Dr. David Muhlestein and Mathew Petersen, both of whom participate with Leavitt Partners' research on Accountable Care Organizations, co-authored the article ACO Results: What We Know So Far in Health Affairs Blog column on May 30th, 2014.
Growth and Dispersion of Accountable Care OrganizationsLeavitt Partners
The Leavitt Partners Center for ACO Intelligence, which tracks national and regional trends related to ACOs and other emerging care delivery systems, published a white paper entitled "Growth and Dispersion of Accountable Care Organizations." This is the first report of its kind regarding the types and locations of ACOs. The report provides data-driven insights into the evolution of ACOs following federal health reform and the recent announcement of the Medicare Shared Savings Program. Data and analysis on the growth and national dispersion trends of more than 160 ACO or ACO-like organizations are highlighted.
Attorney Michael James spoke to Michigan Association of CPAs yesterday on his presentation "Accountable Care Organizations 2.0". The presentation addressed the hundreds of pages of recently proposed regulations related to ACOs that represent the most dramatic overhaul of the Medicare Shared Savings Program since its inception. Other insights in the presentation:
- Current Regulatory Environment for Integrated Models
- How Environment Evolves Under Proposed Regulations
- Various Requirements Needed for ACOs
- Potential Risks Under Current ACO Models
To learn more, contact attorney Michael James at mjames@fraserlawfirm.com or 517-377-0823. Michael James is a senior attorney at Fraser Trebilcock, providing representation and counseling related to all facets of business enterprise and health care matters.
NOTE: Information contained in this presentation is only current as of the blog publish date. For updated information, refer to the Fraser Trebilcock Health Care Reform blog: fraserlawfirm.com
Accountable Care Organizations and The Medicare Shared Savings ProgramPhytel
Population Health Management, Enabled by Information Technology, Will Be Critical To Success. In 2012, the Centers for Medicare and Medicaid Services (CMS) will launch a shared-savings program with accountable care organizations (ACOs). ACOs that meet specified quality goals will be able to split with CMS any savings that surpass a minimum level. The challenge facing ACOs is choosing the right information technologies so they can track the health status of and the care provided to every one of their patients to produce significant savings or meet the quality benchmarks of CMS
Growth and Dispersion of Accountable Care OrganizationsLeavitt Partners
The Leavitt Partners Center for ACO Intelligence, which tracks national and regional trends related to ACOs and other emerging care delivery systems, published a white paper entitled "Growth and Dispersion of Accountable Care Organizations." This is the first report of its kind regarding the types and locations of ACOs. The report provides data-driven insights into the evolution of ACOs following federal health reform and the recent announcement of the Medicare Shared Savings Program. Data and analysis on the growth and national dispersion trends of more than 160 ACO or ACO-like organizations are highlighted.
Attorney Michael James spoke to Michigan Association of CPAs yesterday on his presentation "Accountable Care Organizations 2.0". The presentation addressed the hundreds of pages of recently proposed regulations related to ACOs that represent the most dramatic overhaul of the Medicare Shared Savings Program since its inception. Other insights in the presentation:
- Current Regulatory Environment for Integrated Models
- How Environment Evolves Under Proposed Regulations
- Various Requirements Needed for ACOs
- Potential Risks Under Current ACO Models
To learn more, contact attorney Michael James at mjames@fraserlawfirm.com or 517-377-0823. Michael James is a senior attorney at Fraser Trebilcock, providing representation and counseling related to all facets of business enterprise and health care matters.
