DataBrief No. 22: Medicare Spending by Functional Impairment and Chronic Con...The Scan Foundation
In 2006, Medicare spent almost three times more per capita on seniors with chronic conditions and functional impairment than on seniors with chronic conditions alone?
DataBrief No. 21: Dual Eligibles, Chronic Conditions and Functional ImpairmentThe Scan Foundation
In 2006, 37% of seniors eligible for both Medicare and Medicaid had functional impairment in addition to chronic conditions, compared to only 9% of seniors eligible for Medicare-only. This DataBrief describes how dual eligibles have higher rates of both chronic conditions and functional impairment than Medicare-only beneficiaries.
This prep material partners with the video and is for participants attending ConC 2012 - it is presented by Camille Bonta for the workshops she will lead at the Fight Colorectal Cancer conference. This is the second part of the three part series
DataBrief No. 22: Medicare Spending by Functional Impairment and Chronic Con...The Scan Foundation
In 2006, Medicare spent almost three times more per capita on seniors with chronic conditions and functional impairment than on seniors with chronic conditions alone?
DataBrief No. 21: Dual Eligibles, Chronic Conditions and Functional ImpairmentThe Scan Foundation
In 2006, 37% of seniors eligible for both Medicare and Medicaid had functional impairment in addition to chronic conditions, compared to only 9% of seniors eligible for Medicare-only. This DataBrief describes how dual eligibles have higher rates of both chronic conditions and functional impairment than Medicare-only beneficiaries.
This prep material partners with the video and is for participants attending ConC 2012 - it is presented by Camille Bonta for the workshops she will lead at the Fight Colorectal Cancer conference. This is the second part of the three part series
Current healthcare trends and jobs outlook for 2025needppthelp
This is a team assignment for HCAD 600 for the MS program in Healthcare Administration by UMUC. This presentation is a analysis of the current healthcare trends and job outlook for 2025 to be presented to the HR committee of Board of Directors of a healthcare organization to address workforce shortages in key healthcare areas.
Single Payer Systems: Equity in Access to Caresoder145
Presentation by Lynn Blewett at "The True Workings of Single Payer Systems: Lessons or Warnings for U.S. Reform' conference sponsored by the Journal of Health Politics Policy and Law, May 10 2008.
IHI LAUNCHES NATIONAL CAMPAIGN TO REDUCE MEDICAL HARM IN U.S. HOSPITALS, BUIL...abimorg
The Institute for Healthcare Improvement (IHI) announced,
with the support of prominent leaders in American health care, a national campaign to dramatically
reduce incidents of medical harm in U.S. hospitals. The 5 Million Lives Campaign will ask hospitals to
improve more rapidly than before the care they provide in order to protect patients from five million
incidents of medical harm over a 24-month period, ending December 9, 2008. This represents a
continuation of the largest improvement effort undertaken in recent history by the health care industry. http://www.abim.org/
CFPHD Guest Speaker Dr. Chisholm: Nursing Home Quality and Financial PerformanceCFPHD
Conversation on Nursing Home Quality, Health Disparities in Central Florida
Health Professionals Discuss the Facts and Future for Aging, Poor Central Floridians
The Central Florida Partnership on Health Disparities invited members and guests to join the conversation with University of Central Florida assistant professor Dr. Latarsha Chisholm as we discussed her recent publication within the Health Services Research journal – Nursing Home Quality and Financial Performance: Does the Racial Composition of Residents Matter? This event was held at Anthem College, Tuesday, October 22, 2013, from 3:00 to 5:00pm.
This presentation/lecture was given on Monday, May 18th, 2015 as part of the International Week lecture series at FH-OBEROSTERREICH (FH-Steyr Campus - Upper Austria University of Applied Sciences) in Steyr, Austria.
This lecture covers the historical perspectives that led to the 2010 legislation that has once again changed how healthcare is delivered in the United States; whereas, it discusses in more detail the impact, outcomes and future.
The goal of this webinar was to help healthcare professionals improve care coordination for patients with advanced illness and to reduce hospital readmissions and length of stay.
