The document discusses the patient-centered medical home (PCMH) model and its potential benefits. It summarizes that the PCMH aims to provide patient-centered, coordinated care through a personal physician leading a team. Data from other countries shows primary care-focused systems have better outcomes and lower costs. The PCMH may benefit primary care physicians through payment reform recognizing care coordination work. It may benefit patients through improved access and chronic disease management support. Subspecialists may also benefit from opportunities to lead medical homes and fewer administrative hassles.
Engaging the Participant - Telehospitalist program (innotech)JoAnna Cheshire
A telehospitalist is a physician who provides care for hospitalized patients at a distance using telemedicine. As the US faces a projected physician shortage, telemedicine and utilizing advanced practice clinicians can help address gaps, especially in rural areas with limited access to care. The document describes a telehospitalist program launched in Oklahoma in 2014 connecting physicians in Oklahoma City to patients in rural hospitals over 60 miles away. The program has had over 3,900 telemedicine visits for more than 1,100 patients. Key lessons learned include the importance of local buy-in, flexibility, and focusing on patient-centered care.
National Conference on Health and Domestic Violence. Plenary talk Paul Grundy
explaining how the Patient Centered Medical Home (PCMH) platform for healthcare deliver is more likely to support domestic violence prevention and creat a safer environment than the FFS episode of care system we are in now. The medical Home is a home for the data where the all the data goes and is held accountable this idea was first articulated by Dr. Calvin C.J. Sia, a Honolulu-based pediatrician in 1967.
This concept of the medical home was integrated with Ed Wagners Chronic disease Model and Thomas Bodenheimer Kevin Grumbach advanced/proactive primary care at the request of the Patient Centered Primary care Collaborative into a set of principles Know as the Joint principles of the Patient centered medical home.
The patient-centered medical home (PCMH), is a team based health care delivery set of principles led by a physician that provides comprehensive and continuous medical care to patients with the goal of obtaining maximized health outcomes. It is "an approach to providing comprehensive primary care for children, youth and adults" The provision PCMH medical homes allow better access to health care, increase satisfaction with care, and improve health. Joint principles that define a PCMH have been established through the cohesive efforts of the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), American College of Physicians (ACP), and American Osteopathic Association (AOA).[10] Care coordination is an essential component of the PCMH. Care coordination requires additional resources such as health information technology, and appropriately trained staff to provide coordinated care through team-based models. Additionally, payment models that compensate PCMHs for their effort devoted to care coordination activities and patient-centered care management that fall outside the face-to-face patient encounter may help encourage coordination.
The document summarizes a presentation by Paul Grundy on extracting value from the patient centered medical home model. It discusses:
1) How the patient centered medical home model creates partnerships across the healthcare system to drive primary care redesign, offer population health management, and move away from an episodic, fee-for-service model.
2) Studies that show improvements in costs, quality, access, and utilization from implementing the patient centered medical home model, including reduced hospital and ER use.
3) How payment models are shifting towards value-based purchasing tied to quality, utilization, and patient satisfaction outcomes rather than volume of services.
Pharmacy's Role in Worksite and Community WellnessAmy Robinson
Presentation at the Alabama Department of Public Health's Worksite Wellness Conference by Rebecca Sterling on 6/28/12. Slides by Amy Robinson. More information at healthsterling.com.
The Patient-Centered Medical Home in the Transformation From Healthcare to He...Paul Grundy
Surgeon General of the Navy VADM Matthew L. Nathan, MC USN
Fortunately, we have a way to address this crisis—the
Patient-Centered Medical Home (PCMH) model launched at Naval Hospital Pensacola and Walter Reed National Military Medical Center, Bethesda, Maryland (formerly the National Naval Medical Center) in 2008. It is now being implemented throughout the Military Health System (MHS) and carries great promise. It provides the clinical framework we need to meet our strategic objectives in terms of quality of care, impact on costs, population health, and readiness. One of the most significant benefits of the team-based, collaborative approach is that it allows us to embed within a primary care environment the psychologists, nutritionists, tobacco cessation specialists, mind-body medicine therapists, and health educators our patients need in order to develop and maintain mindful, healthy behaviors—along with the “mental armor,” our active duty military personnel need to increase their operational effectiveness and their resiliency in bouncing back from stressful situations. As we move ahead with this more comprehensive approach to health, we can begin to better address so many of our patients for whom we can find no specific reason for pain and discomfort. The PCMH model also provides a positive impact on our costs. Early data reporting from the PCMH clinics at Bethesda show reduced visits to the emergency room, lowered pharmacy costs, and significant per beneficiary per year savings and improved Healthcare Effectiveness Data and Information Set metrics, access, and patient satisfaction and trust. These positive impacts on the bottom line can be applied directly to improved costs or toward the reallocation of resources from reimbursing those who are sick to the population health-based programs that can make and keep our patients healthy.More significant, however, the PCMH environment allows us to go beyond mere collaboration and to a much more proactive approach to managing our patient populations. It is within the context of the medical home that we can begin to surround our patients with the tools and resources they need to move them from health care to health.
This is the presentation Victor Montori (KER UNIT, Healthcare Delivery Research Program, Mayo Clinic) gave at the Normalization Process Theory symposium at King's Fund, London, UK on October 22, 2010.
UPMC is a large integrated delivery and finance system with 62,000 employees and $10 billion in revenue. It operates 20+ hospitals, senior living communities, insurance plans, and international services across 18 countries. UPMC aims to promote high quality, low cost care through its integrated structure. In 2011, UPMC launched several initiatives in hospitals, long-term care facilities, and communities focused on palliative care, transitions of care, quality improvement, consistent staff assignments, end of life training, and palliative care consult teams. The health plan developed a Care Through Transitions model to provide functional assessments, interdisciplinary care planning, and transitional care days to reduce avoidable hospitalizations. ClinicalConnect is an HIE system that connects
The document discusses the patient-centered medical home (PCMH) model and its potential benefits. It summarizes that the PCMH aims to provide patient-centered, coordinated care through a personal physician leading a team. Data from other countries shows primary care-focused systems have better outcomes and lower costs. The PCMH may benefit primary care physicians through payment reform recognizing care coordination work. It may benefit patients through improved access and chronic disease management support. Subspecialists may also benefit from opportunities to lead medical homes and fewer administrative hassles.
Engaging the Participant - Telehospitalist program (innotech)JoAnna Cheshire
A telehospitalist is a physician who provides care for hospitalized patients at a distance using telemedicine. As the US faces a projected physician shortage, telemedicine and utilizing advanced practice clinicians can help address gaps, especially in rural areas with limited access to care. The document describes a telehospitalist program launched in Oklahoma in 2014 connecting physicians in Oklahoma City to patients in rural hospitals over 60 miles away. The program has had over 3,900 telemedicine visits for more than 1,100 patients. Key lessons learned include the importance of local buy-in, flexibility, and focusing on patient-centered care.
