. I think by having access to our notes, we can take control, and that’s important."
In addition, half of patients surveyed reported that they would consider sharing their notes with other people, including other doctors.
"As I help my aging mother with her medical needs, I wish I could see the notes her doctors have made," wrote one patient. "I think it would help me in caring for her."
In an accompanying editorial, Thomas W. Feeley, MD, of the MD Anderson Cancer, and Kenneth I. Shine, MD, of the University of Texas, urged that electronic health records be used to engage participants in all parts of the health care delivery system.
"Expanding who uses the records and how they use them promises to facilitate communication, decrease redundant testing, and enhance our care delivery in ways we have yet to imagine."
The year-long OpenNotes study period has now ended, and Walker and her colleagues in the three diverse sites are eager to learn how the baseline expectations will play out. They are currently evaluating reports from follow-up surveys completed by participating doctors and patients and analyzing other metrics, such as how often patients reviewed their notes, shared them with others, or corrected errors their doctors may have made.
"They said they wanted the notes. They said they’d use them, but we have no idea if they actually went online and read them," said Walker. "And if they did read them, we don’t know yet what impact that had on the patients or the doctors."
"Patients want to look into the doctor’s black box, and many doctors are a bit nervous about what they’ll find," said Tom Delbanco, MD, senior author and co-principal investigator of OpenNotes. "But I expect that over time everyone will benefit enormously from such transparency."
"While OpenNotes represents a simple change of practice, the effect on the patient-doctor relationship could be profound. The fact that there’s such a gap between how most patients and many doctors expect that patients will handle the information contained in these notes hints at just how profound that effect might be," added Steve Downs, Robert Wood Johnson Foundation’s Chief Technology and Information Officer. In addition to Walker and Delbanco, the study’s co-authors include: Henry Feldman, MD and Long Ngo, PhD, BIDMC; Suzanne G. Leveille, PhD, RN, University of Massachusetts Boston; Jonathan D. Darer, MD, MPH, Marc J. Lichtenfeld, PhD, Geisinger Health System, Pennsylvania; Shireesha Dhanireddy, MD, Joann G. Elmore, MD, MPH, Natalia Oster, MPH, Elisabeth Vodicka, BA; Harborview Medical Center, Seattle; James D. Ralston, MD, MPH, Group Health Research Institute, Seattle; and Stephen E. Ross, MD, University of Colorado Health Sciences Center.
Source: OpenNotes Press Release
In a study published in the Dec. 20 issue of the Annals of Internal Medicine, patient and doctor attitudes were surveyed extensively prior to the launch of the OpenNotes trial in which patients at BIDMC, Geisinger Health System of Danville, PA, and Harborview Medical Center in Seattle were offered online access to their doctors’ notes written after office visits. Such notes have long been primarily within the doctors’ domain, even though patients have the legal right to obtain them.
"Doctors were divided in many of their expectations, and the issues we highlight have important consequences for both their work life and quality of care," writes lead author Jan Walker, RN, MBA, of BIDMC’s Division of General Medicine and Primary Care.
While many of the more than 100 primary care doctors who volunteered to participate in this experiment predicted possible health benefits from allowing patients to read their notes, the majority of those who declined participation were doubtful about positive impacts. And among the 173 doctors completing surveys, the majority expressed concerns about confusing or worrying patients with the content. Doctors also anticipated that they would write their notes less candidly and that responding to patient questions might be exceedingly time-consuming.
In contrast to the doctors surveyed, the nearly 38,000 patients who completed the baseline survey were almost uniformly optimistic about OpenNotes, and few anticipated being confused or worried
"The enthusiasm of patients exceeded our expectations," wrote Walker. "Most of them were overwhelmingly positive about the prospect of reading visit notes, regardless of demographic or health characteristics."
More than 90 percent favored making the notes available. Well over half anticipated improved adherence to their medications, 90 percent expected to feel more in control of their care, and four out of five predicted they would take better care of themselves.
"We know a lot more about our cars than our own bodies," responded one patient. "We leave all of that to the clinicians. I think by having access to our notes, we can take control, and that’s important."
In addition, half of patients surveyed reported that they would consider sharing their notes with other people, including other doctors.
"As I help my aging mother with her medical needs, I wish I could see the notes her doctors have made," wrote one patient. "I think it would help me in caring for her."
In an accompanying editorial, Thomas W. Feeley, MD, of the MD Anderson Cancer, and Kenneth I. Shine, MD, of the University of Texas, urged that electronic health records be used to engage participants in all parts of the health care delivery system.
"Expanding who uses the records and how they use them promises to facilitate communication, decrease redundant testing, and enhance our care delivery in ways we have yet to imagine."
The year-long OpenNotes study period has now ended, and Walker and her colleagues in the three diverse sites are eager to learn how the baseline expectations will play out. They are currently evaluating reports from follow-up surveys completed by participating doctors and patients and analyzing other metrics, such as how often patients reviewed their notes, shared them with others, or corrected errors their doctors may have made.
"They said they wanted the notes. They said they’d use them, but we have no idea if they actually went online and read them," said Walker. "And if they did read them, we don’t know yet what impact that had on the patients or the doctors."
