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Health Affairs, vol. 31 no. 9

Monday, September 10th, 2012 | Posted in Collections, Faculty, News, Resources, Students by Tomaro Taylor | Comments Off on Health Affairs, vol. 31 no. 9

The most recent edition of Health Affairs is available at the FMHI Research Library.

Volume 31, number 9: “Payment Reform to Achieve Better Health Care”

Medicare Hospital Payment Postacute Care Payment Capitation & Shared Savings Physician Payment Patient-Centered Medical Homes
Payers & Reference Pricing Government’s Role End Stage Renal Disease Effects on Drugs & Devices Compensating Doctors
Medicare Advantage Variations in Costs Shared Decision Making Report from the Field Web First

Medicare Hospital Payment

  • The lessons of Medicare’s prospective payment system show that the bundled payment program faces challenges (Altman, p. 1923)
  • A giant of health policy reflects on past reforms (p. 1931)
  • Medicare’s new hospital value-based purchasing program is likely to have only a small impact on hospital payments (Werner & Dudley, p. 1932)

Postacute Care Payment

  • Medicare postacute care payment reforms have potential to improve efficiency of care, but may need changes to cut costs (Grabowski, Huckfeldt, Sood, Escarce & Newhouse, p. 1941)

Capitation & Shared Savings

  • Beyond capitation: How new payment experiments seek to find the ‘Sweet Spot’ in amount of risk providers and payers bear (Frakt & Mayes, p. 1951)
  • The design and application of shared savings programs: Lessons from early adopters (Weissman, Bailit, D’Andrea & Rosenthal, p. 1959)
  • A global budget pilot project among provider partners and Blue Shield of California led to savings in first two years (Markovich, p. 1969)

Physician Payment

  • Fee-for-service will remain a feature of major payment reforms, requiring more changes in Medicare physician payment (Ginsberg, p. 1977)
  • Many large medical groups will need to acquire new skills and tools to be ready for payment reform (Mechanic & Zinner, p. 1984)
  • Michigan’s physician group incentive program offers a regional model for incremental ‘Fee for Value’ payment reform (Share & Mason, p. 1993)

Patient-Centered Medical Homes

  • Early results show WellPoint’s patient-centered medical home pilots have met some goals for costs, utilization, and quality (Raskas, Latts, Hummel, Wennders, Levine & Nussbaum, p. 2002)
  • Colorado’s patient-centered medical home pilot met numerous obstacles, yet saw results such as reduced hospital admissions (Harbrecht & Latts, p. 2010)
  • Horizon’s patient-centered medical home program shows practices need much more than payment changes to transform (Patel, Rathjen & Rubin, p. 2018)

Payers & Reference Pricing

  • Payers test reference pricing and centers of excellence to steer patients to low-price and high-quality providers (Robinson & MacPherson, p. 2028)

Government’s Role

  • Posing a framework to guide government’s role in payment and delivery system reform (Sood & Higgins, p. 2043)

End-Stage Renal Disease

  • Medicare’s payment strategy for end-state renal disease now embraces bundled payment and pay-for-performance to cut costs (Swaminathan, Mor, Mehrotra & Trivedi, p. 2051)

Effects on Drugs and Devices

  • Providers’ payment and delivery system reforms hold both treats and opportunities for the drug and device industries (Robinson, p. 2059)

Compensating Doctors

  • How Geisinger structures its physicians’ compensation to support improvements in quality, efficiency and volume (Lee, Bothe, & Steele, p. 2068)

Medicare Advantage

  • Payer-provider collaboration in accountable care reduced use and improved quality in Maine Medicare advantage plan (Claffey, Agostini, Collet, Reisman & Krakauer, p. 2074)

Variations in Costs

  • Wide variation in episode costs within a commercially insured population highlights potential to improve the efficiency of care (Ellis, Sandy, Larson, & Stevens p. 2084)

Shared Decision Making

  • Introducing decision aids at group health was linked to sharply lower hip and knee surgery rates and costs (Arterburn, Wellman, Westbrook, Rutter, Ross, McCulloch, Handley, and Jung, p. 2094)

Report from the Field

  • Personal Responsibility: How Mitt Romney embraced the individual mandate in Massachusetts health reform (Bebinger, p. 2015)

Web First

  • In amenable mortality- Deaths avoidable through health care – Progress in the US lags that of three European countries (Nolte & McKee, p. 2114)
  • Visits to retail clinics grew fourfold from 2007-2009, although their share of overall outpatient visits remains low (Mehrotra & Lave, p. 2123)
  • Health in all policies: The role of the US Department of Housing and Urban Development and present and future challenges (Bostic, Thornton, Rudd & Sternthal, p. 2130)

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