National Conference on Health and Domestic Violence. Plenary talk Paul Grundy
explaining how the Patient Centered Medical Home (PCMH) platform for healthcare deliver is more likely to support domestic violence prevention and creat a safer environment than the FFS episode of care system we are in now. The medical Home is a home for the data where the all the data goes and is held accountable this idea was first articulated by Dr. Calvin C.J. Sia, a Honolulu-based pediatrician in 1967.
This concept of the medical home was integrated with Ed Wagners Chronic disease Model and Thomas Bodenheimer Kevin Grumbach advanced/proactive primary care at the request of the Patient Centered Primary care Collaborative into a set of principles Know as the Joint principles of the Patient centered medical home.
The patient-centered medical home (PCMH), is a team based health care delivery set of principles led by a physician that provides comprehensive and continuous medical care to patients with the goal of obtaining maximized health outcomes. It is "an approach to providing comprehensive primary care for children, youth and adults" The provision PCMH medical homes allow better access to health care, increase satisfaction with care, and improve health. Joint principles that define a PCMH have been established through the cohesive efforts of the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), American College of Physicians (ACP), and American Osteopathic Association (AOA).[10] Care coordination is an essential component of the PCMH. Care coordination requires additional resources such as health information technology, and appropriately trained staff to provide coordinated care through team-based models. Additionally, payment models that compensate PCMHs for their effort devoted to care coordination activities and patient-centered care management that fall outside the face-to-face patient encounter may help encourage coordination.
The document summarizes a presentation by Paul Grundy on extracting value from the patient centered medical home model. It discusses:
1) How the patient centered medical home model creates partnerships across the healthcare system to drive primary care redesign, offer population health management, and move away from an episodic, fee-for-service model.
2) Studies that show improvements in costs, quality, access, and utilization from implementing the patient centered medical home model, including reduced hospital and ER use.
3) How payment models are shifting towards value-based purchasing tied to quality, utilization, and patient satisfaction outcomes rather than volume of services.
Pharmacy's Role in Worksite and Community WellnessAmy Robinson
Presentation at the Alabama Department of Public Health's Worksite Wellness Conference by Rebecca Sterling on 6/28/12. Slides by Amy Robinson. More information at healthsterling.com.
The Patient-Centered Medical Home in the Transformation From Healthcare to He...Paul Grundy
Surgeon General of the Navy VADM Matthew L. Nathan, MC USN
Fortunately, we have a way to address this crisis—the
Patient-Centered Medical Home (PCMH) model launched at Naval Hospital Pensacola and Walter Reed National Military Medical Center, Bethesda, Maryland (formerly the National Naval Medical Center) in 2008. It is now being implemented throughout the Military Health System (MHS) and carries great promise. It provides the clinical framework we need to meet our strategic objectives in terms of quality of care, impact on costs, population health, and readiness. One of the most significant benefits of the team-based, collaborative approach is that it allows us to embed within a primary care environment the psychologists, nutritionists, tobacco cessation specialists, mind-body medicine therapists, and health educators our patients need in order to develop and maintain mindful, healthy behaviors—along with the “mental armor,” our active duty military personnel need to increase their operational effectiveness and their resiliency in bouncing back from stressful situations. As we move ahead with this more comprehensive approach to health, we can begin to better address so many of our patients for whom we can find no specific reason for pain and discomfort. The PCMH model also provides a positive impact on our costs. Early data reporting from the PCMH clinics at Bethesda show reduced visits to the emergency room, lowered pharmacy costs, and significant per beneficiary per year savings and improved Healthcare Effectiveness Data and Information Set metrics, access, and patient satisfaction and trust. These positive impacts on the bottom line can be applied directly to improved costs or toward the reallocation of resources from reimbursing those who are sick to the population health-based programs that can make and keep our patients healthy.More significant, however, the PCMH environment allows us to go beyond mere collaboration and to a much more proactive approach to managing our patient populations. It is within the context of the medical home that we can begin to surround our patients with the tools and resources they need to move them from health care to health.
This is the presentation Victor Montori (KER UNIT, Healthcare Delivery Research Program, Mayo Clinic) gave at the Normalization Process Theory symposium at King's Fund, London, UK on October 22, 2010.
UPMC is a large integrated delivery and finance system with 62,000 employees and $10 billion in revenue. It operates 20+ hospitals, senior living communities, insurance plans, and international services across 18 countries. UPMC aims to promote high quality, low cost care through its integrated structure. In 2011, UPMC launched several initiatives in hospitals, long-term care facilities, and communities focused on palliative care, transitions of care, quality improvement, consistent staff assignments, end of life training, and palliative care consult teams. The health plan developed a Care Through Transitions model to provide functional assessments, interdisciplinary care planning, and transitional care days to reduce avoidable hospitalizations. ClinicalConnect is an HIE system that connects
Patient-centered medical homes (PCMHs) are intended to actively provide effective care by physician-led teams, Where patients take a leading role and responsibility. Objective: To determine whether the Walter Reed PCMH has reduced costs while at least maintaining if not improving access to and quality of care, and to determine
whether access, quality, and cost impacts differ by chronic condition status. Design, setting, and patients: This study
conducted a retrospective analysis using a patient-level utilization database to determine the impact of the Walter Reed PCMH on utilization and cost metrics, and a survey of enrollees in the Walter Reed PCMH to address access to care and quality of care. Outcome measures: Inpatient and outpatient utilization, per member per quarter costs, Healthcare Effectiveness Data and Information Set metrics, and composite measures for access, patient satisfaction, provider communication, and customer service are included. Results: Costs were 11% lower for those with chronic conditions compared to 7% lower for those without. Since treating patients with chronic conditions is 4 times more costly than treating patients without such conditions, the vast majority of dollar savings are attributable to chronic care.
Telehealth offers convenient virtual care that can reduce costs while improving outcomes. It allows patients to access care remotely through video or phone instead of visiting physical offices. This saves money by reducing unnecessary emergency room visits and tests. It also improves productivity and wellness by making care more accessible. Telehealth is highly satisfactory to patients and can help prevent medical issues by facilitating preventative care. Its 24/7 availability makes telehealth a valuable option for employers and insurers to include in health plans.
This document provides a summary of evidence on the impact of patient-centered medical homes (PCMHs) and primary care innovations on cost and quality from 2013-2014. It finds that PCMH interventions are associated with modest improvements in quality of care and reductions in utilization and costs. It also discusses challenges in evaluating PCMHs and outlines opportunities to further integrate primary care with other specialties and engage consumers. The future of the PCMH relies on continued financial support, training interprofessional teams, harnessing technology, and partnering with patients and communities.
Proposed changes in health care payment, from fee-for-service to alternative, risk-sharing payment models, can have a substantial impact on health services for children, especially those with complex care needs. In addition, tying payment to value can increase use of ambulatory and preventive services and encourage creative outreach. However, abrupt changes can interrupt continuity and reduce access to care.
