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Wednesday, April 12, 2017
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CMS announced Thursday the 32 entities that will participate in the Accountable Health Communities Model. Participants will serve as local hubs that link clinical and community services and address social determinants of health, including housing, food and transportation. The goals of the five-year CMS Innovation Center program are to lower health care costs, reduce avoidable utilization and improve the health and quality of care of Medicare and Medicaid beneficiaries. CMS selected these 32 “bridge organizations” to represent a variety of provider types, sizes, markets and beneficiary demographics. (
Fierce Healthcare;
announcement)
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The National Committee for Quality Assurance has introduced a new version of its Patient-Centered Medical Home Recognition program. According to the NCQA, “the streamlined program includes a new process that reduces paperwork and requirements that allow primary care practices to focus more on providing strong, patient-centered care.” The biggest change is the move from a three-year recognition cycle to an annual one that promotes ongoing quality improvement. (
NCQA)
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A bipartisan Senate bill introduced last week would, among other things, expand Medicare Advantage coverage of telemedicine for all patients. It would also expand coverage of telehealth for stroke patients and at-home dialysis recipients: They could have their monthly clinical assessments performed via telehealth without geographic restrictions,
Modern Healthcare reports. The bill would also expand the CMS Independence at Home demonstration, through which seniors with multiple chronic conditions can receive care at home. The bill comes on the heels of another Senate bill to allow Medicare to test covering more telehealth models. (
Modern Healthcare)
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Want the conservative Freedom Caucus to support health care legislation? Make three changes, says Rep. Mark Meadows: Do away with essential health benefits, community rating (which says insurers can’t charge sick people more for insurance) and guaranteed issue, which requires insurers to cover those with pre-existing conditions. However,
The Hill points out that moderate Republicans would not support such changes. (
The Hill)
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Innovation & Transformation
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Integrating caregivers into the planning process of the discharge of elderly patients can significantly reduce 90-day readmission rates, according to a paper published in the Journal of the American Geriatrics Society. Researchers conducted a systemic review of previous research. They found that integrating informal caregivers--often family members--into the discharge planning process was associated with a 25 percent reduction in the likelihood of an elderly patient being readmitted to the hospital within 90 days of discharge and a 24 percent reduction in the possibility of readmission within 180 days. (Becker’s Hospital Review; Journal of the American Geriatrics Society)
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Hospitals in expansion states increased Medicaid revenue an average of $5.2 million in 2015, reduced uncompensated care by $3.2 million and improved operating margins by 2.5 percentage points, according to a new report from the Urban Institute. In contrast, according to the University of North Carolina Rural Health Research Program, 78 rural hospitals have closed since the Affordable Care Act was passed in 2010. More than 75 percent of those closures were in non-expansion states. (
HealthLeaders Media;
Urban Institute Report;
UNC report)
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The American Academy of Family Physicians is taking on social determinants of health. It’s newly launched Center for Diversity and Health Equity will “take a leadership role in addressing social determinants of health, nurturing diversity and promoting health equity through collaboration, policy development, advocacy and education,” says Julie Wood, MD, MPH, AAFP senior vice president. Activities will include evaluating current research. (
AAFP News)
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Why is age the first statistic medical professionals highlight when talking about a patient? What assumptions are automatically made based on the age of the patient? A 50-year-old patient who falls and has a change in mental status will likely receive a different prognosis than a patient who is 80. Speaking at Penn Medicine’s Health Equity Week, Rebecca Trotta, PhD, RN, director of nursing research and science at the Hospital of the University of Pennsylvania, says there’s a connection between “having those presumptions about older people and their likelihood of achieving the best possible outcomes and quality.” (
Philly.com)
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Research published in
Health Affairs finds significant churn among physicians participating in the Pioneer ACO program. During the 2012-14 contract period studied, 41 percent of physicians joined and 18 percent left. When physicians left, so did most of their attributed beneficiaries. “Conversely, about half of the growth in the beneficiary population was because of new physicians affiliating with the ACO,” the researchers note. “These findings may help explain the muted financial impact ACOs have had overall, and they raise the possibility of future gaming on the part of ACOs to artificially control spending.” (
Health Affairs)
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Immeasurable quality: In a recent blog post, Kjell Benson, MD, makes the case that attempts to quantify quality are misguided. “The use of value reflects an economic creep of the mission of medicine and a subtle deterioration of the relational aspect of ‘my doctor,’” he warns. (
KevinMD)
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The skinny on supplements: The Office of Dietary Supplements has created a web page--
ods.od.nih.gov--designed for health care professionals, including educators and public health officers. It features evidence-based information on dietary supplements and provides a range of resources, including fact sheets, recommendations and databases. (
AAFP News)
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Letting patients lead: In this first-person piece that appeared in
Pulse, family practitioner
Mitch Kaminski, MD, writes about how he learned the value of asking patients what they want from end-of-life care. He asks, “What are your goals for your care? How can I help you?” (
Washington Post)
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The VA’s comprehensive caregiver support program pays a stipend to family members of veterans with disabilities. But in some regions, it’s being cut back. National Public Radio reports that although the program has added 6,300 caregivers since 2014, 32 out of 140 VA medical centers were cutting their programs during the same period--some drastically. (
NPR)
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MarketVoices...quotes worth reading
“Two quality metrics walk into a bar. One demands, ‘Give me the best beer you’ve got!’ The other says, ‘Give me the second-best beer you’ve got.’ The bartender pours the beers and states, ‘You can have them both for free if you can tell me why this one is better than that one.’”--Kjell Benson, MD, on why “quantifying quality” doesn’t help patients, writing in KevinMD
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H2R Minutes
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