"Patients want to look into the doctor’s black box, and many doctors are a bit nervous about what they’ll find," said Tom Delbanco, MD, senior author and co-principal investigator of OpenNotes. "But I expect that over time everyone will benefit enormously from such transparency."
"While OpenNotes represents a simple change of practice, the effect on the patient-doctor relationship could be profound. The fact that there’s such a gap between how most patients and many doctors expect that patients will handle the information contained in these notes hints at just how profound that effect might be," added Steve Downs, Robert Wood Johnson Foundation’s Chief Technology and Information Officer. In addition to Walker and Delbanco, the study’s co-authors include: Henry Feldman, MD and Long Ngo, PhD, BIDMC; Suzanne G. Leveille, PhD, RN, University of Massachusetts Boston; Jonathan D. Darer, MD, MPH, Marc J. Lichtenfeld, PhD, Geisinger Health System, Pennsylvania; Shireesha Dhanireddy, MD, Joann G. Elmore, MD, MPH, Natalia Oster, MPH, Elisabeth Vodicka, BA; Harborview Medical Center, Seattle; James D. Ralston, MD, MPH, Group Health Research Institute, Seattle; and Stephen E. Ross, MD, University of Colorado Health Sciences Center.
Source: OpenNotes Press Release
Wednesday, January 4, 2012
Choosing Wisely Campaign Launches to Help Physicians Better Manage Health Care
Recognizing that patients often ask for tests and treatments that are not necessarily in their best
interest, and physicians often struggle with decisions about prescribing tests and procedures as a way of covering all possible bases, the ABIM Foundation has joined with nine leading medical specialty societies to develop evidence-based lists of tests and procedures for patients and physicians to question as part of Choosing Wisely TM.
The goal of the campaign is to help physicians, patients and other health care stakeholders think and talk about overuse or misuse of health care resources in the United States.
Consumer Reports, the nation’s leading expert, independent, nonprofit consumer organization, has also joined the campaign to provide resources for consumers and physicians to engage in these important conversations. The campaign is part of the ABIM Foundation’s goal of promoting wise choices by clinicians in order to improve health care outcomes, provide patient-centered care that avoids unnecessary and even harmful interventions and reduce the rapidly-expanding costs of the health care system. The lists of Five Things Physicians and Patients
Should Question is modeled after the successful National Physicians Alliance (NPA) project titled “Five Things You Can Do in Your Practice,” which was funded by the ABIM Foundation in 2009.
As part of Choosing Wisely, each participating specialty society will identify its own list of five common tests or procedures whose use in their profession should be discussed or questioned. The lists will be unveiled in April 2012. The societies were given the following parameters to develop the lists:
- Each item should be within the specialty’s purview and control;
- Procedures should be used frequently and/or carry a significant cost; and
- There needs to be evidence to support each recommendation.
“Physicians play a leading role in addressing problems with our nation’s health care system. That is why the ABIM Foundation is proud to be working with specialty societies that have proactively decided to address some of the most important issues in health care head on,” said Christine K. Cassel, MD, president and CEO of the ABIM Foundation. “By identifying specific procedures or tests that may commonly be ordered, but not always necessary to improving patient care, we’re kicking off an important and overdue conversation about making wise choices in health care. Everyone – providers, patients and others – plays a part in being better stewards of the system’s finite resources.”
The Congressional Budget Office estimates that up to 30 percent of care delivered in America goes toward unnecessary tests, procedures, medical appointments, hospital stays and other services that may not improve people’s health – and in fact may actually cause harm. If current trends remain unchanged, the Centers for Medicare & Medicaid Services project U.S. health care spending will reach $4.3 trillion and account for 19.3 percent of the nation’s gross domestic product by 2019.
First announced in March 2011, Choosing Wisely is part of a multi-year effort led by the ABIM Foundation to support and engage physicians in being better stewards of finite health care resources. It is part of the ABIM Foundation’s long history of advancing medical professionalism and supporting similar initiatives. In 2002 the Foundation, along with the American College of Physicians Foundation and European Federation of Internal Medicine, authored Medical Professionalism in the New Millennium: A Physician Charter. The Physician Charter has as its fundamental principles the primacy of patient welfare, patient autonomy and social justice and articulates professional responsibilities of physicians, including a commitment to improving quality and access to care, advocating for a just and cost-effective distribution of finite resources and maintaining trust by managing conflicts of interest.
To learn more about Choosing Wisely visit www.ChoosingWisely.org.
Source: Choosing Wisely News Release
interest, and physicians often struggle with decisions about prescribing tests and procedures as a way of covering all possible bases, the ABIM Foundation has joined with nine leading medical specialty societies to develop evidence-based lists of tests and procedures for patients and physicians to question as part of Choosing Wisely TM.
The goal of the campaign is to help physicians, patients and other health care stakeholders think and talk about overuse or misuse of health care resources in the United States.
Consumer Reports, the nation’s leading expert, independent, nonprofit consumer organization, has also joined the campaign to provide resources for consumers and physicians to engage in these important conversations. The campaign is part of the ABIM Foundation’s goal of promoting wise choices by clinicians in order to improve health care outcomes, provide patient-centered care that avoids unnecessary and even harmful interventions and reduce the rapidly-expanding costs of the health care system. The lists of Five Things Physicians and Patients
Should Question is modeled after the successful National Physicians Alliance (NPA) project titled “Five Things You Can Do in Your Practice,” which was funded by the ABIM Foundation in 2009.