NOTE: Information contained in this presentation is only current as of the blog publish date. For updated information, refer to the Fraser Trebilcock Health Care Reform blog: fraserlawfirm.com
Accountable Care Organizations and The Medicare Shared Savings ProgramPhytel
Population Health Management, Enabled by Information Technology, Will Be Critical To Success. In 2012, the Centers for Medicare and Medicaid Services (CMS) will launch a shared-savings program with accountable care organizations (ACOs). ACOs that meet specified quality goals will be able to split with CMS any savings that surpass a minimum level. The challenge facing ACOs is choosing the right information technologies so they can track the health status of and the care provided to every one of their patients to produce significant savings or meet the quality benchmarks of CMS
Accountable Care Organizations: 4 Physician BenefitsGreenway Health
Why would physicians join an Accountable Care Oragnization (ACO)? This informative slide presentation gives a brief overview of ACOs, their benefits, and four reasons physicians may have for joining one.
Succeeding in Population Health Management: Why the Right Tools MatterHealth Catalyst
The U.S. healthcare market projects that by 2022 90 million Americans will be in an ACO. The upward trend in population health management (PHM) makes the move towards risk-based contracts increasingly urgent for health systems. The industry has been largely unprepared for the shift, as it hasn’t established a clear definition of population health or solid guidelines on transitioning from volume to value. Organizations can, however, prepare for the demands of PHM by adopting a solution that manages comprehensive population health data, provides advanced analytics from new and complex challenges, and connects them with the deep expertise to thrive in a value-based landscape.
Learn some simple truths about how ACO's operate and function. Adapted from http://www.insight-txcin.org/post/why-accountable-care-organizations-succeed
Provider participation in accountable care organizations (ACOs) is becoming the new normal. As of January 1, 2016, there are 434 ACOs
in the Medicare Shared Savings Program. More than 160,000 providers now participate in an MSSP ACO. These organizations now serve
7.7 million Medicare beneficiaries residing in 49 of the 50 states. Here’s the road to the MSSP destination of shared savings.
Value-Based Purchasing and the Role of Home Care TechnologyAlayaCare
While shifting financial models is a major challenge facing healthcare, we can safely assume where that shift is heading. As it stands, there continues to be a paucity of good evidence as to how to run an effective Value-Based Purchasing (VBP) program, and definitive metrics on how it can lead to better outcomes. Thus, this shift is underway filled with far more expectations than answers.
With this guide will you learn how your home care agency can prepare, adapt and thrive in a value-based purchasing landscape with the help of modern home care technology.
What is MIPS and How it Affects My Practice?
For additional information on MIPS, you can visit: https://bit.ly/2I6TUxq, or contact us at 888-357-3226/ info@medicalbillersandcoders.com with your questions.
Click Here For More Information: https://bit.ly/3k7QS9P
Get a Free Quote: https://bit.ly/30DFr2z
#texasmedicalbillingandcodingservices #medicalbillingauditing #medicare #medicalbillingandcoding #MBC #MIPS #medicalbillingguideline #mipsaffectsmypractice
Consumer-Centric Healthcare: 2015--The Tipping Point Has Arrived (Report by William Blair)
Consumers—in tandem with disruptive healthcare technology and healthcare services providers—are the key to solving many of US healthcare's woes, particularly the unsustainably high cost of care.
Public exchanges, private exchanges, and high-deductible health plans are growing quickly. Disruptive forces of competition will create a lower-cost system that promotes the growth of highly efficient, low-cost, and high-quality providers and technologies.
The continued movement of financial and quality risk back to providers (and increasingly to consumers themselves) is encouraging providers and consumers to seek preventive medicine, cost efficiency, clinical efficacy, and overall value in healthcare. In turn, this could drive significant change regarding the primary point of care delivery (rapidly moving outside the hospital), the overall cost of healthcare and investment decisions made by healthcare providers.
Consumer-centric healthcare providers will experience strong top- and bottom-line growth over the coming years. Investors in both the public and private-equity markets will achieve superior long-term returns by identifying and investing in these companies.
Accountable Care Organizations: 4 Physician BenefitsGreenway Health
Why would physicians join an Accountable Care Oragnization (ACO)? This informative slide presentation gives a brief overview of ACOs, their benefits, and four reasons physicians may have for joining one.
