HCI3 Library

Search results for: Studies by Others

Consumer Financial Incentives: A Decision Guide for Purchasers

This Guide reviews the application of incentives to five types of consumer decisions: (1) Selecting a high value provider, (2) Selecting a high value health plan, (3) Deciding among treatment options, (4) Reducing health risks by seeking preventive care, and…

March 20, 2013

Benefit Design Innovations: Implications for Consumer-Directed Health Care

A description of various innovations in benefit design for consumer directed health care and their policy implications http://www.hschange.com/CONTENT/913/#ib3

March 20, 2013

Using Evidence to Design Benefits

Research Insights

A research brief describing the use of evidence about medical effectiveness to design value-based benefit design. http://www.academyhealth.org/files/publications/RschInsightsDesignBenefit.pdf

March 20, 2013

Value-Based Purchasing Guide

An overview of various value-based benefit design strategies focusing on health behaviors, chronic condition management, medications, and provider choice http://www.nbch.org/VBBD-Introduction

March 20, 2013

Value-Based Ecosystem: value-based benefit design and outcomes-based contracting

Highlights and insights nto new efforts in outcomes-based design and value based benefit design to improve prevention and wellness, chronic care management, and care guidance/management. http://www.cyndynayer.com/value-based-ecosystem-brief/  …

March 20, 2013

Copayment Reductions Generate Greater Medication Adherence in Targeted Patients

Value-based insurance design program via BCBSNC eliminated generic medication copayments for brand name meds and improved adherence to meds for diabetes, hypertension, hyperlipidemia, and CHF. http://www.rwjf.org/en/research-publications/find-rwjf-research/2010/11/copayment-reductions-generate-greater-medication-adherence-in-ta.html

March 11, 2013

Health Care Benefits – Creating the Optimal Design

RWJF - Changes in Health Care Financing & Organization (HCFO)

Issue Brief describes the role of benefit design such as consumer-driven health plan and VBID to maximize coverage and offer incentives for quality and efficiency. http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2009/rwjf46743

March 11, 2013

Low-Value Services in Value-Based Insurance Design

Identifies low value medical treatments in order to deter their use http://www.ajmc.com/publications/issue/2010/2010-04-vol16-n04/AJMC_10apr_Neumann_280to286/

March 11, 2013

State Insurance Exchanges Face Challenges In Offering Standardized Choices Alongside Innovative Value-Based Insurance

How states and health plans aim to implement VBID http://content.healthaffairs.org/content/32/2/418.full?ijkey=vDdQOiqFqTlNc&keytype=ref&siteid=healthaff

March 11, 2013

Medication Adherence Changes Following Value-Based Insurance Design

VBIP design improves adherence to medications to treat cardiometabolic conditions http://www.ajmc.com/publications/issue/2012/2012-5-vol18-n5/Medication-Adherence-Changes-Following-Value-Based-Insurance-Design

March 11, 2013

Value-Based Insurance Design

More Health at Any Price

This article explores value-based insurance design (V-BID), which acknowledges the importance of cost-sharing, but aligns patient contributions with the intervention’s potential for clinical benefit. http://www.rwjf.org/en/research-publications/find-rwjf-research/2012/02/special-issue-of-health-services-research-links-health-care-rese/value-based-insurance-design.html

March 11, 2013

CMS Roadmaps for Quality Measurement, Resource Use and Promoting Value in Medicare: Charting a Path that Could Support Transformation in Health Care

Description of 3 "roadmaps" for achieving high value health care http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2009/rwjf47343

March 11, 2013

A Transparency and Accountability Framework for High-Value Inpatient Nursing Care

This article outlines a framework for achieving are rewarding high-value inpatient nursing care http://www.nursingeconomics.net/ce/2012/article28295306.pdf

March 11, 2013

Open Door Forum: Hospital Value-Based Purchasing

Fiscal Year 2013 Overview for Beneficiaries, Providers, and Stakeholders

CMS presentation that details the Hospital Value-Based Purchasing program https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/hospital-value-based-purchasing/downloads/HospVBP_ODF_072711.pdf

March 11, 2013

How does Medicare value-based purchasing work?