Current healthcare trends and jobs outlook for 2025needppthelp
This is a team assignment for HCAD 600 for the MS program in Healthcare Administration by UMUC. This presentation is a analysis of the current healthcare trends and job outlook for 2025 to be presented to the HR committee of Board of Directors of a healthcare organization to address workforce shortages in key healthcare areas.
Single Payer Systems: Equity in Access to Caresoder145
Presentation by Lynn Blewett at "The True Workings of Single Payer Systems: Lessons or Warnings for U.S. Reform' conference sponsored by the Journal of Health Politics Policy and Law, May 10 2008.
IHI LAUNCHES NATIONAL CAMPAIGN TO REDUCE MEDICAL HARM IN U.S. HOSPITALS, BUIL...abimorg
The Institute for Healthcare Improvement (IHI) announced,
with the support of prominent leaders in American health care, a national campaign to dramatically
reduce incidents of medical harm in U.S. hospitals. The 5 Million Lives Campaign will ask hospitals to
improve more rapidly than before the care they provide in order to protect patients from five million
incidents of medical harm over a 24-month period, ending December 9, 2008. This represents a
continuation of the largest improvement effort undertaken in recent history by the health care industry. http://www.abim.org/
CFPHD Guest Speaker Dr. Chisholm: Nursing Home Quality and Financial PerformanceCFPHD
Conversation on Nursing Home Quality, Health Disparities in Central Florida
Health Professionals Discuss the Facts and Future for Aging, Poor Central Floridians
The Central Florida Partnership on Health Disparities invited members and guests to join the conversation with University of Central Florida assistant professor Dr. Latarsha Chisholm as we discussed her recent publication within the Health Services Research journal – Nursing Home Quality and Financial Performance: Does the Racial Composition of Residents Matter? This event was held at Anthem College, Tuesday, October 22, 2013, from 3:00 to 5:00pm.
This presentation/lecture was given on Monday, May 18th, 2015 as part of the International Week lecture series at FH-OBEROSTERREICH (FH-Steyr Campus - Upper Austria University of Applied Sciences) in Steyr, Austria.
This lecture covers the historical perspectives that led to the 2010 legislation that has once again changed how healthcare is delivered in the United States; whereas, it discusses in more detail the impact, outcomes and future.
The goal of this webinar was to help healthcare professionals improve care coordination for patients with advanced illness and to reduce hospital readmissions and length of stay.
Presentation given by Eric C. Schneider, MD, Senior Vice President for Policy and Research of The Commonwealth Fund at the University of Michigan Institute for Healthcare Policy and Innovation in Ann Arbor, MI on December 7, 2017.
The goal of this webinar is to help healthcare professionals improve care coordination for patients with advanced illness and to reduce hospital readmissions and length of stay (LOS).
Better health outcomes at less cost - future nhs stage, 4pm, 2 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Healthcare costs in the U.S. might be of interest to many. The U.S. is an important non-European country for health economists and decision-analytic modelers because it is a large country in terms of its population size and an even larger market not just but also for health care services and goods. Also, much of not just basic but also translational research including HEOR comes out of the U.S. incl. the original idea for cost-effectiveness analysis.
Regardless of whether you’re American or not, most people have pretty strong ideas about the U.S. Edvard de Bono, not the U2 singer but the originator of the term Lateral Thinking, famously said that the U.S. are not a country but an idea.
This talk attempts to compare the United States’ health care expenditures and outcomes with others around the world; to highlight relevant recent controversies in the U.S. health policy debate related to costs; and to explore why U.S. care is so expensive (and what can be done about it).
The goal of this webinar is to help healthcare professionals improve care coordination for patients with advanced illness and to reduce hospital readmissions and length of stay (LOS).
Study Guide Health Care ReformHealth Care Reform OverviewWhe.docxpicklesvalery
Study Guide: Health Care Reform
Health Care Reform: Overview
When it comes to healthcare in America, we seem to believe that more is better--but does more healthcare result in better health? As a nation, we spend more on healthcare per person than any European country, yet our health outcomes are worse. The PBS documentary, Money and Medicine was aired in 2012, and addresses one of the key issues of healthcare reform--the cost of health care. Watch the trailer below, or the entire episode here: http://video.pbs.org/video/2283573727/
(Links to an external site.)
http://youtu.be/a9oEtRwoVxs
(Links to an external site.)
