Unbiased Analysis of Today's Healthcare Issues
The answer is probably not. The NCQA defines 149 factors which would make a practice a successful medical home. These include physician access during and after office hours, electronic access to patients information, availability of clinical data and use of that data for population management, identification of high risk patients, ability to refer patients to…
The California Health Care Foundation (CHCF)’s Health Care Almanac provides some unique insights on trends in health care quality in California and for the United States as a whole. Many of the national figures for the Almanac come from the CDC (BRFSS and Vital Stats) and AHRQ’s National Healthcare Quality Report. California quality figures come…
Medicare’s push to evaluate all types of providers is being extended to Inpatient Rehabilitation Hospitals (IRFs). According to Health Reform bill (specifically, Section 3004 of the Affordable Care Act), CMS is required to start publishing quality measures for IRFs by October 1, 2012. This newly created IRF Quality Reporting Program (QRP) currently has proposed two…
Starting in fiscal year 2014, Medicare will start rewarding hospitals with high quality care and penalizing hospitals with low quality care. The rewards and penalties will be financial in nature. High-quality hospitals will receive a bonus and low-quality hospitals will receive a financial penalty. There is a lot of existing documentation on this hospital value-based…
Medicare beneficiaries have a choice: pick the standard Medicare fee-for-service (FFS) benefit or rely on managed care plans to supply their healthcare through the Medicare Advantage (MA) program. Many Medicare beneficiaries prefer MA because it offers them lower out-of-pocket costs and provide benefits not available in the traditional FFS Medicare program. Other beneficiaries prefer the…
For nursing homes at least, patients do not seem to have much choice. According to an article by Grabowski and Town: The introduction of the NHQI was generally unrelated to facility quality and consumer demand. However, nursing homes facing greater competition improved their quality more than facilities in less competitive markets…The lack of competition in…
The Agency for Healthcare Research and Quality’s (AHRQ) Healthcare Cost and Utilization Project (HCUP) is a family of databases and tools intended to improve the quality, safety, efficiency, and effectiveness of the U.S. health care system. HCUP results from Federal-State-Industry partnership to build a comprehensive all payer data system. A summary of the databases available from…
Massachusetts’ Medicaid program instituted a pay-for-performance program in 2008. Did it work? According to this paper, the answer is no. MassHealth P4P Background The MassHealth pay-for-perfrmance P4P program was implemented in 2008. At first the program was implmented using a P4P structure for pneumonia and pay-for-reporting for surgical infection prevention (SIP) and transitioning to P4P…
How do you know if a patient is receiving the correct dose? Better yet, how can you check if your entire patient panel is on the right dosage? Although identifying the ‘right’ dosage is difficult, it is much easier to see if your patients are on the wrong dosage. Medi-Span’s Dose-Chek data provides information on…
Today I will discuss the evolution of home health care measures over the past 15 years. The majority of the content comes from an article by Robert Rosati (2009). Timeline Here is a link to a TIMELINE that briefly summarizes the key developments in home health care quality measurements. Risk Adjustment From the early development…