Healthy Aging
Commercial accountable care organization products: Market leaders and trends
In 2006, Elliott Fisher of Dartmouth coined the term “accountable care.” Accountable care arrangements are based on three principles: Accountability for quality: A group of providers is clinically and financially responsible for the entire continuum of care for a group of patients. Depending on the arrangement, providers, hospitals, and health insurers may share responsibility for the patients’ care. Shared savings: …
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Health care spending for chronic conditions in Michigan
Chronic conditions affect millions of Americans and have a major impact on U.S. health care spending each year, accounting for seven out of every ten deaths in the United States annually. It is estimated that more than 75 percent of all health care costs are associated with chronic diseases. Approximately 45 percent of Americans nationwide are affected by at least …
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Community mental health services: Coverage and delivery in Michigan
Since 1965, the number of Community Mental Health centers (CMHs) has increased from 12 covering 16 counties to 46 covering all 83 counties in Michigan. Today, Medicaid is the major source of most funding for the publicly funded mental health system in Michigan, and care at CMHs is an entitled benefit under Medicaid. As such, individuals with Medicaid coverage are …
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Best Practices in Care Management for Senior Populations
Care Management is a service designed to help patients and their caregivers manage medical conditions more effectively, in order to improve health and reduce the need for hospitalizations and emergency department visits. The concept arose in the past decade from disease management programs of the 1990s, which focused on individual diseases rather than more comprehensive consideration of patients’ needs. Care …
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Medicaid and Medicare Disproportionate Share Hospital programs
Congress created the Disproportionate Share Hospital (DSH) program in the early 1980s to help hospitals offset the costs of providing care to low-income individuals. Medicaid and Medicare each have a distinct DSH program, with a unique structure and financing mechanism. In addition to giving a brief overview of the Medicaid and Medicare Disproportionate Share Hospital programs, this document will: Discuss …
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Care transitions: Best practices and evidence-based programs
Poorly coordinated care transitions from the hospital to other care settings cost an estimated $12 billion to $44 billion per year. Poor transitions also often result in poor health outcomes. The most common adverse effects associated with poor transitions are injuries due to medication errors, complications from procedures, infections, and falls. Providers are focused on improving transitions, due in part …
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Affordable Care Act funding: An analysis of grant programs under health care reform
This brief examines grant programs funded by the Affordable Care Act (ACA), how funds have been distributed to states and local organizations, and the effects of budget sequestration on future ACA funding. The ACA aims to expand health insurance coverage and introduce health care delivery reforms that improve quality and lower costs. The ACA is designed to reduce the number …
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Acute care readmission reduction initiatives: Major program highlights
Beginning October 1, 2012, the Centers for Medicare and Medicaid Services (CMS) began reducing hospitals’ Medicare payments based on 30-day hospital readmission rates. The reductions are based on hospitals’ 30-day risk-adjusted readmission rates relative to national averages. Penalties are imposed for each hospital’s percentage of potentially preventable Medicare readmissions for those conditions. Under the Patient Protection and Affordable Care Act …
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Intensity-modulated radiation therapy for breast and lung Cancer: A review of use, cost, clinical evidence, and safety
Intensity-Modulated Radiation Therapy (IMRT) is a type of radiation therapy that uses inverse-planning tools to derive beamlets with variable intensities within each beam to deliver highly conformal radiation doses to tumors while reducing radiation doses to healthy tissues. Its ability to reduce the radiation dose to surrounding tissue means that higher doses can be given to tumors without increasing the …
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Advance directive registries: A policy opportunity
The most critical health care decisions facing patients and families are often made under the most difficult of circumstances—in emergencies, or when patients are not able to speak for themselves. When patients are unable to communicate their own wishes for treatment, and have not made them known to family or physicians in advance with an advance directive, it is up …
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