Week of April 11-15, 2016


Health Care Leadership and Management
Hospital staff and clinicians are often enthusiastic about participating in quality improvement initiatives that can lead to better patient outcomes, more efficient work processes, and increased patient and staff satisfaction. But such enthusiasm is no guarantee of success. Milestones in Quality Improvement Measurement. 

Easy-to-use tools, honest feedback, and incentives improved patient satisfaction scores with hospitalists at Rush University Medical Center. Learn how physician “facecards,” checklists, targeted feedback, and financial incentives can be adopted by other hospitalist programs.  How We Improved Hospitalist-Patient Communication,

Media reports on the VA’s access crisis suggested that hundreds of thousands of veterans may have been in immediate jeopardy due to long wait times for clinical services.  How the VA’s ‘Stand Down’ Resolved 56,000-Plus Urgent-Care Consults,

ACA Implementation
The attempt to impose quality and cost standards on health plans and doctors and hospitals appears to be the first by any Obamacare exchange in the nation.  California Insurance Marketplace Imposes New Quality, Cost Conditions On Plans,

Many insurers have found it difficult to turn a profit in the new markets created by the Affordable Care Act, where individuals turned out to be more costly to care for than the companies expected.  UnitedHealth Quitting Obamacare Markets in Georgia, Arkansas,

The latest problem with health plans obtained through the law’s exchanges is one that’s largely flown under the radar: the enormous deductibles that come with them. The Latest Problem under the Affordable Care Act: Deductibles,

A central challenge in designing health insurance plans is providing coverage that will provide for participants’ unexpected health care needs without encouraging unnecessary spending.  When insured individuals bear a smaller share of their medical care costs, they are likely to consume more care. This is known as “moral hazard.”  Disentangling Moral Hazard and Adverse Selection in Private Health Insurance, 

For workers covered by their employer’s health plans, out-of-pocket costs including deductibles and coinsurance have been increasing significantly faster than costs paid by insurers, reflecting a decade-long trend toward slightly less generous coverage, a new Kaiser Family Foundation analysis finds.  Payments for cost sharing increasing rapidly over time,

A new study, being released by Health Affairs, compared public opinion about the ACA between 2010 and 2014 and found a significant increase in appreciation for the tangible effects of the law in widening access to health insurance.  Significant Shifts Detected In Public Opinion About The ACA, 

What are the virtues and vices of single-payer reform? Is it a realistic option for the United States or a political impossibility?  The Virtues and Vices of Single-Payer Health Care,

In this analysis, the authors found a change in the rate of readmissions coincident with the enactment of the ACA, which suggested that the Hospital Readmissions Reduction Program may have had a broad effect on care, especially for targeted conditions.  In the long-term follow-up period, readmission rates continued to fall for targeted and non-targeted conditions, but at a slower rate.  Readmissions, Observation, and the Hospital Readmissions Reduction Program,


A Medicare proposal to test new ways of paying for chemotherapy and other drugs given in a doctor’s office has sparked a furious battle, and cancer doctors are demanding that the Obama administration scrap the experiment. Associated Press, 

Federal officials are expected to argue in court starting Monday that a large hospital merger in the Chicago area could hurt consumers and should be stopped. But a frenzy of smaller transactions is also profoundly changing the landscape, many of which face little regulatory resistance.  NY Times, 

At least six major health systems across the country have suffered debilitating cyberattacks this year. The rate has unsettled health system information technology administrators who are now working together to block future attacks.  Baltimore Sun, 

Today, CMS announced Comprehensive Primary Care Plus (CPC+), an advanced primary care model and our largest investment in primary care transformation to date.  The model will offer two tracks with incrementally advanced care delivery requirements and payment options to meet the diverse needs of primary care practices. CMS,

CMS announced a new primary care initiative Monday designed to improve primary care by helping practices transition to value-based care models.  Here are 13 things to know about the new initiative.  Becker’s,

Nine of the 10 states with the highest mortality rates are below the Mason-Dixon line, where life expectancy is two to four years shorter than the national average.  WSJ,

A small nonprofit group that assesses the value of medicines — and proposes a fair price — is quickly gaining value itself.  The Boston-based organization, which is funded by foundations as well as drug makers and insurance companies, has no power to actually drive down costs, but it is influential nonetheless.  STAT, 

Ten years ago today, then-Gov. Mitt Romney signed into law a bill with an ambitious goal: health coverage for virtually every Massachusetts resident. To mark the 10th anniversary, we asked health experts of all stripes to assess the law’s first decade. 12 facts and figures, NPR Boston,

The Centers for Medicare and Medicaid Services has been letting patients grade their hospital experiences, and those “patient experience scores” may give some insight into a hospital’s health outcomes, a new study suggests.  JAMA, 

The system for paying health care providers is extremely fragmented. In response, both the United States and the Netherlands are now experimenting with bundled-payment models.  I believe that the ongoing Dutch experience with bundled payments has unique lessons for U.S. policymakers.  NEJM Catalyst,

Given a choice between the doctor’s office or a retail health clinic when one of his children is sick, Aaron E. Carroll, a professor of pediatrics at Indiana University School of Medicine, said he chooses the retail clinic every time.  NY Times, 

Hospitals and healthcare institutions can reduce the spread of the emerging “superbug” carbapenem-resistant Enterobacteriaceae (CRE) by 75 percent when they coordinate their efforts, according to a study by the Johns Hopkins Bloomberg School of Public Health.  American Journal of Epidemiology,  

The decision by House Speaker Paul Ryan to bow out of any attempt to draft him as the Republican presidential nominee in Cleveland and press ahead with his domestic policy agenda could be significant for health care. The next big debate might not be about Republican proposals to repeal and replace the Affordable Care Act.  WSJ, 

The world’s largest surgeons’ organization has issued its first-ever guidelines for surgeons managing simultaneous operations, saying the controversial practice is broadly permissible, within limits, but that “the patient needs to be informed” whenever a doctor runs more than one operating room at a time. Boston Globe,

A CDC review published online Wednesday in the NEJM describes evidence of what U.S. health officials now call a causal relationship between the Zika virus and a severe form of microcephaly and intracranial calcifications.  NEJM,

The Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities held a workshop in October 2014 focusing on the use of digital health technologies to improve health outcomes for racial and ethnic minority population. Read the report. National Academy of Medicine, 



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