This document introduces the Macon Value Formula, which provides a quantitative method to compare the value of different spine procedures based on outcomes and costs. The formula calculates a relative value score from 0-1000 based on outcomes achieved (measured on a 0-100 scale), costs, and whether the outcome was a success or failure. The document provides an example application comparing lumbar epidural steroid injections and lumbar discectomy. It finds that lumbar discectomy provided higher value at 12 months based on 100% success rate and lower total costs compared to epidural steroid injections. The goal of using this formula is to maximize value, effectiveness and success of procedures by comparing and optimizing treatment sequences.
Procedure outcomes and cost analysis using the Macon Value Formula
Value analysis duration and Place of service effect on Value
Competition on Value for Patients in Pain Management
WHEN AND HOW DOES VALUE BASED PURCHASING IMPACT HOSPITAL PERFORMANCE?Kirsty Macauldy, MBA
To improve the overall quality of healthcare, The National Quality Strategy of the U.S. Department of Health and Human Services broadly defines the outcomes that the Centers for Medicare and Medicaid Services (CMS) wants to achieve through the care it purchases for its beneficiaries. The strategies; aims of better health, better care, and lower costs.
Power Point Presentation made to a major pharmaceutical manufacturer in 1998. Identifies cause of Medical Crisis and how Pharm mfgrs can use regulations to add value to their contracts with MCOs.
Procedure outcomes and cost analysis using the Macon Value Formula
Value analysis duration and Place of service effect on Value
Competition on Value for Patients in Pain Management
WHEN AND HOW DOES VALUE BASED PURCHASING IMPACT HOSPITAL PERFORMANCE?Kirsty Macauldy, MBA
To improve the overall quality of healthcare, The National Quality Strategy of the U.S. Department of Health and Human Services broadly defines the outcomes that the Centers for Medicare and Medicaid Services (CMS) wants to achieve through the care it purchases for its beneficiaries. The strategies; aims of better health, better care, and lower costs.
Power Point Presentation made to a major pharmaceutical manufacturer in 1998. Identifies cause of Medical Crisis and how Pharm mfgrs can use regulations to add value to their contracts with MCOs.
Quality Medical Care presentation made to a major Pharm mfgr in 1998 at a national meeting. Purpose is to explain how pharm company could use gov mandates to add value to contracts with MCOs.
This Slideshare introduces CMAP-Pro to Practice Managers and Administrators explaining how the device helps doctors improve outcomes for patients with soft tissue injuries, while increasing profit for the practice, and also shares 5 keys to easy implementation into your practice workflow. TO SEE TO LIVE PRESENTATION GO TO: https://nvmanagementcorp.com/cmap-perfect-auto-webinaripqpl961
The CMAP-Pro protocols capture the activity and function of specific muscle and nerve groups involved in soft tissue injuries.
FDA-approved in 2012, CMAP-Pro patient results have been validated through published clinical studies and featured in several peer reviewed journal articles.
A study was conducted with 114 consecutive patients with musculoskeletal pain claims results indicated a 6.9 times increase in the odds of case closure when there was concordance between CMAP-Pro results & the physicians independent diagnosis.
CMAP-Pro is indicated for use with:
Sprains or strains of the spine or limbs after 4 weeks without improvement; Upon consideration of upper or lower extremities; upon diagnosis of Carpal Tunnel Syndrome / Median Nerve Dysfunction; Upon diagnosis of Fibromyalgia, Myofascial Pain, Chronic Fatigue Syndrome; At symptom onset of Cumulative trauma disorder; Prior to or as part of the evaluation of Agreed Medical Evaluation / Qualified Medical Evaluation / Independent Medical Evaluation; At onset of new claim of patients with recurrent soft tissue claims; All neck and back cases when surgery considered; when symptoms do not match the description of injury/accident (ambiguous etiology); when trying to determine whether or not an injury is work related (causation analysis); when presence of pathology is in doubt (claims of an uncertain nature); to determine permanent and stationary (P&S) status or maximum medical improvement (MMI) in unexplained delayed return to work (RTW) claims; Prior to release of patient to modified duty to objectively define transitional/modified duties.
The impact of quality and CMS scores on costJames Case
Quality performance is important for provider organizations, but it can be difficult to understand the financial implications of improved quality performance. Despite controversy, the CMS star ratings for providers will have a substantial impact on hospital's financial position through the relationships it has through the entire organization.
Mh0059 – quality management in healthcare servicessmumbahelp
Dear students get fully solved assignments
Send your semester & Specialization name to our mail id :
“ help.mbaassignments@gmail.com ”
or
Call us at : 08263069601
(Prefer mailing. Call in emergency )
By 2015, group physician practices of 10 or more eligible Medicare providers will be required by the Centers for Medicare and Medicaid Services to participate in the value-based modifier program. Is your practice prepared to participate? This Quirk Healthcare Solutions Insights webinar provides a solid overview of the impending rollout.
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Quality Medical Care presentation made to a major Pharm mfgr in 1998 at a national meeting. Purpose is to explain how pharm company could use gov mandates to add value to contracts with MCOs.
This Slideshare introduces CMAP-Pro to Practice Managers and Administrators explaining how the device helps doctors improve outcomes for patients with soft tissue injuries, while increasing profit for the practice, and also shares 5 keys to easy implementation into your practice workflow. TO SEE TO LIVE PRESENTATION GO TO: https://nvmanagementcorp.com/cmap-perfect-auto-webinaripqpl961
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(Prefer mailing. Call in emergency )
By 2015, group physician practices of 10 or more eligible Medicare providers will be required by the Centers for Medicare and Medicaid Services to participate in the value-based modifier program. Is your practice prepared to participate? This Quirk Healthcare Solutions Insights webinar provides a solid overview of the impending rollout.