4 replies one for each claudiamajor disasters and emeAASTHA76
This document discusses health policies and their impact on nursing practice, particularly during disasters and emergencies. It notes that health policies provide guidelines for patient care during normal times and can act as a "guiding light" during abnormal situations like disasters. Nurses must be trained on protocols and have a general understanding of what to do in emergencies in order to respond rapidly and effectively. The document also emphasizes that nurses should feel confident in their actions during emergencies and that their experiences can help inform future health policies.
The document discusses the need for healthcare reform in the United States. It notes that around 47 million Americans are uninsured, 50 million are underinsured, and 79 million struggle with medical debt. It argues that the current healthcare system lacks an organizing principle to effectively link resources into a high value system. Reform is necessary to address issues like a lack of coordinated care, high costs, inconsistent quality, and an inefficient use of resources. The document advocates for a patient-centered medical home model and insurance reforms influenced by state-level decisions around insurance exchanges.
This document discusses the complex care needs of patients with multiple chronic conditions. It notes that such patients often have high treatment burdens from multiple medications and self-care needs that can exceed their capacity. Guidelines and care are often focused on single diseases and do not consider patient context. The document calls for a focus on balancing patient workload from treatment with their capacity through strategies like prioritizing care, deprescribing unnecessary treatments, coaching, and connecting patients to community resources.
The document discusses rising health care costs in the United States from 1969 to 2004, factors contributing to increased costs such as an aging population and technology, and responses to rising costs including managed care and malpractice reform. It also covers health care financing through programs like Medicare, Medicaid and private insurance, as well as the growing number of uninsured Americans.
Redesigning a care model for better health. CareOregon's MEDS (My Easy Drug System), Health Resilience program, and human-centered design programs are leading the way.
A webinar hosted with the Interdisciplinary Nursing Quality Research Initiative (INQRI) featuring Barbara Safriet, JD, LLM, Associate Dean and Lecturer, Yale Law School, who outlined why removing barriers to APRN practice and care matters to consumers.
Ed Wagner: Integrated care: what are the key factors for successNuffield Trust
Integrated care systems that coordinate care through a shared electronic medical record, common guidelines and formularies, and co-located primary and specialty care can help prevent fragmented care. However, these systems still struggle with communication failures between primary care and specialists. Truly integrated care requires personal relationships and accountability to ensure patients receive necessary services from a collaborating care team.
Polls show overwhelming evidence that patients WANT to be involved in their medical records and health data, so they can partner with their clinicians for better health. Survey results from Society for Participatory Medicine 2014 and 2015 surveys.
The document discusses strategies for transforming healthcare delivery through population health management, care coordination, and virtual care technologies. It provides examples of how partnerships between healthcare organizations and technology companies have implemented programs utilizing telehealth, remote patient monitoring, and digital platforms to improve outcomes, lower costs, and enable aging in place. Case studies demonstrate how these approaches have reduced hospital admissions and lengths of stay, ICU transfers, mortality rates, and costs while improving quality of life.
The study aimed to investigate associations between regulatory policy, workforce capacity, and health outcomes using Medicaid data from four states. However, the analysis found significant data quality issues. Key variables like service provider specialty were missing or incomplete, preventing valid conclusions about the proportion of services provided by nurse practitioners and physician assistants. At best, Alabama had 85% reporting but showed nurse practitioners and physician assistants providing significantly fewer services than medical doctors for selected chronic conditions despite making up over half of primary care workforce capacity. Overall, the Medicaid data proved inadequate for the research purposes due to inconsistent and missing coding across states.
Validity and bias in epidemiological studyAbhijit Das
Validity and bias are essential aspects of any research—a brief description of internal and external validity and different types of bias related to the epidemiological study.
Can we solve the adult primary care shortage without more physicians? CHC Connecticut
Tom Bodenheimer,of the Center for Excellence in Primary Care at UCSF Dep’t of Family and Community Medicine talks about addressing the primary care shortage at the 2014 Weitzman Symposium
The document discusses potential impacts of US health care reform on the workers' compensation system. In the short term, there is likely no direct impact. However, long term there may be impacts as health care reform aims to reduce costs through lower Medicare reimbursement rates, which providers could seek to offset by increasing workers' compensation billing. Other possible long term impacts include changes to medical treatment patterns through new models like accountable care organizations, and improved medical records and health promotion in workplaces through greater employer involvement.
This document discusses improving patient safety and care coordination. It notes that 33% of Medicare patients were harmed during skilled nursing facility stays, and 59% of incidents were preventable. Poor care coordination can increase costs by $25-45 billion annually. The document advocates for standardizing care practices and improving collaboration and communication among care teams to reduce medical errors and associated costs. It argues that effective care coordination requires engaging all players, including doctors, nurses and pharmacists, with the patient at the center.
Policy & management initiatives needed for hrh responsibilityPrabir Chatterjee
The document discusses several policy and management initiatives needed to address human resource issues in healthcare in order to meet India's health goals. It identifies inadequate numbers of doctors in rural areas, poor salaries and infrastructure, issues with patient and doctor behavior, and lack of health education as key barriers. Some interventions proposed include assigning doctors to specific areas, reserving medical education seats for local people on the condition of fixed postings, improved rural infrastructure and salaries for doctors, strict governance and oversight to reduce corruption and private practice, and continued education initiatives. A composite package of interventions is needed to effectively address the complex human resource challenges facing India's healthcare system.
Next generation predictive models leveraging real patient data from electronic health records will transform care management by enabling individualized, automated, and proactive care. Key factors enabling this transformation include meaningful use of EHRs to capture structured clinical data, more granular ICD-10 coding, and using real-time EHR data to continuously enhance predictive models and tightly couple model insights with care processes and clinical decision support. This will allow identifying high-risk complex patients early and providing optimized individualized guidelines that can improve outcomes while reducing costs compared to general guidelines.
This paper articulates the function of Malaysia Healthcare Travel Council (MHTC) in developing the Health
Tourism Industry. Focus was given in identifying the challenges faced by MHTC, understanding the
competitiveness of the industry and proposing a suitable value chain framework for the industry. Total of 12
organizations have been identified, which were including private and public organizations. Conclusions of
findings have been derived and few recommendations made at the end of this article.
Keywords: Health tourism, medical tourism, competitive, leisure services and value chain
A value chain is a set of activities that a firm operating in a specific industry performs in order to deliver a valuable product and servicef for the market .
Patient-centered medical homes (PCMHs) are intended to actively provide effective care by physician-led teams, Where patients take a leading role and responsibility. Objective: To determine whether the Walter Reed PCMH has reduced costs while at least maintaining if not improving access to and quality of care, and to determine
whether access, quality, and cost impacts differ by chronic condition status. Design, setting, and patients: This study
conducted a retrospective analysis using a patient-level utilization database to determine the impact of the Walter Reed PCMH on utilization and cost metrics, and a survey of enrollees in the Walter Reed PCMH to address access to care and quality of care. Outcome measures: Inpatient and outpatient utilization, per member per quarter costs, Healthcare Effectiveness Data and Information Set metrics, and composite measures for access, patient satisfaction, provider communication, and customer service are included. Results: Costs were 11% lower for those with chronic conditions compared to 7% lower for those without. Since treating patients with chronic conditions is 4 times more costly than treating patients without such conditions, the vast majority of dollar savings are attributable to chronic care.