Issue Brief that describes Medicare's Value-Based Purchasing Program, created via the Affordable Care Act, which aims to reward hospitals that meet specific quality standards http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2012/rwjf73146

March 11, 2013

Hospitals on the Path to Accountable Care

Highlights from a 2011 National Survey of Hospital Readiness to Participate in an Accountable Care Organization

ABSTRACT: Accountable care organizations (ACOs) are forming in communities across the country. In ACOs, health care providers take responsibility for a defined patient popu- lation, coordinate their care across settings, and are held jointly accountable for the quality and cost…

August 17, 2012

Accountable Care Strategies

Lessons from the Premier Health Care Alliance's Accountable Care Collaborative

Abstract: Accountable care organizations (ACOs)—groups of providers that agree to take collective responsibility for delivering and coordinating care for a designated population—are being promoted as a means to improve health and health care while containing costs. This report shares the…

August 17, 2012

Delineating Episodes of Medical Care

The original idea for a medical episode is laid out here.  The usual measures used to document use of medical services were found insufficiently penetrating in a utilization study conducted by the authors. A useful measure which gives meaning and…

April 25, 2012

Medicare Spends Less Than Private Insurers On Knee Replacements

The federal government spends 14 percent less than private insurers for knee replacement surgery and its related costs, even though Medicare patients are older and twice as likely to be readmitted to the hospital, a research paper released this week…

March 9, 2012

An Experiment Shows That A Well-Designed Report On Costs And Quality Can Help Consumers Choose High-Value Health Care

Advocates of health reform continue to pursue policies and tools that will make information about comparative costs and resource use available to consumers. Reformers expect that consumers will use the data to choose high-value providers—those who offer higher quality and…

March 9, 2012

Medicare: Lack of Price Transparency May Hamper Hospitals’ Ability to Be Prudent Purchasers of Implantable Medical Devices

GAO: Report to the Chairman, Committee on Finance, U.S. Senate

Why GAO Did This Study — Implantable medical devices (IMD)— including a variety of cardiac and orthopedic devices provided to Medicare beneficiaries in inpatient or outpatient hospital settings—represent a significant share of hospitals’ supply costs. Hospitals purchase IMDs directly from manufacturers…

February 24, 2012

Reforming Payments to Healthcare Providers

The Key to Slowing Healthcare Cost Growth While Improving Quality?

The seemingly intractable debate about how to slow the growth of healthcare costs in the United States and elsewhere has traditionally boiled down to efforts to limit prices and quantities directly. In public healthcare programs, the focus in the United…

February 23, 2012

Sources of Regional Variation in Medicare Part D Drug Spending

Sources of regional variation in spending for prescription drugs under Medicare Part D are poorly understood, and such variation may reflect differences in health status, use of effective treatments, or selection of branded drugs over lower-cost generics… We analyzed 2008…

February 10, 2012

Medicare: Lack of Price Transparency May Hamper Hospitals™ Ability to Be Prudent Purchasers of Implantable Medical Devices

GAO: Report to the Chairman, Committee on Finance, U.S. Senate

From 2004 through 2009, expenditures for hospital IMD procedures increased from $16.1 billion to $19.8 billion, an increase of 4.3 percent per year—a rate equal to that of Medicare spending for other hospital procedures. While cardiac and orthopedic procedures accounted…

February 10, 2012

Summary of the National Demonstration Project and Recommendations for the Patient-Centered Medical Home

This article summarizes findings from the National Demonstration Project (NDP) and makes recommendations for policy makers and those implementing patient-centered medical homes (PCMHs) based on these findings and an understanding of diverse efforts to transform primary care. The NDP was…

February 8, 2012