As part of Choosing Wisely, each participating specialty society will identify its own list of five common tests or procedures whose use in their profession should be discussed or questioned. The lists will be unveiled in April 2012. The societies were given the following parameters to develop the lists:
- Each item should be within the specialty’s purview and control;
- Procedures should be used frequently and/or carry a significant cost; and
- There needs to be evidence to support each recommendation.
“Physicians play a leading role in addressing problems with our nation’s health care system. That is why the ABIM Foundation is proud to be working with specialty societies that have proactively decided to address some of the most important issues in health care head on,” said Christine K. Cassel, MD, president and CEO of the ABIM Foundation. “By identifying specific procedures or tests that may commonly be ordered, but not always necessary to improving patient care, we’re kicking off an important and overdue conversation about making wise choices in health care. Everyone – providers, patients and others – plays a part in being better stewards of the system’s finite resources.”
The Congressional Budget Office estimates that up to 30 percent of care delivered in America goes toward unnecessary tests, procedures, medical appointments, hospital stays and other services that may not improve people’s health – and in fact may actually cause harm. If current trends remain unchanged, the Centers for Medicare & Medicaid Services project U.S. health care spending will reach $4.3 trillion and account for 19.3 percent of the nation’s gross domestic product by 2019.
First announced in March 2011, Choosing Wisely is part of a multi-year effort led by the ABIM Foundation to support and engage physicians in being better stewards of finite health care resources. It is part of the ABIM Foundation’s long history of advancing medical professionalism and supporting similar initiatives. In 2002 the Foundation, along with the American College of Physicians Foundation and European Federation of Internal Medicine, authored Medical Professionalism in the New Millennium: A Physician Charter. The Physician Charter has as its fundamental principles the primacy of patient welfare, patient autonomy and social justice and articulates professional responsibilities of physicians, including a commitment to improving quality and access to care, advocating for a just and cost-effective distribution of finite resources and maintaining trust by managing conflicts of interest.
To learn more about Choosing Wisely visit www.ChoosingWisely.org.
Source: Choosing Wisely News Release
Thursday, December 15, 2011
TJC Issues Call to Action to Prevent Healthcare Worker Fatigue
The link between health care worker fatigue and adverse events is well documented, prompting The Joint Commission (TJC) to issue a new Sentinel Event Alert: Health care worker fatigue and patient safety.
The Alert urges greater attention to preventing fatigue among health care workers and suggests specific actions for health care organizations to mitigate the risks. An article in the November 2007 issue of The Joint Commission Journal on Quality and Patient Safety reported that nurses who work more than 12-hour shifts and residents working recurrent 24-hour shifts were involved in three times more fatigue-related preventable adverse events. In addition, health care professionals who work long hours are at greater risk of injuring themselves on the job.
“Health care is a round-the-clock job, and safety has to be the priority,” says Mark R. Chassin, M.D., FACP, M.P.P., M.P.H., president, The Joint Commission. “The recommendations in this Alert give health care organizations the strategies to help mitigate the risks of fatigue that result from extended work hours – and, thereby, reduce the likelihood that fatigue will contribute to preventable patient harm."
The Alert addresses the effects and risks of an extended work day and of cumulative days of extended work hours. The Joint Commission Alert recommends that health care organizations:
- Assess fatigue-related risks such as off-shift hours, consecutive shift work and staffing levels.
- Examine processes when patients are handed off or transitioned from one caregiver to another, a time of risk that is compounded by fatigue.
- Seek staff input on how to design work schedules that minimize the potential for fatigue and provide opportunities for staff to express concerns about fatigue.
- Create and implement a fatigue management plan that includes scientific strategies for fighting fatigue such as engaging in conversation, physical activity, strategic caffeine consumption and short naps.
- Educate staff about good sleep habits and the effects of fatigue on patient safety.
The Joint Commission also suggests that health care organizations encourage teamwork as a strategy to support staff who work extended work shifts or hours. For example, use a system of independent second checks for critical tasks or complex patients. Also, organizations should consider fatigue as a potentially contributing factor when reviewing all adverse events, and educate employees on the importance of good sleep habits, including ensuring their rest environment is conducive to sleeping.
The warning about health care worker fatigue is part of a series of Alerts issued by the Joint Commission. Previous Alerts have addressed diagnostic imaging risks, violence in health care facilities, maternal deaths, health care technology, anticoagulants, wrong-site surgery, medication mix-ups, health care-associated infections, and patient suicides, among others.
Source: TJC News Release
The Alert urges greater attention to preventing fatigue among health care workers and suggests specific actions for health care organizations to mitigate the risks. An article in the November 2007 issue of The Joint Commission Journal on Quality and Patient Safety reported that nurses who work more than 12-hour shifts and residents working recurrent 24-hour shifts were involved in three times more fatigue-related preventable adverse events. In addition, health care professionals who work long hours are at greater risk of injuring themselves on the job.