Telehealth offers convenient virtual care that can reduce costs while improving outcomes. It allows patients to access care remotely through video or phone instead of visiting physical offices. This saves money by reducing unnecessary emergency room visits and tests. It also improves productivity and wellness by making care more accessible. Telehealth is highly satisfactory to patients and can help prevent medical issues by facilitating preventative care. Its 24/7 availability makes telehealth a valuable option for employers and insurers to include in health plans.
This document provides a summary of evidence on the impact of patient-centered medical homes (PCMHs) and primary care innovations on cost and quality from 2013-2014. It finds that PCMH interventions are associated with modest improvements in quality of care and reductions in utilization and costs. It also discusses challenges in evaluating PCMHs and outlines opportunities to further integrate primary care with other specialties and engage consumers. The future of the PCMH relies on continued financial support, training interprofessional teams, harnessing technology, and partnering with patients and communities.
Proposed changes in health care payment, from fee-for-service to alternative, risk-sharing payment models, can have a substantial impact on health services for children, especially those with complex care needs. In addition, tying payment to value can increase use of ambulatory and preventive services and encourage creative outreach. However, abrupt changes can interrupt continuity and reduce access to care.
4 replies one for each claudiamajor disasters and emeAASTHA76
This document discusses health policies and their impact on nursing practice, particularly during disasters and emergencies. It notes that health policies provide guidelines for patient care during normal times and can act as a "guiding light" during abnormal situations like disasters. Nurses must be trained on protocols and have a general understanding of what to do in emergencies in order to respond rapidly and effectively. The document also emphasizes that nurses should feel confident in their actions during emergencies and that their experiences can help inform future health policies.
The document discusses the need for healthcare reform in the United States. It notes that around 47 million Americans are uninsured, 50 million are underinsured, and 79 million struggle with medical debt. It argues that the current healthcare system lacks an organizing principle to effectively link resources into a high value system. Reform is necessary to address issues like a lack of coordinated care, high costs, inconsistent quality, and an inefficient use of resources. The document advocates for a patient-centered medical home model and insurance reforms influenced by state-level decisions around insurance exchanges.
This document discusses the complex care needs of patients with multiple chronic conditions. It notes that such patients often have high treatment burdens from multiple medications and self-care needs that can exceed their capacity. Guidelines and care are often focused on single diseases and do not consider patient context. The document calls for a focus on balancing patient workload from treatment with their capacity through strategies like prioritizing care, deprescribing unnecessary treatments, coaching, and connecting patients to community resources.
The document discusses rising health care costs in the United States from 1969 to 2004, factors contributing to increased costs such as an aging population and technology, and responses to rising costs including managed care and malpractice reform. It also covers health care financing through programs like Medicare, Medicaid and private insurance, as well as the growing number of uninsured Americans.
Redesigning a care model for better health. CareOregon's MEDS (My Easy Drug System), Health Resilience program, and human-centered design programs are leading the way.
A webinar hosted with the Interdisciplinary Nursing Quality Research Initiative (INQRI) featuring Barbara Safriet, JD, LLM, Associate Dean and Lecturer, Yale Law School, who outlined why removing barriers to APRN practice and care matters to consumers.
Ed Wagner: Integrated care: what are the key factors for successNuffield Trust
Integrated care systems that coordinate care through a shared electronic medical record, common guidelines and formularies, and co-located primary and specialty care can help prevent fragmented care. However, these systems still struggle with communication failures between primary care and specialists. Truly integrated care requires personal relationships and accountability to ensure patients receive necessary services from a collaborating care team.
Polls show overwhelming evidence that patients WANT to be involved in their medical records and health data, so they can partner with their clinicians for better health. Survey results from Society for Participatory Medicine 2014 and 2015 surveys.
The document discusses strategies for transforming healthcare delivery through population health management, care coordination, and virtual care technologies. It provides examples of how partnerships between healthcare organizations and technology companies have implemented programs utilizing telehealth, remote patient monitoring, and digital platforms to improve outcomes, lower costs, and enable aging in place. Case studies demonstrate how these approaches have reduced hospital admissions and lengths of stay, ICU transfers, mortality rates, and costs while improving quality of life.
The study aimed to investigate associations between regulatory policy, workforce capacity, and health outcomes using Medicaid data from four states. However, the analysis found significant data quality issues. Key variables like service provider specialty were missing or incomplete, preventing valid conclusions about the proportion of services provided by nurse practitioners and physician assistants. At best, Alabama had 85% reporting but showed nurse practitioners and physician assistants providing significantly fewer services than medical doctors for selected chronic conditions despite making up over half of primary care workforce capacity. Overall, the Medicaid data proved inadequate for the research purposes due to inconsistent and missing coding across states.
Validity and bias in epidemiological studyAbhijit Das
Validity and bias are essential aspects of any research—a brief description of internal and external validity and different types of bias related to the epidemiological study.
Can we solve the adult primary care shortage without more physicians? CHC Connecticut
Tom Bodenheimer,of the Center for Excellence in Primary Care at UCSF Dep’t of Family and Community Medicine talks about addressing the primary care shortage at the 2014 Weitzman Symposium
The document discusses potential impacts of US health care reform on the workers' compensation system. In the short term, there is likely no direct impact. However, long term there may be impacts as health care reform aims to reduce costs through lower Medicare reimbursement rates, which providers could seek to offset by increasing workers' compensation billing. Other possible long term impacts include changes to medical treatment patterns through new models like accountable care organizations, and improved medical records and health promotion in workplaces through greater employer involvement.
This document discusses improving patient safety and care coordination. It notes that 33% of Medicare patients were harmed during skilled nursing facility stays, and 59% of incidents were preventable. Poor care coordination can increase costs by $25-45 billion annually. The document advocates for standardizing care practices and improving collaboration and communication among care teams to reduce medical errors and associated costs. It argues that effective care coordination requires engaging all players, including doctors, nurses and pharmacists, with the patient at the center.
Policy & management initiatives needed for hrh responsibilityPrabir Chatterjee
The document discusses several policy and management initiatives needed to address human resource issues in healthcare in order to meet India's health goals. It identifies inadequate numbers of doctors in rural areas, poor salaries and infrastructure, issues with patient and doctor behavior, and lack of health education as key barriers. Some interventions proposed include assigning doctors to specific areas, reserving medical education seats for local people on the condition of fixed postings, improved rural infrastructure and salaries for doctors, strict governance and oversight to reduce corruption and private practice, and continued education initiatives. A composite package of interventions is needed to effectively address the complex human resource challenges facing India's healthcare system.
Next generation predictive models leveraging real patient data from electronic health records will transform care management by enabling individualized, automated, and proactive care. Key factors enabling this transformation include meaningful use of EHRs to capture structured clinical data, more granular ICD-10 coding, and using real-time EHR data to continuously enhance predictive models and tightly couple model insights with care processes and clinical decision support. This will allow identifying high-risk complex patients early and providing optimized individualized guidelines that can improve outcomes while reducing costs compared to general guidelines.