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Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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Value Calculator for Pain Procedures Cost-Effectiveness Comparison
1. A Relative Value Calculator ForA Relative Value Calculator For
Pain ProceduresPain Procedures
James B. Macon, M.D.James B. Macon, M.D.
Framingham NeuroSpineFramingham NeuroSpine
Framingham, MassachusettsFramingham, Massachusetts
Copyright 2010 James B. Macon, M.D.Copyright 2010 James B. Macon, M.D.
2. DisclosureDisclosure
James B. Macon, M.D. is a consultant forJames B. Macon, M.D. is a consultant for
Spine Surgical Innovations, Inc.Spine Surgical Innovations, Inc.
3. Value DefinitionValue Definition
Value for patientsValue for patients ==
Health Outcomes perHealth Outcomes per
$ Cost Expended$ Cost Expended
Porter, M.E. “A Strategy for Health CarePorter, M.E. “A Strategy for Health Care
Reform – Toward a Value-Based System”Reform – Toward a Value-Based System”
NEJMNEJM 361: 109-112, 2009361: 109-112, 2009
4.
5. Value =Value = Successful OutcomesSuccessful Outcomes
Provider PaymentsProvider Payments
6. Outcome TiersOutcome Tiers
Tier I :Tier I : primary outcomeprimary outcome (pain, neuro status,(pain, neuro status,
return to work, disability status)return to work, disability status)
Tier II :Tier II : complicationscomplications (infections, root injury,(infections, root injury,
CSF leak, delay to recovery)CSF leak, delay to recovery)
Tier III :Tier III : recurrencesrecurrences ( re-herniation, re-op,( re-herniation, re-op,
delayed adverse events- scarring)delayed adverse events- scarring)
Convert all outcomes to % recovery to baselineConvert all outcomes to % recovery to baseline
7. MaconMacon Value FormulaValue Formula
A Quantitative Value Analysis FormulaA Quantitative Value Analysis Formula
for Comparison of Spine Interventionsfor Comparison of Spine Interventions
Based on Outcome and Cost DataBased on Outcome and Cost Data
8. Formula VariablesFormula Variables
OOkk is the outcome for individual k (0-100)is the outcome for individual k (0-100)
n is the number in the intervention groupn is the number in the intervention group
s is 1 if outcome success and 0 if failures is 1 if outcome success and 0 if failure
DDkk is the total provider payment (min. $100)is the total provider payment (min. $100)
c is 1 for additional cost and 0 if no costc is 1 for additional cost and 0 if no cost
V is the relative value calculated (0-1000)V is the relative value calculated (0-1000)
9. Formula StepsFormula Steps
Identify condition ICD9 codes (722.10/724.3) <4 wksIdentify condition ICD9 codes (722.10/724.3) <4 wks
Identify intervention groups CPT code (62311/63030)Identify intervention groups CPT code (62311/63030)
Define group size n to be studied (10)Define group size n to be studied (10)
Define severity rating for the condition (8-10/10 pain)Define severity rating for the condition (8-10/10 pain)
Select outcome measures to be studied ( Tiers 1-3)Select outcome measures to be studied ( Tiers 1-3)
Convert outcome measure to scale (0-100% pain relief)Convert outcome measure to scale (0-100% pain relief)
Define success range for outcomes (70-100)Define success range for outcomes (70-100)
Collect outcomes for study time interval (3-12 months)Collect outcomes for study time interval (3-12 months)
Collect cost data = total payments to all providersCollect cost data = total payments to all providers
Enter outcome and cost data into spreadsheetEnter outcome and cost data into spreadsheet
Prepare formula summary table based on resultsPrepare formula summary table based on results
Use table results to optimize value and successUse table results to optimize value and success
Plot graph of value over study duration to compare proceduresPlot graph of value over study duration to compare procedures
14. Value Formula Summary TableValue Formula Summary Table
12 Months12 Months
CPT VALUE SUCCESS COSTCPT VALUE SUCCESS COST
62311/63030 23 100% $36,19562311/63030 23 100% $36,195
63030 9 100% $103,75063030 9 100% $103,750
15.
16. Value-Based ConclusionsValue-Based Conclusions
The goal of care is to maximize group valueThe goal of care is to maximize group value
Maximum value is not always max effectivenessMaximum value is not always max effectiveness
Maximum value is not always evidence-basedMaximum value is not always evidence-based
Less effective procedures may have high valueLess effective procedures may have high value
Sequence procedures to maximize group valueSequence procedures to maximize group value
Order procedures to perform high value firstOrder procedures to perform high value first
Perform high success low value procedures lastPerform high success low value procedures last
Eliminate ineffective unsuccessful proceduresEliminate ineffective unsuccessful procedures
17.
18. To use the Macon Value FormulaTo use the Macon Value Formula
Request a copy of the spread sheet for use inRequest a copy of the spread sheet for use in
your practice to compare intervention groupsyour practice to compare intervention groups
E-mail :E-mail : macon@fnspine.commacon@fnspine.com and requestand request
Website: www.fnspine.comWebsite: www.fnspine.com
The Macon value formula is copyright protectedThe Macon value formula is copyright protected
by the U.S. Copyright Officeby the U.S. Copyright Office
Credit the formula to the author when data isCredit the formula to the author when data is
presented or published.presented or published.
19. E-mail :E-mail : macon@fnspine.commacon@fnspine.com
ICD 9 of studyICD 9 of study
CPT for all groupsCPT for all groups
Group sizeGroup size
Number of groups in studyNumber of groups in study
Success range definitionSuccess range definition
Crossover designCrossover design
Return e-mail addressReturn e-mail address