The Affordable Care Act
The Patient Protection and Affordable Care Act (ACA), passed in 2010, is a collection of laws that were created to reform health insurance and healthcare.
The ACA significantly impacts nurses both personally and professionally. Bedside nurses are impacted by organizational changes that affect patient care, and may be providing information and resources to patients and caregivers about the ACA. However, as Hynds, Hatch and Samuels (2014) noted, nurses indicate they need more knowledge to understand the ACA policy implications of their practice.
Now, you can either read the 974 pages of the law itself, or you can watch this short, animated video produced by the Kaiser Family Foundation, and visit the helpful online resources below:
http://youtu.be/JZkk6ueZt-U
(Links to an external site.)
The YouToons Get Ready for Obamacare
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Affordable Care Act: Five Years Later
The Commonwealth Fund has developed several online, interactive resources to illustrate the impact of the Affordable Care Act in its first five years of implementation. Through personal stories, population and health systems data analysis, and graphics, the Commonwealth fund paints the picture of the impact of the ACA on individuals, businesses, providers and healthcare systems. Take some time to explore these resources in preparation for this week's discussion board. Link: The Affordable Care Act: A Look Back at the First Five Years.
(Links to an external site.)
Review the two interactive digital features: Coverage Reform
(Links to an external site.)
and Delivery Reform
(Links to an external site.)
.
Value-Based Purchasing--"Pay for Performance"
Increasingly, hospitals and healthcare providers are reimbursed not just for the amount of services provided (fee-for service), but for the results that are achieved for a particular patient population. As nurses, you may have observed policy changes that emphasize patient experience, prevention of hospital-acquired infections, and effective discharge planning ...
The goal of this webinar was to help healthcare professionals improve care coordination for patients with advanced illness and to reduce hospital readmissions and length of stay (LOS).
The Canadian healthcare system: May 20, 2011CFHI-FCASS
This presentation was given on May 20, 2011, as an overview of healthcare in Canada to a group of American Congressional Fellows on Parliament Hill. The Fellows were in Canada on an official visit, sponsored by the Department of Foreign Affairs and International Trade Canada (DFAIT), as part of an exchange with the Parliamentary Internship Programme. The group included 20 mid- to senior career professionals from various departments in the American and some foreign Governments, professors from American universities and journalists. They also include a number of Robert Wood Johnson Foundation Fellows, who are all medical professionals.
Edwina Rogers, executive director of Patient-Centered Primary Care Collaborative, began her presentation by highlighting the movement to advance medical homes.
With the U.S. being the number one in the world for the cost of healthcare and ranked number 37 in the quality category, something needs to change. Rogers discussed the broad stakeholder support and participation for the movement, as well as the incredible volunteer involvement. The four ‘centers’ include: the Center to Promote Public-Payer Implementation, the Center for Multi-Stakeholder Demonstration, the Center for eHealth Information Adoption and Exchange and the Center for Health Benefit Redesign and Implementation. Medical Homes will provide superb access to care, patient engagament in care, clinical information systems, care coordination, team care, patient feedback and publically available information.
Edwards explained that the Obama administration believes the medical homes concept is the best way to approach healthcare reform. The U.S. House of Representatives has showed great support for the movement and is helping develop and allocate funds for a five-year pilot program. She expressed her enthusiasm for the movement and her prediction that the medical home model is certainly the future of health care.
A complete version of Rogers’ presentation on the Patient-Centered Primary Care Collaborative is available online.
1. Impending Advancements in Healthcare
Quality and Outcomes in the United
States
By: Erik Hollander, MBA
Milwaukee, WI (United States)
May 2016, Upper Austria
6. Terms - Defined
• Medicare
– Medicare is the federal health insurance program
for people who are 65 or older, certain younger
people with disabilities, and people with End-
Stage Renal Disease (permanent kidney failure
requiring dialysis or a transplant, sometimes
called ESRD).