This paper articulates the function of Malaysia Healthcare Travel Council (MHTC) in developing the Health
Tourism Industry. Focus was given in identifying the challenges faced by MHTC, understanding the
competitiveness of the industry and proposing a suitable value chain framework for the industry. Total of 12
organizations have been identified, which were including private and public organizations. Conclusions of
findings have been derived and few recommendations made at the end of this article.
Keywords: Health tourism, medical tourism, competitive, leisure services and value chain
A value chain is a set of activities that a firm operating in a specific industry performs in order to deliver a valuable product and servicef for the market .
The Role And Value Of Primary Care Practiceprimary
This document summarizes discussions from a 2002 conference on building consensus for healthcare reform in Canada. It includes summaries of two presentations:
1. Marie-Dominique Beaulieu's presentation on the role and value of primary care. She defines primary care and argues for strengthening it in Canada. She calls for changes like developing primary care teams with nurses and better information systems.
2. Howard Bergman's presentation in which he argues for strengthening and transforming primary care as the foundation of the healthcare system. He calls for an evidence-based approach and investing in primary care to improve health outcomes. Both agree comprehensive reform is needed, not just changes to primary care itself.
Pizza Hut is an international pizza chain with over 6,000 locations in the United States and over 5,600 locations in 94 other countries. It entered India in 1996. Pizza Hut believes in providing excellent pizza and service to create happy customers who return frequently. Its value chain involves primary activities like procuring ingredients, producing pizzas and pastas, and delivering orders on time. Support activities include human resource management to train employees, technology development to improve products, and procurement to source high quality ingredients from local and international suppliers.
Value chain analysis is a tool used to identify sources of competitive advantage. It examines a firm's activities and how they interact and affect costs and performance. Michael Porter developed the value chain model which divides a firm's activities into primary and support activities. Primary activities directly involve creating and delivering a product. Support activities provide inputs for primary activities. Tata Motors' value chain includes long-term supplier contracts, efficient manufacturing processes, a large dealer network, and investments in research and development. Analyzing a firm's value chain can reveal opportunities to lower costs or differentiate products compared to competitors.
There have been numerous efforts by payers and providers to improve patient access to high-functioning medical homes—an enhanced model of primary care that offers whole-person, comprehensive, ongoing, and coordinated patient- and familycentered care. Public payers, especially Medicaid, have been leaders in these efforts, with the hopes of preventing illness, reducing wasteful fragmentation, and averting the need for costly emergency department visits, hospitalizations, and institutionalizations. With the support of The Commonwealth Fund, the National Academy for State Health Policy (NASHP) has fostered these efforts through the Consortia to Advance Medical Homes for Medicaid and CHIP Participants.
The document discusses the growing interest in coordinated and integrated healthcare delivery through models like patient-centered medical homes (PCMHs) and accountable care organizations (ACOs). It notes the potential benefits of these models, including improved quality of care and reduced costs. Specifically, it cites evidence that Geisinger Health System achieved a 9% reduction in total healthcare costs and lower hospital admission and readmission rates through implementing a PCMH-based accountable care model. The long-term goal is for PCMHs and ACOs to transform healthcare delivery in the US to a more coordinated, high-value system focused on primary care.
Patient Centered Medical home talk at WVUPaul Grundy
To employers the cost of healthcare is now a business issue and this talk is about what one large buyer IBM did to drive transformation via broad coalition with other large employers to form the Patient Centered Medical Home movement and the covenant between buyer and provider away from the garbage we now buy episodic uncoordinated disintegrated care. In the change of convenient conversation we have worked with the Primary care providers to give us coordinated, integrated, accessible and compressive care with a set of principles know as the Patient centered medical home.
A Patient Centered Medical Home (PCMH) happens when primary care healers keeping that core healing relationship with their patients step up to become specialists in Family and Community Medicine. The move is to the discipline of leading a team that delivers population health management, patent centered prevention, care that is coordination, comprehensive accessible 24/7 and integrated across a deliver system. PCMH happens when the specialists in Family and Community Medicine wake up every morning and ask the question how will my team improve the health of my community today?
All over the world three huge factors are in play that is driving the concept of Patient Centered Medical Home. They are:
1) Cost and demography
2) Information technology and data (information that is actionable will equal a demand for accountability by the payer or buyer of the care)
3) Consumer demand to engage healthcare differently (at least as well as they can their bank- on line) have a question about lab results why not e-mail?
But at its core it is a move toward integration of a healing relationship in primary care and population management all at the point of care with the tools to do just that.
Why Emplyers care about Pimary care 2008Paul Grundy
Employers have struggled with rising healthcare costs and uneven quality of care. Investing in primary care may help address these issues, as primary care is associated with reduced costs and better health outcomes. However, primary care faces a crisis in the US with a declining primary care workforce. Employers are well positioned to help strengthen primary care through initiatives that support primary care practices, payment reform, and advocating for policies that value primary care. By rebuilding the primary care system, employers can work towards stabilizing costs and improving employee productivity.
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.
Patient-centered medical home initiatives in several states have shown promising results in improving access to care, quality, and cost control for Medicaid patients. Oklahoma saw a $29 per patient annual reduction in Medicaid costs from 2008-2010 alongside increased use of preventive care. Colorado expanded Medicaid access from 20% to 96% of pediatricians at lower costs. Vermont saw 21-22% decreases in inpatient care use and costs from 2008-2010 alongside 31-36% drops in ER use and related costs. Washington state's acute care spending was 18% below average with 35% fewer inpatient stays per beneficiary. Overall, these initiatives demonstrate that the patient-centered medical home model can positively impact Medicaid programs.
PCPCC on the Patient-Centered Medical Homedebronkart
The document discusses transforming primary care practices into patient-centered medical homes (PCMHs) through collaboration between large employers, employer coalitions, and primary care providers. The key points are:
1) Establishing long-term patient-doctor relationships and comprehensive primary care focused on patients' needs can improve health outcomes and reduce costs.
2) The current healthcare system fails to support primary care adequately through funding and incentives.
3) Transforming primary care practices into PCMHs through collaborative efforts between employers and providers can help fix these issues by improving care coordination and shifting reimbursements to support comprehensive care.
Realizing Health Reform’s Potential How the Affordable Care .docxsodhi3
Realizing Health Reform’s Potential
How the Affordable Care Act Will Strengthen Primary
Care and Benefit Patients, Providers, and Payers
JANUARY 2011
Melinda Abrams, Rachel Nuzum, Stephanie Mika,
and Georgette Lawlor
Abstract: Although primary care is fundamental to health system performance, the
United States has undervalued and underinvested in primary care for decades. This brief
describes how the Affordable Care Act will begin to address the neglect of America’s
primary care system and, wherever possible, estimates the potential impact these efforts
will have on patients, providers, and payers. The health reform law includes numerous
provisions for improving primary care: temporary increases in Medicare and Medicaid
payments to primary care providers; support for innovation in the delivery of care, with
an emphasis on achieving better health outcomes and patient care experiences; enhanced
support of primary care providers; and investment in the continued development of the
primary care workforce.