“Health care is a round-the-clock job, and safety has to be the priority,” says Mark R. Chassin, M.D., FACP, M.P.P., M.P.H., president, The Joint Commission. “The recommendations in this Alert give health care organizations the strategies to help mitigate the risks of fatigue that result from extended work hours – and, thereby, reduce the likelihood that fatigue will contribute to preventable patient harm."
The Alert addresses the effects and risks of an extended work day and of cumulative days of extended work hours. The Joint Commission Alert recommends that health care organizations:
- Assess fatigue-related risks such as off-shift hours, consecutive shift work and staffing levels.
- Examine processes when patients are handed off or transitioned from one caregiver to another, a time of risk that is compounded by fatigue.
- Seek staff input on how to design work schedules that minimize the potential for fatigue and provide opportunities for staff to express concerns about fatigue.
- Create and implement a fatigue management plan that includes scientific strategies for fighting fatigue such as engaging in conversation, physical activity, strategic caffeine consumption and short naps.
- Educate staff about good sleep habits and the effects of fatigue on patient safety.
The Joint Commission also suggests that health care organizations encourage teamwork as a strategy to support staff who work extended work shifts or hours. For example, use a system of independent second checks for critical tasks or complex patients. Also, organizations should consider fatigue as a potentially contributing factor when reviewing all adverse events, and educate employees on the importance of good sleep habits, including ensuring their rest environment is conducive to sleeping.
The warning about health care worker fatigue is part of a series of Alerts issued by the Joint Commission. Previous Alerts have addressed diagnostic imaging risks, violence in health care facilities, maternal deaths, health care technology, anticoagulants, wrong-site surgery, medication mix-ups, health care-associated infections, and patient suicides, among others.
Source: TJC News Release
Monday, December 5, 2011
Timeline for Health Care Reform
According to a recently published timeline for the implementation of the Affordable Care Act (health care reform), in 2012, Affordable Care Organizations will be voluntarily formed by health care providers to assume care for groups of 5000 or more Medicare patients.
The goal of the initiative is to lower the cost of health care without sacrificing quality.
Source: Article in Times Free Press
The goal of the initiative is to lower the cost of health care without sacrificing quality.
Source: Article in Times Free Press
Monday, November 28, 2011
Patient Engagement Important to Success of Health Care Reform
Kenneth Bertka, MD, recently authored an article about the importance of patient engagement in the success of health care reform. In his article Patient Engagement's Critical Role in Post-Reform Success: 6 Steps to Improve Patient Centeredness, Dr. Bertka says that "[p]atient engagement...is more than a nice thing to do. Engaged patients are more likely to comply with their treatment and prevention plans, which results in higher quality care, fewer medical errors and lower cost."
Read Dr. Bertka's article here.
Source: Becker's Hospital Review
Read Dr. Bertka's article here.
Source: Becker's Hospital Review
Monday, October 31, 2011
HHS Announces Refined Survey Standards to More Constitently Measure Care Disparities
The U.S. Department of Health and Human Services (HHS) released final standards to more consistently measure race, ethnicity, sex, primary language, and disability status, thereby improving the ability to highlight disparities in health status and target interventions to reduce these disparities.
“It is our job to get a better understanding of why disparities occur and how to eliminate them. Improving the breadth and quality of our data collection and analysis on key areas, like race, ethnicity, sex, primary language and disability status, is critical to better understanding who we are serving,” said HHS Secretary Sebelius. "Today, through these new standards, we are providing a new set of powerful tools to help us achieve our vision of a nation free of disparities in health and health care.”
The Affordable Care Act requires new standards for the collection and reporting of health care information based on race, ethnicity, sex, and primary language. Making data standards consistent will help identify the significant health differences that often exist between and within ethnic groups, particularly among Asian, Hispanic/Latino and Pacific Islander populations.
For example, a study showed that the diabetes-related mortality rate for Mexican Americans (251 per 100, 000) and Puerto Ricans (204 deaths per 100, 000) was twice as high as the diabetes-related mortality rate for Cuban Americans (101 deaths per 100, 000). However, this information would have remained unknown if only the umbrella terms of “Hispanic” or “Latino” had been used.
By adding Mexican American and Chicano/a, Puerto Rican, Cuban, and other Hispanic Latino/a or Spanish origin as explicit categories required on all HHS-sponsored health surveys, we can better capture the individual ethnic group challenges that are often found within minority populations. This specificity allows for better measurement and tracking of health differences in these populations and target interventions appropriately.
The new data collection requirements also will improve researchers' ability to consistently monitor more dimensions of health disparities among people with disabilities. Collection of all data will take place under HHS’ longstanding, strict commitment to protecting privacy.
“Many racial and ethnic minorities, people with limited English proficiency, people with disabilities, and other populations face unique health challenges, often have reduced access to health care and often pay the price with poorer health,” said Garth Graham, M.D., MPH, HHS deputy assistant secretary for minority health. “Today we are implementing an important provision of the Affordable Care Act that reinforces our commitment to reducing these health disparities. These new standards will help us carry forward the HHS Action Plan to Reduce Racial and Ethnic Health Disparities and our work to address disparities in people with disabilities as well.”
The standards, effective upon publication today, apply to health surveys sponsored by HHS where respondents either self-report information or a knowledgeable person responds for all members of a household. The standards will be used in all new surveys and at the time of revision to current surveys.