Succeeding in Population Health Management: Why the Right Tools MatterHealth Catalyst
The U.S. healthcare market projects that by 2022 90 million Americans will be in an ACO. The upward trend in population health management (PHM) makes the move towards risk-based contracts increasingly urgent for health systems. The industry has been largely unprepared for the shift, as it hasn’t established a clear definition of population health or solid guidelines on transitioning from volume to value. Organizations can, however, prepare for the demands of PHM by adopting a solution that manages comprehensive population health data, provides advanced analytics from new and complex challenges, and connects them with the deep expertise to thrive in a value-based landscape.
Learn some simple truths about how ACO's operate and function. Adapted from http://www.insight-txcin.org/post/why-accountable-care-organizations-succeed
Provider participation in accountable care organizations (ACOs) is becoming the new normal. As of January 1, 2016, there are 434 ACOs
in the Medicare Shared Savings Program. More than 160,000 providers now participate in an MSSP ACO. These organizations now serve
7.7 million Medicare beneficiaries residing in 49 of the 50 states. Here’s the road to the MSSP destination of shared savings.
Value-Based Purchasing and the Role of Home Care TechnologyAlayaCare
While shifting financial models is a major challenge facing healthcare, we can safely assume where that shift is heading. As it stands, there continues to be a paucity of good evidence as to how to run an effective Value-Based Purchasing (VBP) program, and definitive metrics on how it can lead to better outcomes. Thus, this shift is underway filled with far more expectations than answers.
With this guide will you learn how your home care agency can prepare, adapt and thrive in a value-based purchasing landscape with the help of modern home care technology.
What is MIPS and How it Affects My Practice?
For additional information on MIPS, you can visit: https://bit.ly/2I6TUxq, or contact us at 888-357-3226/ info@medicalbillersandcoders.com with your questions.
Click Here For More Information: https://bit.ly/3k7QS9P
Get a Free Quote: https://bit.ly/30DFr2z
#texasmedicalbillingandcodingservices #medicalbillingauditing #medicare #medicalbillingandcoding #MBC #MIPS #medicalbillingguideline #mipsaffectsmypractice
Consumer-Centric Healthcare: 2015--The Tipping Point Has Arrived (Report by William Blair)
Consumers—in tandem with disruptive healthcare technology and healthcare services providers—are the key to solving many of US healthcare's woes, particularly the unsustainably high cost of care.
Public exchanges, private exchanges, and high-deductible health plans are growing quickly. Disruptive forces of competition will create a lower-cost system that promotes the growth of highly efficient, low-cost, and high-quality providers and technologies.
The continued movement of financial and quality risk back to providers (and increasingly to consumers themselves) is encouraging providers and consumers to seek preventive medicine, cost efficiency, clinical efficacy, and overall value in healthcare. In turn, this could drive significant change regarding the primary point of care delivery (rapidly moving outside the hospital), the overall cost of healthcare and investment decisions made by healthcare providers.
Consumer-centric healthcare providers will experience strong top- and bottom-line growth over the coming years. Investors in both the public and private-equity markets will achieve superior long-term returns by identifying and investing in these companies.
Health Reform Bracketology is a scenario-planning tool that assesses the future of specific policies and provisions within the Patient Protection and Affordable Care Act. This assessment is conducted across a myriad of different political scenarios.
Patients are receiving disjointed care in the present expensive system. Changing the model:
- Identifying the components of The Transformed System; affordable, accessible, seamless, and coordinated plus high quality, person and family centered, and clinically supportive
- Listing ways to develop partnerships that create strong symbiotic teams
- Creating Care and Operation Interventions that integrate with Care Transitions, Guided Care in the PCMM(H), and ACO models
The Center for Medicare & Medicaid Services (CMS) recently announced 23 additional participants for the Community-based Care Transitions Program (CCTP). These participants will join seven other community-based organizations already working with local hospitals and other health care and social service providers to support high-risk Medicare patients in maintaining the healing process as they transition from hospital stays to home, a nursing home, or other care setting.