• Part A (Hospital)
• Part B (Medical)
• Part C (Medicare Advantage Plan)
• Part D (Prescription Drug Coverage)
Source: Adapted from: https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/whats-medicare/what-is-
medicare.html
7. Terms – Defined (Con’t)
• Medicaid
– Medicaid is a joint federal and state program that
helps with medical costs for some people with
limited income and resources. Medicaid also
offers benefits not normally covered by Medicare,
like nursing home care and personal care services.
Source: Adapted from: https://www.medicare.gov/your-medicare-costs/help-paying-costs/medicaid/medicaid.html
8. FQHC
• Federally Qualified Health Center (FQHC)
– Federally qualified health centers (FQHCs) served
the “underserved” with a special pay structure
and are reimbursed/compensated through our
government
– Supported through Health and Human Services
(HHS) / Health Resources & Services
Administration (HRSA)
– US (21,726,965) / WI (284,072) = 1.3%
Sources: Adapted from: http://www.hrsa.gov/index.html
http://www.hrsa.gov/healthit/toolbox/RuralHealthITtoolbox/Introduction/qualified.html
http://kff.org/other/state-indicator/total-patients-served-by-fqhcs/
9. History of HC in US
Source: Adapted from: A Brief History: Universal Health Care Efforts in the US: transcribed from a talk given by Karen S/ Palmer, MPH, MS in San
Francisco at the Spring, 1999 PNHP meeting
Source: Adapted from: PBS Healthcare Crisis: Healthcare Timeline,
Source: Adapted from US Dept. of Health and Human Services, Historical Highlights, 2014
Source: Adapted from Kaiser Family Foundation, Timeline: History of Health Reform in the US, May 2013
10. Current
Source: Adapted from: Are Healthcare Consumers at the Forefront of Digital
Health? By Barbara Ficarra, RN, BSN, MPA and Ben Heubl
Source: Adapted from: Experts say rural healthcare in crisis: OIG report,
Medicaid opt-outs cause concern; August 29, 2013 by Zack Budryk
Source: Adapted from: 8 Issues Affecting Population Health Management Right
Now; Dec. 16th, 2012, by Matthew Smith
11. US Census Data (2012)
United States Census Bureau
Ortman.May.2016.pdf
Source: Adapted from: U.S. Population Projections 2012 – 2060; Presentation for the FFC/GW Brown Bag Seminar Series on Forecasting; Washington, D.C.,
February 7, 2013 by Jennifer M. Ortman, Population Division, United States Census Bureau
13. Terms - Defined
• Charity Care and Uncompensated Care
– Charity Care – Patient cannot afford
– Uncompensated Care – Payment is expected but
hospital is unable to collect
Source: Adapted from: https://www.dhs.wisconsin.gov/guide/freehosp.htm
14. Charity Care
Source: Adapted from: Milwaukee-Area Hospital Systems; Milwaukee Business Journal,
Charity Care, bad debt increased in 2011; Corrinne Hess, December 23, 2011
Source: Milwaukee Business Journal, More Charity at Hospitals, June 29th, 2006, by Ben Fishcer
Source: Hospitals seeing drop in bad debt, charity care, October 22, 2010, by Corrinne Hess
(8.6 million Euro)
(100 million Euro)
16. Terms – Defined (Con’t)
• Medicaid
– Medicaid is a joint federal and state program that
helps with medical costs for some people with
limited income and resources. Medicaid also
offers benefits not normally covered by Medicare,
like nursing home care and personal care services.
Source: Adapted from: https://www.medicare.gov/your-medicare-costs/help-paying-costs/medicaid/medicaid.html
17. Terms - Defined
• Medicare
– Medicare is the federal health insurance program
for people who are 65 or older, certain younger
people with disabilities, and people with End-
Stage Renal Disease (permanent kidney failure
requiring dialysis or a transplant, sometimes
called ESRD).