For more information on the final data standards, visit www.minorityhealth.hhs.gov/section4302.
Source: HHS News Release
“It is our job to get a better understanding of why disparities occur and how to eliminate them. Improving the breadth and quality of our data collection and analysis on key areas, like race, ethnicity, sex, primary language and disability status, is critical to better understanding who we are serving,” said HHS Secretary Sebelius. "Today, through these new standards, we are providing a new set of powerful tools to help us achieve our vision of a nation free of disparities in health and health care.”
The Affordable Care Act requires new standards for the collection and reporting of health care information based on race, ethnicity, sex, and primary language. Making data standards consistent will help identify the significant health differences that often exist between and within ethnic groups, particularly among Asian, Hispanic/Latino and Pacific Islander populations.
For example, a study showed that the diabetes-related mortality rate for Mexican Americans (251 per 100, 000) and Puerto Ricans (204 deaths per 100, 000) was twice as high as the diabetes-related mortality rate for Cuban Americans (101 deaths per 100, 000). However, this information would have remained unknown if only the umbrella terms of “Hispanic” or “Latino” had been used.
By adding Mexican American and Chicano/a, Puerto Rican, Cuban, and other Hispanic Latino/a or Spanish origin as explicit categories required on all HHS-sponsored health surveys, we can better capture the individual ethnic group challenges that are often found within minority populations. This specificity allows for better measurement and tracking of health differences in these populations and target interventions appropriately.
The new data collection requirements also will improve researchers' ability to consistently monitor more dimensions of health disparities among people with disabilities. Collection of all data will take place under HHS’ longstanding, strict commitment to protecting privacy.
“Many racial and ethnic minorities, people with limited English proficiency, people with disabilities, and other populations face unique health challenges, often have reduced access to health care and often pay the price with poorer health,” said Garth Graham, M.D., MPH, HHS deputy assistant secretary for minority health. “Today we are implementing an important provision of the Affordable Care Act that reinforces our commitment to reducing these health disparities. These new standards will help us carry forward the HHS Action Plan to Reduce Racial and Ethnic Health Disparities and our work to address disparities in people with disabilities as well.”
The standards, effective upon publication today, apply to health surveys sponsored by HHS where respondents either self-report information or a knowledgeable person responds for all members of a household. The standards will be used in all new surveys and at the time of revision to current surveys.
For more information on the final data standards, visit www.minorityhealth.hhs.gov/section4302.
Source: HHS News Release
Monday, October 24, 2011
HHS Releases New Program to Help Providers Give Better Care to Medicare Patients
People with Medicare will be able to benefit from a new program designed to encourage primary care doctors, specialists, hospitals, and other health care providers to coordinate their care under a final regulation issued today by the Department of Health and Human Services (HHS).
Created by the Affordable Care Act, these final rules on Accountable Care Organizations add to the menu of options for providers looking to better coordinate care for patients and will make it easier for providers to deliver high quality care and use health care dollars more wisely.
The initiatives announced are just two of several efforts made possible by the Affordable Care Act to help bring better health, better care and lower costs not just to Medicare beneficiaries, but to all Americans. For example, the Bundled Payments for Care Improvement Initiative and Comprehensive Primary Care Initiative offer alternatives to coordinate and improve health care.
“Today we have taken another step to improve health care for people with Medicare,” said HHS Secretary Kathleen Sebelius. “We are excited to give doctors, hospitals and other providers the flexibility and support they need to work together and focus on making sure patients get the care they need.”
“This model of delivering care may not be right for everyone, but it provides new incentives for doctors, hospitals, and other health care providers to work together in new ways,” said Secretary Sebelius.
The two initiatives launched – the Medicare Shared Savings Program and the Advance Payment model – will help providers form Accountable Care Organizations and reflect the significant input provided by stakeholders as well as lessons learned by innovators in care coordination in the private sector.
The Medicare Shared Savings Program will provide incentives for participating health care providers who agree to work together and become accountable for coordinating care for patients. Providers who band together through this model and who meet certain quality standards based upon, among other measures, patient outcomes and care coordination among the provider team, may share in savings they achieve for the Medicare program. The higher the quality of care providers deliver, the more shared savings the providers may keep.
The Advance Payment model will provide additional support to physician-owned and rural providers participating in the Medicare Shared Savings Program who also would benefit from additional start-up resources to build the necessary infrastructure, such as new staff or information technology systems. The advanced payments would be recovered from any future shared savings achieved by the Accountable Care Organization.
“As a physician I understand the complexities of caring for a patient who may have multiple providers,” said Donald M. Berwick, M.D., administrator of the Centers for Medicare & Medicaid Services (CMS). “This opportunity to coordinate care among providers could greatly improve the quality of care Medicare beneficiaries receive.”
Both the Medicare Shared Savings Program and Advance Payment model create incentives for health care providers to work together to treat an individual patient across care settings – including doctors’ offices, hospitals, and long-term care facilities.
Unlike a managed care plan, Medicare beneficiaries will not be locked into a restricted panel of providers. Rather, a determination of whether an Accountable Care Organization was responsible for coordinating care for a beneficiary will be based on whether that person received most of their primary care services from the organization.