This webinar will allow stakeholders to hear directly from some of the newly selected sites. CMS Innovation Center staff will provide additional information about the program and will be available to answer questions.
More at: http://innovations.cms.gov/resources/CCTP-RdcReadmiss.html
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http://innovation.cms.gov
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Why Pioneer ACOs Are Disappearing and 3 Trends to Expect from the ExodusHealth Catalyst
Over of half the Pioneer ACOs have dropped from the program in the last four years, despite achieving $304 million in savings, and fifty percent of the participating ACOs receiving shared savings reimbursements. Why the exodus? Overutilization and inconsistent performance benchmarking and attribution hindered the ability of many participants to achieve success. The overall impact of the program, however, has been a positive one for value-based care. In the next 3-5 years, providers and health systems will bear more of the financial risk of the populations they serve. The proliferation of data, and the tools to analyze and exchange it, will be critical to the long-term success of value-based care.
Establishing a Community-based Framework for ACOs - slide-share 120116Jennifer D.
With the rapid growth of state Medicaid, Medicare, and commercial ACOs, now is the time to establish best practices for addressing the full spectrum of patient needs within an accountable care setting.
ACOs: Four Ways Technology Contributes to SuccessHealth Catalyst
With an increasing emphasis on value-based care, Accountable Care Organizations (ACOs) are here to stay. In an ACO, healthcare providers and hospitals come together with the shared goals of reducing costs and increasing patient satisfaction by providing high-quality coordinated healthcare to Medicare patients. However, many ACOs lack direction and experience difficulty understanding how to use data to improve care. Implementing a robust data analytics system to automate the process of data gathering and analysis as well as aligning data with ACO quality reporting measures. The article walks through four keys to effectively implementing technology for ACO success:
Build a data repository with an analytics platform.
Bring data to the point of care.
Analyze claims data, identify outliers, including successes and failures.
Combine clinical claims, and quality data to identify opportunities for improvement.
Many healthcare organizations seem to have been in perpetual pilot stage while experimenting with value-based payment models. Healthcare organizations are focusing their efforts in two primary areas: developing the skills to successfully manage at-risk contracts and, preparing for the considerable business and care delivery transformation necessary for true population health management. But what are the foundational competencies needed to take on risk? Healthcare organizations should consider the following 5 key areas: 1) at-risk contract management, 2) network management, 3) care management, 4) performance monitoring, and 5) improvement prioritization. The value of analytics in each of these competency areas is to prioritize limited resources on the highest impact area.
White Paper - Building Your ACO and Healthcare IT’s RoleNextGen Healthcare
The tools needed to capture, organize, and share healthcare data are truly evolving at the speed of light. Patient Centered Medical Homes play a vital role in the path toward accountable care and technology, staff, and workflow transformation are necessary to achieve PCMH recognition. This transformation allows healthcare providers to deliver higher quality coordinated care by streamlining and rationalizing the patient experience.
Value-Based Purchasing: Four Need-to-Know Domains for 2018Health Catalyst
Health systems that meet the 2018 Hospital Value-Based Purchasing Program measures stand to benefit from CMS’s $1.9 billion incentive pool. Under the 2018 regulations, CMS continues to emphasize quality. To reduce the risk of penalty and vie for bonuses, it’s increasingly critical that organizations leverage data to build skills and processes that meet more demanding reimbursement measures.
To thrive under value-based payment, healthcare systems must understand CMS’s four quality domains, and their associated measures, for 2018:
Clinical Care
Patient- and Caregiver-Centered Experience of Care/Care Coordination
Efficiency and Cost Reduction
Safety
Resetting Payer-Provider Arrangements for COVID-19 and the Evolving Improveme...Health Catalyst
As the healthcare industry recovers from COVID-19, providers are re-evaluating the financial arrangements that motivate them to improve their processes while benefiting payers and patients.
