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Search results for: Studies by Others

Model State Health Care Price and Quality Transparency Legislation

In March 2013, the Health Care Incentives Improvement Institute and Catalyst for Payment Reform issued a report card ranking each state in the US on the availability and accessibility of health care services pricing. In December 2013, another report card…

July 25, 2013

Rhode Island – Health Insurance Bulletin 2013-1

Health Care Price Transparency

(a) Purpose. This Bulletin is issued by the Office of the Health Insurance Commissioner [of Rhode Island] for the purpose of communicating to health insurance issuers the Commissioner’s interpretation of their obligations under state laws and regulations to disclose to…

May 23, 2013

Designing Incentives to Improve Care: Tools from the Leapfrog Group

The Leapfrog Group is a coalition of many of the nation's largest corporations and public agencies founded by The Business Roundtable, a national association of Fortune 500 CEOs, to address patient safety and quality issues in the American health care…

March 22, 2013

Physician Pay-for-Performance in Medicaid: A Guide for States

Medicaid, one of the largest health care purchasers in the country, can play a leading role in testing the viability of physician-level pay-for-performance (P4P) strategies to improve health care quality for low-income, racially diverse, and chronically ill individuals. Physician Pay-for-Performance…

March 22, 2013

Wellness Incentives, Equity, and the Five Groups Problem

The study's author, 2009–10 Commonwealth Fund Harkness Fellow Harald Schmidt, characterized employees as belonging to one of five groups: "the lucky ones," whose behavior is effortlessly compatible with wellness goals; "the yes-I-can" group, who welcome the opportunity to join an…

March 22, 2013

Shared-Savings Payment Arrangements in Health Care: Six Case Studies

Driven by widespread interest in improving health care quality and reducing costs and by the Affordable Care Act’s “accountable care” provisions, shared-savings programs are gaining traction as an alternative approach to paying health care providers. Providers receive a share of…

March 22, 2013

Aligning Incentives in Medicaid: How Colorado, Minnesota, and Vermont Are Reforming Care Delivery and Payment to Improve Health and Lower Costs

Colorado, Minnesota, and Vermont are pioneering innovative health care payment and delivery system reforms. While the states are pursuing different models, all three are working to align incentives between health care payers and providers to better coordinate care, enhance prevention…

March 22, 2013

Ethical Physician Incentives – – From Carrots and Sticks to Shared Purpose

For ACOs to be successful, they must improve the efficiency of care, meet patients’ expectations for care and clinical outcomes, and attract and retain top-quality professionals. Incentives like pay-for-performance bonuses are key management tools for achieving these goals. Taken alone,…

March 22, 2013

Payments in Support of Effective Primary Care for Chronic Conditions

The researchers used Capital District Physicians’ Health Plan, a nonprofit network-model HMO in New York, as a test case. In January 2009, the plan launched a pilot program in three primary care practices where providers received bundled payments, adjusted to…

March 22, 2013

At Pitney Bowes, Value-Based Insurance Design Cut Copayments and Increased Drug Adherence

By eliminating or reducing copayments for key drugs prescribed for employees at risk for cardiovascular disease, a value-based health insurance program at the U.S.-based firm Pitney Bowes led to modest increases in medication adherence rates compared with a control group.…

March 22, 2013

Full Coverage for Preventive Medications After Myocardial Infarction

Heart attack patients discharged from the hospital were more likely to take prescription medications for their condition when copayments were eliminated, compared with patients who had copayments. Patients who had their copayments waived also experienced fewer heart attacks, strokes, and…

March 22, 2013

Full Coverage for Preventive Medications After Myocardial Infarction

Heart attack patients discharged from the hospital were more likely to take prescription medications for their condition when copayments were eliminated, compared with patients who had copayments. Patients who had their copayments waived also experienced fewer heart attacks, strokes, and…

March 22, 2013

The Impact of Reducing Cardiovascular Medication Copayments on Health Spending and Resource Utilization