“We listened very carefully to the more than 1,300 comments we received on the proposed rule released this spring, and this final rule includes a number of improvements suggested by those comments that will strengthen the program,” Dr. Berwick said. “For example, the final rule will increase the incentives and streamline the Shared Savings Program, extending the benefits of the new program to a broader range of beneficiaries.”
Other changes from the proposed rule include making the one-sided model truly one-sided, expanding participation to Rural Health Clinics and Federally Qualified Health Centers and organizations where specialists provide primary care, and providing a flexible starting date in 2012. Federal savings from this initiative could be up to $940 million over four years.
To aid organizations interested in becoming Accountable Care Organizations, CMS offers a number of learning opportunities for providers, including the third Accelerated Development Learning Session on November 17-18 in Baltimore. This free session will offer providers the opportunity to learn more about this option for providing care. For more information, visit https://acoregister.rti.org/.
People with Medicare have received information about what an Accountable Care Organization could mean for them in the annual issue of “Medicare & You” and if their current health care provider is participating in an Accountable Care Organization, they will receive additional information from their provider.
The Shared Savings Program final rule can be found at: http://www.HealthCare.gov/law/resources/regulations/index.html. (See Final Rule on Shared Savings Program: Accountable Care Organizations)
The Advanced Payment solicitation is posted at: http://innovations.cms.gov/areas-of-focus/seamless-and-coordinated-care-models/advance-payment/.
For more information, fact sheets are posted at: http://www.HealthCare.gov/news/factsheets/2011/10/accountable-care10202011a.html and http://www.cms.gov/ACO/.
The joint CMS and Department of Health and Human Services Office of Inspector General (OIG) Interim Final Rule with Comment Period addressing waivers of certain fraud and abuse laws in connection with the Shared Savings Program can be found at: http://www.HealthCare.gov/law/resources/regulations/index.html. (See Request for Public Comment on Final Waivers in Connection with the Shared Savings Program).
The Antitrust Policy Statement is posted at: www.ftc.gov/opp/aco/ andhttp://www.justice.gov/atr/public/health_care/aco.html.
The Internal Revenue Service (IRS) Fact Sheet, Tax-Exempt Organizations Participating in the Medicare Shared Savings Program through Accountable Care (FS-2001-11), is posted at: http://www.irs.gov/newsroom/article/0,,id=248490,00.html.
Source: HHS News Release
Created by the Affordable Care Act, these final rules on Accountable Care Organizations add to the menu of options for providers looking to better coordinate care for patients and will make it easier for providers to deliver high quality care and use health care dollars more wisely.
The initiatives announced are just two of several efforts made possible by the Affordable Care Act to help bring better health, better care and lower costs not just to Medicare beneficiaries, but to all Americans. For example, the Bundled Payments for Care Improvement Initiative and Comprehensive Primary Care Initiative offer alternatives to coordinate and improve health care.
“Today we have taken another step to improve health care for people with Medicare,” said HHS Secretary Kathleen Sebelius. “We are excited to give doctors, hospitals and other providers the flexibility and support they need to work together and focus on making sure patients get the care they need.”
“This model of delivering care may not be right for everyone, but it provides new incentives for doctors, hospitals, and other health care providers to work together in new ways,” said Secretary Sebelius.
The two initiatives launched – the Medicare Shared Savings Program and the Advance Payment model – will help providers form Accountable Care Organizations and reflect the significant input provided by stakeholders as well as lessons learned by innovators in care coordination in the private sector.
The Medicare Shared Savings Program will provide incentives for participating health care providers who agree to work together and become accountable for coordinating care for patients. Providers who band together through this model and who meet certain quality standards based upon, among other measures, patient outcomes and care coordination among the provider team, may share in savings they achieve for the Medicare program. The higher the quality of care providers deliver, the more shared savings the providers may keep.
The Advance Payment model will provide additional support to physician-owned and rural providers participating in the Medicare Shared Savings Program who also would benefit from additional start-up resources to build the necessary infrastructure, such as new staff or information technology systems. The advanced payments would be recovered from any future shared savings achieved by the Accountable Care Organization.
“As a physician I understand the complexities of caring for a patient who may have multiple providers,” said Donald M. Berwick, M.D., administrator of the Centers for Medicare & Medicaid Services (CMS). “This opportunity to coordinate care among providers could greatly improve the quality of care Medicare beneficiaries receive.”
Both the Medicare Shared Savings Program and Advance Payment model create incentives for health care providers to work together to treat an individual patient across care settings – including doctors’ offices, hospitals, and long-term care facilities.
Unlike a managed care plan, Medicare beneficiaries will not be locked into a restricted panel of providers. Rather, a determination of whether an Accountable Care Organization was responsible for coordinating care for a beneficiary will be based on whether that person received most of their primary care services from the organization.
“We listened very carefully to the more than 1,300 comments we received on the proposed rule released this spring, and this final rule includes a number of improvements suggested by those comments that will strengthen the program,” Dr. Berwick said. “For example, the final rule will increase the incentives and streamline the Shared Savings Program, extending the benefits of the new program to a broader range of beneficiaries.”