OVERVIEW
Among the Affordable Care Act’s many provisions, perhaps the least discussed
are those reforms directly targeting primary care—the underpinning of efforts
to achieve a high-performing health system. This brief describes how the health
reform law will begin to address the decades-long neglect of America’s primary
care system and, wherever possible, estimates the potential impact these efforts
will have on patients, providers, and payers. The primary care reforms in the
Affordable Care Act include provisions for temporarily increasing Medicare and
Medicaid payments to primary care providers; fostering innovation in the delivery
of care, with an emphasis on care models that lead to better health outcomes and
patient care experiences; enhancing support of primary care providers; and invest-
ing in the continued development of the primary care workforce (Exhibit 1).
Together, these changes, if implemented effectively, will start the United States
on the path to a stronger and more sustainable primary care system, one that pro-
vides expanded access, superior quality, and better health outcomes for millions of
Americans while reducing future health care costs for the nation.
For more information about this study,
please contact:
Melinda Abrams, M.S.
Vice President
Patient-Centered Coordinated Care
The Commonwealth Fund
[email protected]
The mission of The Commonwealth Fund is
to promote a high performance health care
system. The Fund carries out this mandate by
supporting independent research on health
care issues and making grants to improve
health care practice and policy. Support for this
research was provided by The Commonwealth
Fund. The views presented here are those of
the authors and not necessarily those of The
Commonwealth Fund or its directors, officers,
or staff.
To learn more about new publications when
they become available, visit the Fund's Web
site and re ...
The document discusses several topics:
1. A new set of criteria has been developed by NCQA and PCPCC to recognize physician practices as patient-centered medical homes based on 7 principles.
2. Matria has partnered with Microsoft to support HealthVault, a new health platform that allows users to store and access personal health information online.
3. A case study describes how Matria client BD integrated disability management with disease management, increasing participation in health programs from 23% to 48%.
The document summarizes issues with the current US healthcare system including high costs, large number of uninsured, restricted access to care, and high administrative costs. It presents single-payer healthcare as an alternative that could provide universal comprehensive coverage for all Americans through tax funding, reduce costs, improve access and choice, while maintaining physician autonomy and quality of care. Medical students would have lower debt under such a system.
Running head A REVIEW OF KEY CURRENT HEALTHCARE ISSUES QUALITY A.docxtoddr4
Running head: A REVIEW OF KEY CURRENT HEALTHCARE ISSUES: QUALITY AND VALUE IN THE U.S’S HEALTHCARE SYSTEM 1
A REVIEW OF KEY CURRENT HEALTHCARE ISSUES: QUALITY AND VALUE IN THE U.S’S HEALTHCARE SYSTEM
A Review of Key Current Healthcare Issues: Quality and Value in the U.S's Healthcare System
Student's Name
Institution Affiliation
Date
A Review of Key Current Healthcare Issues: Quality and Value in the U.S's Healthcare System
Healthcare regulations, funds, workload, and technology continue to complicate and inconvenient the U.S healthcare system. However, the quality and value of care tops. In the United States of America, despite significant healthcare transformation efforts, poor care lingers a considerable concern.
America is second to none in terms of healthcare expenditure across the globe. Ironically, evidence shows that its citizens do not receive the most appropriate care, or at least, which they need. For instance, Graban (2018) documents that preventive care is underutilized in the country, which is escalating the budget of managing advanced diseases. On the other hand, patients of chronic ailments such as diabetes, hypertension, and cardiac complications, do not also usually get treatments that are proven and effective (Wiler, Pines, & Ward, 2019). According to Strome (2019), this case is particularly true and event rampant to the persons that insured, uninsured, or under-insured. The lack of proper coordination of chronic diseases patients' care would only source more or exuberate poor healthcare. The unsurprising healthcare system's underlying fragmentation only fuels the issue given that many health care providers hardly have the payment support such related gears, necessary for effective communication and coordination to improve patient care.
While a significant number of patients miss medically necessary care, other clients get unnecessary or even unsafe attention. Research depicts terrific variations in hospital inpatient lengths of stay, specialists' visits, testing and procedures, and costs — not just by United States' unalike geographic areas, but from one health institution to another in the same town (Wiler, Pines, & Ward, 2019). Though limited, evidence on the most effective treatments and procedures, on the best way of informing providers about the efficacy of different treatments, and on the failures of detecting and reducing errors further underwrite the gaps care's quality and effectiveness (Strome, 2019). The concerns are especially pertinent to the Americans of the lower social classes as well as to those from diverse demographic and ethnic groups are usually frequent victims of a lot of incongruences in health and health care.
The implication of Poor Patient Care
Poor quality care impacts both patients and providers negatively. For patients, it reduces their survival changes, aggravates illnesses, and leads to unnecessary mortalities (Graban, 2018). To providers, such issu.
Running head A REVIEW OF KEY CURRENT HEALTHCARE ISSUES QUALITY A.docxhealdkathaleen
Running head: A REVIEW OF KEY CURRENT HEALTHCARE ISSUES: QUALITY AND VALUE IN THE U.S’S HEALTHCARE SYSTEM 1
A REVIEW OF KEY CURRENT HEALTHCARE ISSUES: QUALITY AND VALUE IN THE U.S’S HEALTHCARE SYSTEM
A Review of Key Current Healthcare Issues: Quality and Value in the U.S's Healthcare System
Student's Name
Institution Affiliation
Date
A Review of Key Current Healthcare Issues: Quality and Value in the U.S's Healthcare System
Healthcare regulations, funds, workload, and technology continue to complicate and inconvenient the U.S healthcare system. However, the quality and value of care tops. In the United States of America, despite significant healthcare transformation efforts, poor care lingers a considerable concern.
America is second to none in terms of healthcare expenditure across the globe. Ironically, evidence shows that its citizens do not receive the most appropriate care, or at least, which they need. For instance, Graban (2018) documents that preventive care is underutilized in the country, which is escalating the budget of managing advanced diseases. On the other hand, patients of chronic ailments such as diabetes, hypertension, and cardiac complications, do not also usually get treatments that are proven and effective (Wiler, Pines, & Ward, 2019). According to Strome (2019), this case is particularly true and event rampant to the persons that insured, uninsured, or under-insured. The lack of proper coordination of chronic diseases patients' care would only source more or exuberate poor healthcare. The unsurprising healthcare system's underlying fragmentation only fuels the issue given that many health care providers hardly have the payment support such related gears, necessary for effective communication and coordination to improve patient care.