Insurers impose copayments to reduce overall health care spending, but these higher out-of-pocket expenses can also prompt patients to reduce their use of essential medications. Previous studies have shown that reducing or eliminating copayments for cardiovascular medications prescribed after heart…

March 22, 2013

A Hospital System’s Wellness Program Linked to Health Plan Enrollment Cut Hospitalizations but Not Overall Costs

Employers are increasingly looking to wellness programs to encourge healthy behaviors among their employees and control health care spending. A study examining the effects of a wellness program on workers’ health service use found a substantial decrease in hospitalizations for…

March 22, 2013

Lessons from Medicare’s Demonstration Projects on Value-Based Payment

A summarization of the results of Medicare demonstrations of value-based payment systems, which give providers financial incentives to improve the quality and efficiency of care.  http://www.cbo.gov/sites/default/files/cbofiles/attachments/WP2012-02_Nelson_Medicare_VBP_Demonstrations.pdf

March 21, 2013

Rapidly Evolving Physician-Payment Policy More Than the SGR

An analysis and discussion of innovations and challenges in payment reform initiatives. http://www.nejm.org/doi/full/10.1056/NEJMhpr1004028

March 21, 2013

The Evidence for V-BID: Validating an Intuitive Concept

A sample of peer-reviewed research providing evidence, examples and insights on value-based insurance design. http://www.sph.umich.edu/vbidcenter/publications/pdfs/V-BID%20brief%20Evidence%20Nov2012.pdf

March 21, 2013

Assessing The Evidence For Value-Based Insurance Design

A study of value-based insurance design strategies including a description of implementations and results. (Abstract only, full text requires subscription) http://content.healthaffairs.org/content/29/11/1988.abstract

March 21, 2013

Choice Architecture Is A Better Strategy Than Engaging Patients To Spur Behavior Change ABSTRACT Patient engagement is increasingly seen as

Research on whether and in what settings patient engagement is or isn't effective.  (Abstract only. Full text requires subscription.) http://content.healthaffairs.org/content/32/2/242.abstract

March 21, 2013

Evaluating and negotiating payment options

A Guide for Providers

A resource guide for providers for evaluating and negotiating payment options. http://www.ama-assn.org/ama/pub/physician-resources/practice-management-center/claims-revenue-cycle/managed-care-contracting/evaluating-payment-options.page?

March 20, 2013

Purchaser-Provider Synergies Overview

Fact Sheet

In this program, the Agency for Healthcare Research and Quality (AHRQ) helps purchasers and providers enhance quality improvement, public reporting, and pay-for-performance programs. The effort is designed to help purchasers and providers understand the science behind early efforts and benefit…

March 20, 2013

Pay for Performance (P4P): AHRQ Resources

A compilation of Pay for Performance and other purchaser strategies, research and tools that are supported by the Agency for Healthcare Research and Quality http://www.ahrq.gov/legacy/qual/pay4per.htm

March 20, 2013

101 Economic Incentives for Preventive Care: Summary

Provider and Patient Incentives in Preventive Care

A compilation of literature and evidence on the impact of economic incentives targeted at motivating providers and consumers to adopt preventive health behaviors. http://www.ncbi.nlm.nih.gov/books/NBK11845/

March 20, 2013

Insurer Provides Financial Incentives, Infrastructure, and Other Support to Stimulate Provider Participation in Quality Improvement Collaborations

Policy Innovation Profile

A case study of insurer provided financial incentives, infrastructure and other support to stimulate provider participation in quality improvement collaborations http://www.innovations.ahrq.gov/content.aspx?id=3641

March 20, 2013

Innovative Policies: Using ACO Principles and Financial Incentives to Improve Health Outcomes

Webinar Series January 29 2013

Web seminar materials on innovative policies using ACO principles and financial incentives to improve health outcomes http://www.innovations.ahrq.gov/webevents/index.aspx?id=46

March 20, 2013