• Part A (Hospital)
• Part B (Medical)
• Part C (Medicare Advantage Plan)
• Part D (Prescription Drug Coverage)
Source: Adapted from: https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/whats-medicare/what-is-
medicare.html
18. Current
Source: Adapted from: The Joint Commission, Quality logo, 2015
Source: Adapted from: Commission on Cancer, Logo, 2015
Source: Adapted from: NCI, Community Oncology Research Program, 2015
Source: Adapted from: ASCO, QOPI, 2015
Source: Adapted from: Univ. of Nebraska, FACT, 2015
20. Growth in Total Health Expenditure Per Capita, U.S. and
Selected Countries, 1970-2008
Source: adapted from:
Organization for Economic Co-operation and Development (2010), “OECD Health Data”, OECD Health Statistics (database). doi:
10.1787/data-00350-en (Accessed on 14 February 2011).
Notes: Data from Australia and Japan are 2007 data. Figures for Belgium, Canada, Netherlands, Norway and Switzerland, are OECD
estimates. Numbers are PPP adjusted. Break in series: CAN(1995); SWE(1993, 2001); SWI(1995); UK (1997). Numbers are PPP adjusted.
Estimates for Canada and Switzerland in 2008.
21.
22. Quality and Benchmarks
• Quality and Reports
– Hospital Comparison Benchmark Reports (HCBR)
– Rapid Quality Reporting System (RQRS) Flyer
– Quality Care Measures
Source: Adapted from American College of Surgeons, Commission on Cancer, Quality Cancer
Tools, 2015
25. Current / Future
•Reform
Source: Adapted from: Does the Private Option sink or save providers by Katie Bo Williams, March
14, 2014
Source: Adapted from: Dances with Fat: Fat Chance for Healthcare Access, January 20, 2011
Source: Adapted from: The Case for Single Payer, Universal Health Care for The United States:
Outline of Talk given to the assocaition of State Green Parties, Moodus, Connecticut on June 4, 1999;
by John R. Battista, M.D. and Justine McCabe, PhD.
26. PPACA
• Patient Protection and Affordable Care Act =
Obamacare
– The Affordable Care Act was passed by Congress
and then signed into law by the President on
March 23, 2010. On June 28, 2012 the Supreme
Court rendered a final decision to uphold the
health care law.
– PPACA
Source: Adapted from: http://www.hhs.gov/healthcare/about-the-law/read-the-law/index.html
27. Future of Healthcare Delivery
• Fee for Service (FFS) vs. Episodes
• ER Utilization
• Length of Stay (LOS)
• Insurance Coverage (40 million - PPACA)
• Tiered System
• Best Health System in the World (Videos)
28. Fee for Service (FFS) vs. Bundle
• Providers
– (Doctors) paid for each service they provide (i.e.
Office visit, tests, etc.)
• Bundle
– Single payment covering all the care for a patient’s
medical conditions or treatment over a specified
timeframe
Source: Adapted from: https://hbr.org/2015/10/getting-bundled-payments-right-in-health-care
29. Joint Replacements Annually
• 400,000 procedures
(Source: CMS)
• $7 billion for the
hospitalizations alone
(Source: CMS)
• Cost ranges from
$16,500 to $33,000 per
case (Source: CMS)
• Average charges in
Milwaukee: $59,000 per
case (source: Wisconsin PricePoint)
30.
31. Comprehensive Care for Joint
Replacement Model
• Inception: 4/1/2016
• Value Based Care
• Mandatory Enrollment
– 67 metropolitan
communities
PY1 PY2 PY3 PY4 PY5
Hospital specific
episode data
66.6% 66.6% 33.3% 0% 0%
Regional specific
episode data
33.3% 33.3% 66.6% 100% 100%
32. The Strategy That Will Fix Health Care
Michael E. Porter Thomas H. Lee, MD
41. References
• Harvard Business Review; Getting Bundled Payments Right in Health
Care; Derek A. Haas, Robert S. Kaplan, Dereesa Reid, Jonathan Warsh,
Michael E. West; OCTOBER 19, 2015