While a significant number of patients miss medically necessary care, other clients get unnecessary or even unsafe attention. Research depicts terrific variations in hospital inpatient lengths of stay, specialists' visits, testing and procedures, and costs — not just by United States' unalike geographic areas, but from one health institution to another in the same town (Wiler, Pines, & Ward, 2019). Though limited, evidence on the most effective treatments and procedures, on the best way of informing providers about the efficacy of different treatments, and on the failures of detecting and reducing errors further underwrite the gaps care's quality and effectiveness (Strome, 2019). The concerns are especially pertinent to the Americans of the lower social classes as well as to those from diverse demographic and ethnic groups are usually frequent victims of a lot of incongruences in health and health care.
The implication of Poor Patient Care
Poor quality care impacts both patients and providers negatively. For patients, it reduces their survival changes, aggravates illnesses, and leads to unnecessary mortalities (Graban, 2018). To providers, such issu ...
DQ 3-2Integrated health care delivery systems (IDS) was develope.docxelinoraudley582231
DQ 3-2
Integrated health care delivery systems (IDS) was developed to initiate excellence health care access and quality of care to entire populations and community by collaborating and coordinating diverse healthcare professionals. Main driving force of IDS is patient centered care by using resources such as collaborating care from physicians and allied health care professionals to construct continuum of care, to deliver care in the most cost-effective way, utilize trained and competent providers by utilizing evidenced -based practice and combine innovation such as EHR (Electronic Health Records) system and team work to produce improved healthcare system.
Excellence in care is attainable by incorporating allied healthcare professional, as high quality care is possible when coordination is unified and covers all areas of responsibilities. For an example-combining resources and coordination of care by involving physicians, dietitian, physical therapy or occupational therapy to work with patient diagnosed with obesity by promoting teamwork approach and ultimately delivering endurance in care and utilizing various resources.
Barriers to IDS can be a huge block in delivering quality care. Among many one limitation is physicians not participating in integrated healthcare system, which disconnect physicians from team based approached by deterring continuous quality improvement (essentialhospitals.org, n.d). This is because, system such as EHR or new innovative quality assurance programs are time consuming and overwhelming, thus decline in physicians support in IDS programs. By implementing user friendly system approach, enforcing focused based care and accepting the necessity of evidenced based practice can improve these barriers. Hence, increasing clinical expertise to produce better service and quality of care in integrated delivery system.
Essentialhospitls.org (n.d). Retrieved from: http://essentialhospitals.org/wp-content/uploads/2013/12/Integrated-Health-Care-Literature-Review-Webpost-8-22-13-CB.pdf
Dq 3-1
1.
In the US, there is not one type of health care system but rather a subset of systems, some of them catering to specific populations. These subsystems include managed care, military, and vulnerable populations. Managed care is a health care delivery system that seeks to achieve efficiency by integrating the basic functions of health care delivery, employs mechanisms to control utilization of medical services, and determines the price at which the services are purchased and how much the providers get paid, military health care system is available free of charge to active duty military personnel and covers preventative and treatment services that are provided by salaried health care personnel and this system combines public health with medical services, and vulnerable population subsystem offers comprehensive medical and enabling services targeted to the needs of vulnerable populations and government health insurance programs provide.
- The document summarizes the benefits of implementing a patient-centered medical home (PCMH) model, including reduced costs, improved outcomes, and better care coordination.
- Studies show PCMH practices have significantly reduced costs, especially inpatient costs, and utilization for high-risk patients. They have also improved outcomes such as reduced hospital days and emergency room visits.
- Transitioning to a PCMH model focuses on proactive, coordinated care through a team-based approach rather than episodic care during office visits. This emphasizes prevention, chronic disease management, and tracking of tests and follow-ups.
This document discusses the patient-centered medical home (PCMH) model and its benefits. It provides examples of organizations that have implemented PCMH initiatives to improve care coordination, access, costs and outcomes. Key points include:
- PCMH aims to strengthen primary care through care coordination, enhanced access, quality improvement and payment reform.
- Studies show PCMH can reduce costs by decreasing ER visits and hospital days while improving outcomes.
- Several large employers, the Department of Defense, and state governments have adopted PCMH models for the populations they insure.
- Successful PCMH models integrate primary care, specialists, hospitals, and community resources through use of health IT, data sharing and care
This document discusses the patient centered medical home (PCMH) model and its benefits. It notes that PCMHs aim to achieve the triple aim of improved patient care, improved population health, and reduced healthcare costs. Studies show that PCMHs have led to reductions in hospital days, ER visits, and total healthcare costs, while also increasing medication adherence. The document advocates for expanding PCMHs and reforming payment systems to incentivize their growth and success.
This document provides an overview and introduction to palliative care. It discusses that palliative care focuses on relieving pain, symptoms and stress of serious illness to improve quality of life. Palliative care is delivered by an interdisciplinary team and can be provided at any stage of a serious illness alongside curative treatments. The document summarizes research finding that palliative care can reduce costs by lowering hospitalizations and emergency visits while improving quality outcomes like symptoms and satisfaction. It also outlines strategies some health payers and organizations are taking to integrate palliative care, like targeting high-risk patients, dedicating case management resources and reimbursing providers.
The document discusses primary care and its role in an effective healthcare system. It outlines that primary care provides integrated, accessible care that focuses on prevention, chronic disease management, and care coordination. This results in better health outcomes and lower costs compared to healthcare systems without a strong primary care foundation. The principles of good primary care are described, including access, continuity, comprehensive team-based care, community orientation, and evidence-based practice. The patient-centered medical home model aims to incorporate these primary care principles.
Ρητορική και πολιτική στην Πρωτοβάθμια Φροντίδα. Η αναγκαιότητα μιας τεκμηριω...Evangelos Fragkoulis
Παρούσιαση μου στα πλαίσια του 13ου Health Policy Forum, με θέμα:
"Πρωτοβάθμια Φροντίδα Υγείας: Προϋποθέσεις Ανασυγκρότησης και Ανάπτυξης"
Αρχαία Ολυμπία, 15-17 Απριλίου 2016
http://www.healthpolicy.gr/13%CE%B7-%CF%83%CF%85%CE%BD%CE%AC%CE%BD%CF%84%CE%B7%CF%83%CE%B7-%CE%B1%CF%81%CF%87%CE%B1%CE%AF%CE%B1-%CE%BF%CE%BB%CF%85%CE%BC%CF%80%CE%AF%CE%B1-2016/
KYC Compliance: A Cornerstone of Global Crypto Regulatory FrameworksAny kyc Account
This presentation explores the pivotal role of KYC compliance in shaping and enforcing global regulations within the dynamic landscape of cryptocurrencies. Dive into the intricate connection between KYC practices and the evolving legal frameworks governing the crypto industry.
How to Invest in Cryptocurrency for Beginners: A Complete GuideDaniel
Cryptocurrency is digital money that operates independently of a central authority, utilizing cryptography for security. Unlike traditional currencies issued by governments (fiat currencies), cryptocurrencies are decentralized and typically operate on a technology called blockchain. Each cryptocurrency transaction is recorded on a public ledger, ensuring transparency and security.
Cryptocurrencies can be used for various purposes, including online purchases, investment opportunities, and as a means of transferring value globally without the need for intermediaries like banks.
