Preliminary results of the Medicare Comprehensive Joint Replacement bundled-care model show that 382 of about 800 participating health care facilities achieved high enough levels of cost savings and care quality to qualify for incentives. The facilities will share more than $37.5 million in payments ranging from $348.66 for three care episodes to more than $1.2 million for 850 episodes.
The CMS received 85 comments regarding the agency's decision to cancel mandatory bundled-payment programs, and most large organizations commenting supported making the programs voluntary but did not support a return to fee-for-service. Most of the criticism came from employer and consumer groups as well as from individuals.
Despite some Republicans' efforts to cut federal funding of Medicaid, 26 states have expanded or enhanced benefits and 17 plan to expand next year, while six states cut benefits, according to a recent Kaiser Family Foundation and National Association of Medicaid Directors survey. Benefits have been increased for mental health care, substance abuse treatment, telemedicine and dental care.
Health care organizations are using new models of holistic pediatric primary care to address unhealthy behaviors and prevent chronic disease in adulthood, physicians write in Harvard Business Review. These programs must include comprehensive, team-based care and address socioeconomic concerns such as housing, custody issues and substance abuse.
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Researchers said 4.8% of Medicare spending in 2012 was potentially avoidable, and 73.8% of that amount was incurred by patients in the top 10% of total individual spending. The report, in Annals of Internal Medicine, showed frail, elderly Medicare beneficiaries accounted for 43.9% of potentially preventable spending on avoidable emergency department, inpatient and associated post-acute-care costs.
Anthem will offer home-delivered meals after hospital discharge as a benefit for some of its Medicare Advantage plan members starting in 2018. The goal is to help reduce weight loss and malnutrition that can lead to hospital readmissions, longer lengths of stay and poor outcomes.
Health care providers may use EHRs to reduce unnecessary medical testing, which could affect patient safety and satisfaction, researchers reported in JAMA Internal Medicine. Cedars-Sinai Medical Center in Los Angeles, a participant of the Choosing Wisely campaign, integrated an alert system into its physician EHR workflow that resulted in reduced test ordering.
The Network for Regional Healthcare Improvement and the Strategic Health Information Exchange Collaborative will team up to advance policies in support of regional data sharing, share best practices and identify regional partnership opportunities. Ultimately, claims, clinical and demographic data in support of value-based care will be shared across the NRHI's regional health care improvement collaboratives and the SHIEC's health-information exchanges, says SHIEC chairman Dan Porreca.
A review article published in Osteopathic Family Physician said that lifestyle management is "the cornerstone of treatment of patients with diabetes" and stressed the importance of giving evidence-based lifestyle management recommendations to patients. The American Diabetes Association recommends patients increase physical activity levels, reduce sedentary behavior, receive individualized medical nutrition therapy, eat a healthy diet and participate in smoking cessation counseling and diabetes self-management education, the review noted.
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More than 1 in 5 U.S. adults live with a mental health condition, and approximately 20 percent of boys and girls ages 13 to 18 have experienced or will experience a mental health condition. Given these numbers, it's no surprise that health plans have stepped up to improve mental health treatment for all ages. Learn more.