Other changes from the proposed rule include making the one-sided model truly one-sided, expanding participation to Rural Health Clinics and Federally Qualified Health Centers and organizations where specialists provide primary care, and providing a flexible starting date in 2012. Federal savings from this initiative could be up to $940 million over four years.
To aid organizations interested in becoming Accountable Care Organizations, CMS offers a number of learning opportunities for providers, including the third Accelerated Development Learning Session on November 17-18 in Baltimore. This free session will offer providers the opportunity to learn more about this option for providing care. For more information, visit https://acoregister.rti.org/.
People with Medicare have received information about what an Accountable Care Organization could mean for them in the annual issue of “Medicare & You” and if their current health care provider is participating in an Accountable Care Organization, they will receive additional information from their provider.
The Shared Savings Program final rule can be found at: http://www.HealthCare.gov/law/resources/regulations/index.html. (See Final Rule on Shared Savings Program: Accountable Care Organizations)
The Advanced Payment solicitation is posted at: http://innovations.cms.gov/areas-of-focus/seamless-and-coordinated-care-models/advance-payment/.
For more information, fact sheets are posted at: http://www.HealthCare.gov/news/factsheets/2011/10/accountable-care10202011a.html and http://www.cms.gov/ACO/.
The joint CMS and Department of Health and Human Services Office of Inspector General (OIG) Interim Final Rule with Comment Period addressing waivers of certain fraud and abuse laws in connection with the Shared Savings Program can be found at: http://www.HealthCare.gov/law/resources/regulations/index.html. (See Request for Public Comment on Final Waivers in Connection with the Shared Savings Program).
The Antitrust Policy Statement is posted at: www.ftc.gov/opp/aco/ andhttp://www.justice.gov/atr/public/health_care/aco.html.
The Internal Revenue Service (IRS) Fact Sheet, Tax-Exempt Organizations Participating in the Medicare Shared Savings Program through Accountable Care (FS-2001-11), is posted at: http://www.irs.gov/newsroom/article/0,,id=248490,00.html.
Source: HHS News Release
EHR Decision Support Tool Saved Physicians Time, Errors in Retrieving Clinical Information
A decision support tool generated by an electronic health record (EHR) that collects clinical information on ambulatory diabetes care saved primary care physicians more than 4 minutes compared to the conventional method of searching on multiple EHR screens, an AHRQ-funded study has found. Writing in the September/October 2011 issue of the Annals of Family Medicine, researchers at the University of Missouri family medicine department created an EHR-generated diabetes “dashboard” with the technology company Cerner. The dashboard collects important diabetes clinical data on one page and mirrors the information sought by national organizations to benchmark high-quality diabetes care. Physicians using the dashboard located the 10 data elements within 1.3 minutes, compared to 5.5 minutes among physicians searching multiple EHR screens. Physicians who used the dashboard correctly identified the data requested 100 percent of the time, compared to 94 percent for physicians using the conventional method.
Select for the article.
Source: AHRQ News Release
Select for the article.
Source: AHRQ News Release
Monday, October 17, 2011
Health Care Reform Presents Opportunities for Performance Improvement
A recent article Becker's Hospital Review says that providers will need to find ways to reduce costs - particularly in Medicare and Medicaid - while maintaining or improving quality.
William C. Mohlenbrock, MD, FACS, discusses "three specific initiatives to improve quality and control costs [in the healthcare reform law]: the Medicare Shared Savings Program, which establishes Medicare accountable care organizations; the Bundled Payments for Care Initiative, which expands CMS' Acute Care Episodes; and Consumer Operated and Oriented Plans."
Source: Becker's Hospital Review
William C. Mohlenbrock, MD, FACS, discusses "three specific initiatives to improve quality and control costs [in the healthcare reform law]: the Medicare Shared Savings Program, which establishes Medicare accountable care organizations; the Bundled Payments for Care Initiative, which expands CMS' Acute Care Episodes; and Consumer Operated and Oriented Plans."
Source: Becker's Hospital Review
Friday, October 7, 2011
HSPH Study: Lower Quality, High Cost Hospitals Treat More Poor, Minorities
Hospitals with the lowest scores on certain quality and cost measures treat more than twice as many minority and poor patients as hospitals with the highest scores, according to a Harvard School of Public Health study published in Health Affairs.
The study compared quality and cost measures at roughly 3,200 hospitals with the proportion of minority and Medicaid patients the hospitals served. "As the United States embarks on efforts to improve hospital care using value-based purchasing principles, we will need to help hospitals improve quality and efficiency simultaneously and to monitor the results of their efforts, so that we do not inadvertently worsen disparities in care," the study concludes.
Maulik Joshi, president of the Health Research & Educational Trust and senior vice president of research for the AHA, said the AHA "is committed to sharing with hospitals tools and strategies that can help eliminate disparities in care. As noted by today's study and others in Health Affairs, there are many community-based influences on health and health care. We need to address the many factors that impact community health, such as access to preventive and follow-up care, and work with all stakeholders to ensure improved care for patients and communities."
Source: AHA News Release
The study compared quality and cost measures at roughly 3,200 hospitals with the proportion of minority and Medicaid patients the hospitals served. "As the United States embarks on efforts to improve hospital care using value-based purchasing principles, we will need to help hospitals improve quality and efficiency simultaneously and to monitor the results of their efforts, so that we do not inadvertently worsen disparities in care," the study concludes.
