Last edited by Faelkis
Wednesday, August 12, 2020 | History

1 edition of Focus on managed care and quality assurance : intergrating acute and chronic care found in the catalog.

Focus on managed care and quality assurance : intergrating acute and chronic care

Focus on managed care and quality assurance : intergrating acute and chronic care

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  • 3 Currently reading

Published by Springer Publishing in New York, NY .
Written in English

    Subjects:
  • Managed care plans (Medical care),
  • Aged -- Care.,
  • Aged -- Institutional care.

  • Edition Notes

    3

    StatementRobert J. Newcomer and Anne M. Wilkinson, eds.
    SeriesAnnual review of gerontology and geriatrics -- 16
    ContributionsNewcomer, Robert J., Wilkinson, Anne M.
    Classifications
    LC ClassificationsRC 952 A1 A56 V.16
    The Physical Object
    Paginationxviii, 259 p.
    Number of Pages259
    ID Numbers
    Open LibraryOL21112636M

    Quality indicators are likely to foster optimal quality of care only if disease-specific and general processes of care are assessed and valued. This dual focus will minimize unintended negative consequences of the application of quality indicators, and will stimulate additional research on the prioritizing function of general practice, which is. The proportion of Medicaid-enrolled children 0 to 20 years of age registered in managed care plans increased from % in federal fiscal year to % in federal fiscal year 3 Medicaid program shifts from fee-for-service to managed care plans have had little consistent effect on the health care use pattern by children and.

    Managed competition and managed care aim to create a competitive health market, which forces health care providers and financiers to deliver efficient and quality care [45, 49]. The methodology of cost-effectiveness studies has been developed to produce scientific knowledge for ranking alternative health interventions or programs in terms of. MMCD Annual Report California Department of Health Care Services Delmarva Foundation 3 Chapter 1: Monitoring and Measurement In the report Crossing the Quality Chasm, the Institute of Medicine (IOM) called for improvement in six dimensions of health care performance: safety, timeliness, effectiveness, patient-centeredness, efficiency, and.

    Integrated Functional Model- Created by integrating the utilization review and discharge planning activities into one role. Clinical Resource management models-The Case Manager follows the patient through acute care facilitating safe, timely, cost efficient care and transition to post acute care. The Healthcare Effectiveness Data and Information Set (HEDIS) is a widely used set of performance measures in the managed care industry, developed and maintained by the National Committee for Quality Assurance (NCQA).. HEDIS was designed to allow consumers to compare health plan performance to other plans and to national or regional benchmarks. Although not originally intended .


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Focus on managed care and quality assurance : intergrating acute and chronic care Download PDF EPUB FB2

ISBN: OCLC Number: Description: xviii, pages ; 24 cm. Contents: Chapter 1. Managed care in acute and primary care settings / Robert Newcomer, Charlene Harrington, and Robert Kane --Chapter te care: its role and the assurance of quality / Jennie Harvell --Chapter ng the care of nursing home residents: the challenge of integration /.

ISBN: OCLC Number: Description: 1 online resource (xviii, pages). Contents: Chapter 1. Managed care in acute and primary care settings / Robert Newcomer, Charlene Harrington, and Robert Kane --Chapter te care: its role and the assurance of quality / Jennie Harvell --Chapter ng the care of nursing home residents: the challenge of.

“The Outcomes and Costs of Care for Acute Low Back Pain among Patients Seen by Primary Care Practitioners, Chiropracters, and Orthopedic Surgeons,” The New England Journal of Medicine Cited by: The assurance of quality is a hallmark of health care and, with the adoption of pay-for-performance and evidenced-based medicine, it is becoming more important and more visible.

In healthcare institutions, quality assurance (QA) teams work throughout the system to design policies and procedures that promote the best possible patient outcomes.

In the National Committee for Quality Assurance released its first version of the “Health Plan—Employer Data and Information Set,” often referred to as the “managed care report card.” The HEDIS criteria were designed to allow comparison of health plan performance to allow purchasers (e.g., employers) to make informed selections.

An Overview of Health Care Quality The Ideal: Key Components of High Quality Health Care According to the IOM, there are six important components of a health care system that provides high quality care to individuals 1.

First, the system is safe (i.e., free from accidental injury) for all patients, in all processes, all the time. Chronic diseases are now the major cause of death and disability worldwide, responsible for 59 percent of deaths and 46 percent of the global burden of disease.

