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Archive for the 'Quality' Category

A cancer tool to improve survival?

A recent paper by Basch et al. 2017, found that electronic patient-reported symptom monitoring improved patient overall survival by 5 months.  This finding came from a randomized clinical trial at Memorial Sloan Kettering. For patients in the arm with electronic patient-reported symptom monitoring, when “…participants reported a severe or worsening symptom, an email alert was triggered to a clinical […]

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What does “value” mean to patients?

There are numerous value frameworks being developed by an alphabet soup of organizations including ACC/AHA, ASCO, ICER, MSKCC, NCCN, and others.  These organizations generally represent providers or payer perspective on value.  But what does “value” mean to patients? The National Patient Advocate Foundation (PAF) provides their thoughts in a recent white paper titled “The Roadmap to […]

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Diagnostic Ability and Quality of Care

Quality of care often is seen as how physicians and other health care providers treat patients with a given disease.  Accurately diagnosing the disease a patient has, however, is in almost all cases a necessary condition to provide high-quality treatment.  Nevertheless, a physician’s ability to accurately diagnose a disease is rarely measured within exsting quality […]

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Measuring the quality of cancer care

How do you measure the quality of care patients with cancer receive?  How long they live?  Avoiding side effects?  Patient satisfaction? Process measures? Further, there are multiple types of cancer and different cancer have different recommended treatments and methods of providing care.  To further complicate the issue, new cancer treatments are being introduced in rapid succession; […]

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Aligning Incentives

An interesting story at AJMC on a new type of wellness program that better aligns outcomes with reimbursement: “Most wellness programs are like most gym memberships,” Adam Fawer, Noom’s chief operating officer, said in an interview. Employers have spent lots of money on programs that fail to help or even reach most of the staff, […]

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Quality of care and prices

There have been a number of studies that have examined how publicly reporting quality ratings (for health plans, physicians, hospitals or other health care providers) affects market share.  Less attention has been paid to the effect of measured quality on health care prices.  A paper by Huang and Hirth (2016) aim to answer just this […]

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Bengt Holmström’s Nobel Prize Lecture

Nobel Prize winner Bengt Holmström talks about the pros and cons of  pay-for-performance.  Interesting throughout.

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VBID in TRICARE

Value-based insurance design looks to be expanding. As the American Journal of Managed Care reports: The bill calls for a pilot demonstrating the feasibility of incorporating VBID by “reducing co-payments or cost shares for targeted populations of covered beneficiaries in the receipt of high-value medications and services and the use of high-value providers” no later […]

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Can we accurately classify physicians as high vs. low quality?

Medicare aims to tie 90% of reimbursement to quality measures.  The potential for quality-linked reimbursement to incentivized improved quality of care, however, depends critically on whether physician quality can be measured reliably. Profiling individual physicians is difficult. Sample sizes are small and attributing patients to a single physician can be difficult (as Mehtrotra et al. 2010 […]

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Geographic Variation in the Quality and Cost of Care for Patients with Rheumatoid Arthritis

This is the title of my latest article in JMCP co-authored with Arijit Ganguli,  Yuri Sanchez Gonzalez, Jin Joo Shim, and Seth A. Seabury.  The paper’s abstract is below. BACKGROUND: There is considerable push to improve value in health care by simultaneously increasing quality while lowering or containing costs. However, for diseases that are best […]

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