With the pandemic driving lower provider volumes and straining hospital resources, the industry has a renewed urgency for policies that drive better outcomes while lowering cost and improving revenue. Moving forward, healthcare must reset its payer-provider performance standards to the post COVID-19 environment.
Renewed approaches to the following models will consider the impact of remote care, how to reimburse telehealth services, and the need for consistent payments to providers:
1. Pay for performance.
2. Bundled payments.
3. ACOs.
Growth and Dispersion of Accountable Care OrganizationsLeavitt Partners
Leavitt Partners’ Center for ACO Intelligence, which tracks national and regional trends related to ACOs and other emerging care delivery systems, released a white paper today entitled Growth and Dispersion of Accountable Care Organizations. This is the first report of its kind regarding the types and locations of ACOs. The report provides data-driven insights into the evolution of ACOs following federal health reform and the recent announcement of the Medicare Shared Savings Program. Data and analysis on the growth and national dispersion trends of more than 160 ACO or ACO-like organizations are highlighted.
CFO Strategies for Balancing Fee-for-Service and ValuePhytel
Moving from fee-for-service to value-based care is not easy. However, leading health systems are all following a similar blueprint that enables the move to value-based care.
Download this whitepaper to learn how:
- Bon Secours Richmond - Closed 75,801 gaps in care within 12 months, generating $7 million in revenue for chronic & preventive care, while improving quality.
- Northeast Georgia Medical Center - Decreased HbA1C levels across uncontrolled diabetes by an average of 1.6 points within 120 days.
- Riverside Medical Center - Reduced unnecessary readmissions by 40% by using automation to reach and assess patients post discharge.
- Prevea Health - Increased care management productivity by 150% by automatically identifying high risk patients, and automating patient engagement.
Michael O Leavitt:
I call these speeches The Prologue Series. There is a statue behind the National
Archives that I look at nearly every day as I drive between HHS and the White
House. The statue, the work of Robert Aitken, is called “The Future.” It depicts a
woman looking up to the horizon from a book as if to ponder what she has just
read. At the base of the statue are the words from Shakespeare’s The Tempest
“What is past is prologue.”
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Immunity to Veterinary parasitic infections power point presentation
ACO Results: What We Know So Far
1. http://healthaffairs.org/blog/2014/05/30/aco-results-what-we-know-so-far/
ACO Results: What We Know So Far
May 30th, 2014
Matthew Petersen and David Muhlestein
Editor’s note: For more on this topic, stay tuned for the upcoming June issue of Health Affairs, which
features a series of articles on accountable care organizations.
Accountable care is a relatively recent addition to the health care vernacular, but its roots can be traced to
the decades-long effort to coordinate medical care. In the United States, health care has evolved into a
fragmented pay-for-volume system which has both driven up cost and decreased quality. Coordination of
care is meant to reverse this trend.
Through such solutions as Health Management Organizations (HMOs), Integrated Delivery Networks
(IDNs) and now Accountable Care Organizations (ACOs), policymakers, providers and payers have
sought to consolidate and coordinate patient care. Contemporary care coordination efforts focus on
accountable care which increases provider accountability for the cost and quality of care.
The driving principle behind the formation of ACOs is the Institute for Healthcare Improvement’s triple
aim: improving the patient experience of care, improving the health of populations, and reducing the per
capita cost of health care. One of the broadest applications of this concept is the creation of Medicare
ACOs under the Patient Protection and Affordable Care Act. This includes the Pioneer ACO Program and
the Medicare Shared Savings Program.
More recently, states have also pursued ACO contracts to cover Medicaid populations. In the private
sector, providers have forged ACO contracts with commercial payers. At the close of 2010, only 41
preliminary Accountable Care Organizations existed. The number of ACOs more than tripled to 138 a
2. http://healthaffairs.org/blog/2014/05/30/aco-results-what-we-know-so-far/
year after the passage of the PPACA. By 2012 the number nearly tripled again, and by the end of 2013
more than 600 ACOs were operating across the U.S.