1 Despite advances in the effectiveness of treatment, research shows that patients frequently do not get the care they want or need. 2 The Chronic Care Model (CCM) is designed to help practices improve patient health outcomes by.

Behavioral Health Integration FAQs (PDF) Chronic Care Management. Changes to Chronic Care Management Services for Fact Sheet (PDF) Chronic Care Management Services Fact Sheet (PDF) Chronic Care Management Services FAQs (PDF) A federal government website managed and paid for by the U.S.

Centers for Medicare & Medicaid Services. Baylor Scott & White Quality Alliance (BSWQA) is the accountable care organization (ACO) affiliated with Baylor Scott & White Health. It is comprised of more than 6, primary and specialty care physician members, 50 hospitals, 95+ post-acute care facilities and other healthcare stakeholders all agreeing to be jointly accountable for improving quality, enhancing the patient experience and.

Introduction. Wennberg and others have documented large regional variations in how medical care is provided1 and Schoen and others reported large regional differences in health outcomes across various regions in the United States.2 In attempting to improve the quality and consistency of care provided across the United States, health service researchers have developed numerous process and.

Kaiser Permanente (KP) is a managed care organization known for its excellence and integrated care for over 9 million members (Strandberg-Larsen et al., ).

Of its 37 hospitals, 27 were named as Top Performers by TJC – i.e., 73% of its medical centers (The Joint Commission, ). KP is referred to as “integrated” because it provides. Long-term care also may include skilled and therapeutic care to treat and manage chronic conditions.

home and home care, assurance of quality, integrating acute and long-term care, and. Integrated care programs are being developed in countries all over the world in order to reduce fragmentation in care and to improve clinical outcomes, quality of life, patient satisfaction, effectiveness (use of evidence-based guidelines) and efficiency or reduce costs [1, 2].Integrated care is defined as a coherent and co-ordinated set of services which are planned, managed and delivered to.

The Institute of Medicine’s report, Vital Signs: Core Metrics for Health and Health Care Progress, highlights how “many measures focus on narrow or technical aspects of health care processes, rather than on overall health system performance and health outcomes” and finds that the proliferation of measures “has begun to create.

Managed Care is a health care delivery system organized to manage cost, utilization, and quality. Medicaid managed care provides for the delivery of Medicaid health benefits and additional services through contracted arrangements between state Medicaid agencies and managed care organizations (MCOs) that accept a set per member per month (capitation) payment for these services.

Six major, inter-related shifts in integration strategies were identified: (1) from a focus on horizontal integration to an emphasis on vertical integration; (2) from acute care and institution.

The Center for Medicaid and CHIP Services (CMCS) Quality Improvement (QI) Program provides state Medicaid and CHIP agencies and their quality improvement partners with the information, tools, and expert support they need to improve care and health outcomes, as demonstrated by performance on Medicaid and CHIP Child and Adult Core Set measures.

Technical assistance is available to help. --Overall, quality of care in MCO plans has been equivalent to traditional FFS --No negative impact on care based on race/socioeconomic status --Quality may be lower in for-profit plans vs.

nonprofit plans. -begun by federal govt for use in medicare and medicaid managed care plans, now also used by commercial health plans-maintained by AHRQ and required as part of NCQA accreditation process-initial focus was on managed health care plans, but is being expanded to ambulatory providers, hospitals, and the Medicare prescription drug program.

based services, informal caregiving, the integration of acute and long-term care, Medicare post-acute services and home care, managed care for people with disabilities, long-term rehabilitation services, children’s disability, and linkages between employment and health policies.

These activities are carried out through policy planning, policy and. Value-based care models focus on helping patients recover from illnesses and injuries more quickly and avoid chronic disease in the first place. As a result, patients face fewer doctor’s visits, medical tests, and procedures, and they spend less money on prescription medication as both near-term and long-term health improve.

The Measurement Year (MY) Integrated Primary Care (IPC) Quality Measure Set was created in collaboration with the Chronic Pulmonary, Heart, Diabetes, and Primary Care (Physical Health), Maternity Care, Behavioral Health, and Children's Health Clinical Advisory Groups (CAGs), as well as the New York State (NYS) Value Based Payment (VBP.

This glossary explores commonly used health care quality improvement terminology. Accountable Care Organization (ACO)—An accountable care organization is a group of health care providers (e.g.

primary care physicians, specialists and hospitals) that have entered into a formal arrangement to assume collective responsibility for the cost and quality of care of a specific group of .