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Why do we need quality measures in emergency medicine?
J Am Coll Emerg Physicians Open
December 2024
Department of Emergency Medicine Stanford University Palo Alto California USA.
Quality measures increasingly influence the delivery and reimbursement of care provided in emergency departments. While emergency physicians are accustomed to using quality measures to improve care delivery, payors, including the Centers for Medicare and Medicaid Services (CMS), are increasingly adjusting reimbursement to measure performance as a means to bend the cost curve and improve the value of healthcare services. The American College of Emergency Physicians Quality and Patient Safety Committee presents this whitepaper to guide practicing emergency physicians through the policy context of implementing measures in emergency care and understanding its impact reimbursement.
View Article and Find Full Text PDFEarly Economic Modeling to Inform a Target Product Profile: A Case Study of a Novel Rapid Test for Infection.
MDM Policy Pract
November 2024
Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.
Unlabelled: Target product profiles (TPPs) specify the essential properties tests must have to be able to address an unmet clinical need. To explore how early economic modeling can help to define TPP specifications based on cost-effectiveness considerations using the example of a new rapid diagnostic for infection (CDI), a contagious health care-associated infection causing potentially fatal diarrhea. A resource-constrained simulation model was developed to compare a hypothetical test for CDI with current practice (i.
View Article and Find Full Text PDFAdvanced Nurse Practitioner (ANPs) experiences of the Quality and Outcomes Framework (QOF) Scheme: a UK case study.
BMJ Open
November 2024
Centre for Health Services Studies, University of Kent, Canterbury, UK.
Objectives: The primary focus of pay-for-performance (P4P) schemes in the UK has traditionally been related to the public health and inclusion elements related to the activities of doctors with comparatively less attention given to nursing care as a component of the scheme. However, nursing is an integral part of healthcare delivery in the National Health Service and nurses constitute the major group of healthcare professionals in most countries. Our aim was to explore advanced nurse practitioner (ANPs) experiences of the Quality and Outcomes Framework (QOF), using the Implicit Leadership Theory (ILT) frame.
View Article and Find Full Text PDFRelative-Value Units in Arthroplasty: Past, Present, and Future.
J Arthroplasty
November 2024
The Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland.
Relative value units (RVUs) were first introduced by the Omnibus Budget Reconciliation Act of 1989 to standardize physician compensation based on the effort, skill, and resources required for medical services. This methodology replaced the "usual, customary, and reasonable" standard, which reduced variability in payments across providers. RVUs are comprised of physician work, practice expenses, and malpractice costs.
View Article and Find Full Text PDFThe impact of financial incentives promoting biosimilar products in oncology: A quasi-experimental study using administrative data.
PLoS One
November 2024
Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Background: Biosimilars have the potential to save a significant amount of money in cancer treatment costs. However, barriers exist in the adoption of biosimilar products. Japan introduced a new health policy in 2022 to promote the use of biosimilars in oncology by offering financial incentives to eligible hospitals.
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