In the past year, CMS has begun releasing both financial and quality results from Pioneer and Medicare
Shared Savings Program (MSSP) ACOs. Some commercial ACOs have released selected results as well.
While results are preliminary and incomplete, both CMS and commercial ACO results warrant a cautious
but optimistic outlook on ACOs and their ability to accomplish the triple aim.
.Sample Group
The Leavitt Partners Center for Accountable Care Intelligence conducted an analysis of ACO results to
determine the cost and quality implications of the ACO model on the U.S. health care system. Information
was gleaned from primary and secondary research, including the Leavitt Partners ACO Database of over
620 ACOs. Information about Pioneer and MSSP ACO results was gathered from CMS, and includes
press releases, announcements, and data sets.
Data was supplemented with information gathered through interviews and surveys carried out with the
leadership of more than a hundred ACOs nationwide. Commercial ACO results were gathered primarily
through publically available data such as press releases by affiliated providers or payers and
supplemented by interviews with ACO leadership. A breakdown of how many ACOs were represented in
our study can be found in Table 1.
3. http://healthaffairs.org/blog/2014/05/30/aco-results-what-we-know-so-far/
Findings
Although ACOs share common goals, they vary widely in terms of organization and level of development.
Results will be discussed separately for Pioneer, MSSP, Medicaid and Commercial ACOs. Where
available, both financial and quality results will be discussed and analyzed.
Pioneer ACOs
Thirty-two organizations began the Pioneer ACO program in 2012. Of these organizations, 23 remain in
the ACO Pioneer program. Nine ACOs left the pioneer program, with seven of those transitioning to the
MSSP ACO program and two leaving completely.
“We really did learn a lot as a Pioneer ACO,” said the VP of one of the departing ACOs. “However, we’d
be better off putting our energy into the health plan we already have… We didn’t have the confidence,
based on historical trends, that we could beat the trend. We would have been in a loss position and
writing a check to Medicare.”
The Pioneer program generated $147 million in total savings with approximately $76 million in savings
returned to ACOs. Of the original 32 Pioneer ACOs, 12 shared in savings while 19 did not share in
savings or losses. Only one ACO shared in losses. Addressing these mixed results, the CEO of one
Pioneer ACO that neither shared savings nor losses stated, “Our objectives were not to do well in a
particular financial cycle. We believe the payoff is going to be accumulated clinical transformation.”
Figure 1
4. http://healthaffairs.org/blog/2014/05/30/aco-results-what-we-know-so-far/
Pioneer ACOs were held to a set of 33 ACO quality metrics, which are also common to the MSSP
program. These metrics span four quality domains: patient experience, care coordination, patient safety,
preventive health and at-risk populations. ACOs were held responsible only for the reporting of these
metrics, not for any quality improvement.
All Pioneer ACOs successfully reported quality metrics to CMS and showed improvement where
comparable data was available. In interviews with Leavitt Partners, Pioneer ACO leaders outlined a few
tools they used to improve the quality of clinical care including best practices, evidence-based medicine,
and electronic health records.
MSSP ACOs
The MSSP ACO program is broader than the Pioneer program with less stringent rules for participation.
CMS has released preliminary results on the first two cohorts of MSSP ACOs, which include 114 ACOs
that started in 2012. Of the 114 MSSP ACOs, 54 kept costs below budget benchmarks and 29 of those
saved more than 2 percent, thus qualifying for shared savings (see figure 2). These 29 ACOs received
$126 million in savings and generated $128 million in total CMS trust fund savings. The other 60 MSSP
ACOs experienced spending above their set benchmark.
Figure 2
One of the principle differences in the MSSP program is the ability to choose between an upside-risk-only
contract (sharing in savings; no risk for losses) or an upside/downside-risk contract (sharing in savings
5. http://healthaffairs.org/blog/2014/05/30/aco-results-what-we-know-so-far/
while being at risk for losses). ACOs accepting both upside and downside risk would receive a larger
share of any shared savings due to their willingness to risk shared losses. Only four ACOs elected to take
downside risk and two of those shared in losses.