Confirmation of Payee (CoP) is a vital security measure adopted by financial institutions and payment service providers. Its core purpose is to confirm that the recipient’s name matches the information provided by the sender during a banking transaction, ensuring that funds are transferred to the correct payment account.
Confirmation of Payee was built to tackle the increasing numbers of APP Fraud and in the landscape of UK banking, the spectre of APP fraud looms large. In 2022, over £1.2 billion was stolen by fraudsters through authorised and unauthorised fraud, equivalent to more than £2,300 every minute. This statistic emphasises the urgent need for robust security measures like CoP. While over £1.2 billion was stolen through fraud in 2022, there was an eight per cent reduction compared to 2021 which highlights the positive outcomes obtained from the implementation of Confirmation of Payee. The number of fraud cases across the UK also decreased by four per cent to nearly three million cases during the same period; latest statistics from UK Finance.
In essence, Confirmation of Payee plays a pivotal role in digital banking, guaranteeing the flawless execution of banking transactions. It stands as a guardian against fraud and misallocation, demonstrating the commitment of financial institutions to safeguard their clients’ assets. The next time you engage in a banking transaction, remember the invaluable role of CoP in ensuring the security of your financial interests.
For more details, you can visit https://technoxander.com.
New Visa Rules for Tourists and Students in Thailand | Amit Kakkar Easy VisaAmit Kakkar
Discover essential details about Thailand's recent visa policy changes, tailored for tourists and students. Amit Kakkar Easy Visa provides a comprehensive overview of new requirements, application processes, and tips to ensure a smooth transition for all travelers.
Vicinity Jobs’ data includes more than three million 2023 OJPs and thousands of skills. Most skills appear in less than 0.02% of job postings, so most postings rely on a small subset of commonly used terms, like teamwork.
Laura Adkins-Hackett, Economist, LMIC, and Sukriti Trehan, Data Scientist, LMIC, presented their research exploring trends in the skills listed in OJPs to develop a deeper understanding of in-demand skills. This research project uses pointwise mutual information and other methods to extract more information about common skills from the relationships between skills, occupations and regions.
An accounting information system (AIS) refers to tools and systems designed for the collection and display of accounting information so accountants and executives can make informed decisions.
University of North Carolina at Charlotte degree offer diploma Transcripttscdzuip
办理美国UNCC毕业证书制作北卡大学夏洛特分校假文凭定制Q微168899991做UNCC留信网教留服认证海牙认证改UNCC成绩单GPA做UNCC假学位证假文凭高仿毕业证GRE代考如何申请北卡罗莱纳大学夏洛特分校University of North Carolina at Charlotte degree offer diploma Transcript
Abhay Bhutada, the Managing Director of Poonawalla Fincorp Limited, is an accomplished leader with over 15 years of experience in commercial and retail lending. A Qualified Chartered Accountant, he has been pivotal in leveraging technology to enhance financial services. Starting his career at Bank of India, he later founded TAB Capital Limited and co-founded Poonawalla Finance Private Limited, emphasizing digital lending. Under his leadership, Poonawalla Fincorp achieved a 'AAA' credit rating, integrating acquisitions and emphasizing corporate governance. Actively involved in industry forums and CSR initiatives, Abhay has been recognized with awards like "Young Entrepreneur of India 2017" and "40 under 40 Most Influential Leader for 2020-21." Personally, he values mindfulness, enjoys gardening, yoga, and sees every day as an opportunity for growth and improvement.
The Impact of Generative AI and 4th Industrial RevolutionPaolo Maresca
This infographic explores the transformative power of Generative AI, a key driver of the 4th Industrial Revolution. Discover how Generative AI is revolutionizing industries, accelerating innovation, and shaping the future of work.
TEST BANK Principles of cost accounting 17th edition edward j vanderbeck mari...Donc Test
TEST BANK Principles of cost accounting 17th edition edward j vanderbeck maria r mitchell.docx
TEST BANK Principles of cost accounting 17th edition edward j vanderbeck maria r mitchell.docx
TEST BANK Principles of cost accounting 17th edition edward j vanderbeck maria r mitchell.docx
Discover the Future of Dogecoin with Our Comprehensive Guidance36 Crypto
Learn in-depth about Dogecoin's trajectory and stay informed with 36crypto's essential and up-to-date information about the crypto space.
Our presentation delves into Dogecoin's potential future, exploring whether it's destined to skyrocket to the moon or face a downward spiral. In addition, it highlights invaluable insights. Don't miss out on this opportunity to enhance your crypto understanding!
https://36crypto.com/the-future-of-dogecoin-how-high-can-this-cryptocurrency-reach/
Independent Study - College of Wooster Research (2023-2024) FDI, Culture, Glo...AntoniaOwensDetwiler
"Does Foreign Direct Investment Negatively Affect Preservation of Culture in the Global South? Case Studies in Thailand and Cambodia."
Do elements of globalization, such as Foreign Direct Investment (FDI), negatively affect the ability of countries in the Global South to preserve their culture? This research aims to answer this question by employing a cross-sectional comparative case study analysis utilizing methods of difference. Thailand and Cambodia are compared as they are in the same region and have a similar culture. The metric of difference between Thailand and Cambodia is their ability to preserve their culture. This ability is operationalized by their respective attitudes towards FDI; Thailand imposes stringent regulations and limitations on FDI while Cambodia does not hesitate to accept most FDI and imposes fewer limitations. The evidence from this study suggests that FDI from globally influential countries with high gross domestic products (GDPs) (e.g. China, U.S.) challenges the ability of countries with lower GDPs (e.g. Cambodia) to protect their culture. Furthermore, the ability, or lack thereof, of the receiving countries to protect their culture is amplified by the existence and implementation of restrictive FDI policies imposed by their governments.
My study abroad in Bali, Indonesia, inspired this research topic as I noticed how globalization is changing the culture of its people. I learned their language and way of life which helped me understand the beauty and importance of cultural preservation. I believe we could all benefit from learning new perspectives as they could help us ideate solutions to contemporary issues and empathize with others.
Independent Study - College of Wooster Research (2023-2024) FDI, Culture, Glo...
The value of primary care
1.
2.
3. “ Across the globe doctors are miserable because they feel like hamsters on a treadmill. They must run faster just to stand still… The result of the wheel going faster is not only a reduction in the quality of care but also a reduction in professional satisfaction and an increase in burnout among doctors.” Morrison and Smith, BMJ 2000;321:1541 Primary Care: Currently an Impossible Job?
4.
5. Primary Care Score vs. Total Expenditures , 1997 Starfield 10/00 00-133 US NTH CAN AUS SWE JAP BEL FR GER SP DK FIN UK Starfield 10/00 IC 1731
6. Primary care score vs rank in outcomes * Rank based on patient satisfaction, expenditures per person, 14 health indicators, and medications per person in Australia, Belgium, Canada, Denmark, Finland, Germany, Netherlands, Spain, Sweden, United Kingdom, United States
7.
8. Total cost of healthcare vs availability of Primary Care
9. Total cost of healthcare vs availability of Specialists