Maulik Joshi, president of the Health Research & Educational Trust and senior vice president of research for the AHA, said the AHA "is committed to sharing with hospitals tools and strategies that can help eliminate disparities in care. As noted by today's study and others in Health Affairs, there are many community-based influences on health and health care. We need to address the many factors that impact community health, such as access to preventive and follow-up care, and work with all stakeholders to ensure improved care for patients and communities."
Source: AHA News Release
Thursday, September 29, 2011
Children's Hospitals Growing; Raises Questions About Spending
A news report by Kaiser Health News says that children's hospitals are growing and this growth spurt has led to questions about spending. The report says that the hospitals have hired lobbyists to obtain ensure special treatment by Congress and ensure that the highest insurance rates are paid to their facilities.
Source: Kaiser Health News Article
Source: Kaiser Health News Article
Survey: Physicians Say They Over-Treat Patients
A recent survey of physicians conducted by the VA Outcomes Group and the Dartmouth Institute for Health Policy and Clinical Practice reveals that they feel that they are over-treating their patients. Many physicians indicate that this is caused by pressures caused by the fear of malpractice suits, the realignment of financial incentives towards more aggressive treatment, and shortened time to spend with patients.
A report about the survey is published in the September 26 issue of Archives of Internal Medicine.
Source: Dartmouth Institute for Health Policy and Clinical Practice News Release
A report about the survey is published in the September 26 issue of Archives of Internal Medicine.
Source: Dartmouth Institute for Health Policy and Clinical Practice News Release
HHS launches new Affordable Care Act initiative to strengthen primary care
The U.S. Department of Health and Human Services (HHS) launched a new initiative made possible by the Affordable Care Act to help primary care practices deliver higher quality, more coordinated and patient-centered care. Under the new initiative, Medicare will work with commercial and state health insurance plans to offer additional support to primary care doctors who better coordinate care for their patients. This collaboration, known as the Comprehensive Primary Care initiative, is modeled after innovative practices developed by large employers and leading private health insurers in the private sector.
“Thanks to the Affordable Care Act, we are helping primary care doctors better coordinate care with patients so they get better care and we use our health care dollars more wisely,” said HHS Secretary Kathleen Sebelius.
The voluntary initiative will begin as a demonstration project available in five to seven health care markets across the country. Public and private health care payers interested in applying to participate in the Comprehensive Primary Care Initiative must submit a Letter of Intent by November 15, 2011. In the selected markets, Medicare and its partners will enroll interested primary care providers into the initiative.
Primary care practices that choose to participate in this initiative will be given support to better coordinate primary care for their Medicare patients.
This support will help doctors:
- Help patients with serious or chronic diseases follow personalized care plans;
- Give patients 24-hour access to care and health information;
- Deliver preventive care;
- Engage patients and their families in their own care;
- Work together with other doctors, including specialists, to provide better coordinated care.
CMS will pay primary care practices a monthly fee for these activities in addition to the usual Medicare fees that these practices would receive for delivering Medicare covered services. This collaborative approach has the potential to strengthen the primary care system for all Americans and reduce health care costs by using resources more wisely and preventing disease before it happens.
Across the country, systems which are based on comprehensive, higher-functioning primary care, similar to the strategy that CMS seeks to test in this initiative, show that patients are healthier and avoid having to seek care in more complex and expensive settings when primary care practices have the resources to better coordinate care, engage patients in their care plan, and provide timely preventive care. Large businesses have been able to make independent investments to promote more comprehensive primary care – improving the health of their employees and lowering their health care costs, thus making it easier for them to hire more workers and invest in their workforce.
“We know that when doctors have time to spend time with their patients and can better coordinate care with specialists, people are healthier and we have lower costs in the health care system,” said CMS Administrator Donald Berwick, M.D.
The Comprehensive Primary Care initiative is just one part of a wide-ranging effort by the Obama Administration to promote coordinated care and lower costs for all Americans, using important new tools provided by the Affordable Care Act. Accountable Care Organizations (ACOs) are another way that doctors, hospitals and other health care providers can work together to better coordinate care for patients, which can help improve health, improve the quality of care, and lower costs. Under the Bundled Payment initiative, payments for multiple services patients receive during an episode of care will be linked to help improve and coordinate care for patients while they are in the hospital and after they are discharged. The Partnership for Patients is bringing together hospitals, doctors, nurses, pharmacists, employers, unions, and state and federal government to keep patients from getting injured or sicker in the health care system and to improve transitions between care settings.
For more information, please see the Comprehensive Primary Care initiative web site at: http://innovations.cms.gov/areas-of-focus/seamless-and-coordinated-care-models/cpci/
For an overview fact sheet about the Comprehensive Primary Care initiative, visit: http://www.healthcare.gov/news/factsheets/2011/09/primary-care09282011a.html
Interested parties may obtain answers to specific questions by e-mailing CMS at: CPCi@cms.hhs.gov.
For more information about the CMS Innovation Center, please visit: http://www.innovations.cms.gov.
Source: HHS News Release
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