The CEO of one ACO that incurred shared losses remained positive when reporting to MedPAC stating,
“I’m actually quite optimistic about ACOs as a real catalyst to change the paradigm of care delivery… I’d
like to wait and give these ACOs a chance to perform. You know, we haven’t gotten a lot of negative
feedback from the marketplace or from our members.”
MSSP ACOs were held to the same aforementioned set of 33 ACO quality metrics. Again, MSSP ACOs
were required only to report quality metrics. Failure to do so resulted in forfeiting a portion potential
shared savings. All but five MSSP ACOs successfully reported their quality metrics.
Medicaid ACOs
Medicaid ACOs are still in their infancy and have only been adopted by a few states, including Oregon,
Iowa, Vermont and Colorado. The maturity of these programs varies widely and little information is
available in the way of results. Perhaps the best test case can be found in Oregon where Medicaid ACOs
have been designed to cover the entire geography of the state. Detailed financial results released by the
Oregon Health Authority (OHA) show that Medicaid ACOs were able to decrease cost of care for 19 out
of the 21 financial measures tracked. Areas of cost increases were focused around outpatient primary
care. While the overall savings were marginal, the OHA is, “encouraged by the first nine months of
progress data.”
In their February 2014 report, OHA highlighted results of their 17 quality metrics. A focus on utilization
resulted in a 13 percent decrease in emergency department visits and an 8 percent decrease in all-cause
readmission while hospitalization for chronic conditions was cut by a third. Other areas of improvement
include technology (EHR adoption has doubled in Oregon), primary care, and preventive care. Colorado’s
Medicaid ACO program has also highlighted positive preliminary results including $44 million in gross
savings in its second year. Few other state programs have publically released their quality or financial
metrics. It remains to be seen if shared savings will offset investment costs.
6. http://healthaffairs.org/blog/2014/05/30/aco-results-what-we-know-so-far/
Commercial ACOs
Perhaps the most diverse group of ACOs are those with commercial contracts. Like Medicare ACOs,
commercial payers with ACO contracts strive for the “triple aim” goals of improved patient experience,
improved quality of care, and decreased cost of care. However, they are not necessarily held to the same
financial requirements, quality metrics, or reporting timeline used by the Center for Medicare and
Medicaid Services (CMS). Publically available commercial results tend to highlight mostly positive aspects
of a particular ACO.
Results are more difficult to compare than Medicaid ACOs due to their lack of uniformity in measurement
and reporting. According to the Leavitt Partners ACO Database, there are 287 ACOs with commercial
contracts, only 12 of which have reported financial results of some sort. Eleven of the 12 commercial
ACOs report having saved money. Very few of these have reported a dollar figure for savings, but costs
were reported to have decreased by between 2 and 12 percent.
Successes include one New England ACO that reported a medical cost trend 1.2 percentage points
better than its market overall, as well as a large Northeast ACO which shared approximately $2 million in
their contract with United Healthcare. Savings aside, the cost of ACO investment was made clear by one
Northwestern ACO that reports spending about $1 million on infrastructure and only earning $125,000 in
savings in the first year.
7. http://healthaffairs.org/blog/2014/05/30/aco-results-what-we-know-so-far/
In addition to negotiating their own financial arrangements with providers, commercial payers with ACO
contracts also determine their own quality metrics. Some metrics are similar to those set by CMS while
others are unique to a specific payer.
Table 2 provides insight into the quality metrics of some of the leading players in ACO commercial
contracts. Commercial ACOs have been tight lipped about their quality metrics; quality metrics found in
table 2 were garnered from publically available sources and are not a comprehensive list. Commercial
contracts focus on preventive care management of chronic illnesses and access to care. Fifteen
commercial ACOs reported quality results, although only about 50 percent of those provided quantifiable
data.