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Background: Prior research has explored the link between health information technology (HIT) and performance of accountable care organizations (ACOs). However, the challenges of HIT use in ACOs for the management of chronic diseases among Medicare beneficiaries remain less examined.
Purpose: Given the high costs of implementing HIT and the occurrence of multiple chronic conditions (MCC) among elderly individuals, it is important to understand the extent to which HIT capabilities enable chronic disease management among the Medicare population.
Palliative Care Consults in the Southeast: Lower Readmissions Despite Increased Length of Stay.
J Palliat Med
January 2025
Department of Surgery, University of Tennessee Medical Center, Knoxville, Tennessee, USA.
: Inpatient palliative care (PC) consultations are increasingly used to address operational challenges. We aimed to understand how PC consultations in a southeastern program, affected by pandemic-related care delays, impacted common clinical performance metrics. : This is a retrospective analysis of a tertiary system's adult patients who received PC consultations from December 2021 to August 2022.
View Article and Find Full Text PDFDissemination of the Care Ecosystem Collaborative Care Model for Dementia.
J Am Geriatr Soc
January 2025
The Global Brain Health Institute, University of California, San Francisco, California, USA.
Background: Dementia represents a growing healthcare challenge in the United States. The Care Ecosystem, an effective collaborative care model, bridges medical and social care needs for individuals with dementia. The purpose of this study was to describe how the Care Ecosystem has been disseminated and the lessons learned from this experience.
View Article and Find Full Text PDFUse Of Patient Health Survey Data For Risk Adjustment To Limit Distortionary Coding Incentives In Medicare.
Health Aff (Millwood)
January 2025
Michael E. Chernew, Harvard University.
A core problem with the current risk-adjustment system in Medicare Advantage and accountable care organization (ACO) programs-the Hierarchical Condition Categories (HCC) model-is that the inputs (coded diagnoses) can be influenced for gain by risk-bearing plans or providers. Using existing survey data on health status (which provide less manipulable inputs), we found that the use of a hybrid risk score drawing from survey data and a scaled-back set of HCCs would, in addition to mitigating coding incentives, modestly lessen risk-selection incentives, strengthen payment incentives to deliver efficient care, allocate payment across ACOs more efficiently according to markers of population health that are not as affected by practice patterns or coding efforts, and redistribute payment in a manner that supports equity goals. Although sampling error and survey nonresponse present challenges, analyses suggest that these should not be prohibitive.
View Article and Find Full Text PDFNavigating performance measures for ambulatory antimicrobial stewardship: a review of HEDIS® and other metrics the steward should know.
Antimicrob Steward Healthc Epidemiol
December 2024
Department of Infectious Diseases, Henry Ford Hospital, Detroit, MI, USA.
Ambulatory antimicrobial stewardship can be challenging due to disparities in resource allocation across the care continuum, competing priorities for ambulatory prescribers, ineffective communication strategies, and lack of incentive to prioritize antimicrobial stewardship program (ASP) initiatives. Efforts to monitor and compare outpatient antibiotic usage metrics have been implemented through quality measures (QM). Healthcare Effectiveness Data and Information Set (HEDIS®) represent standardized measures that examine the quality of antibiotic prescribing by region and across insurance health plans.
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