Feb 252015
 
Purchasing Value – Not Yet Right for Medicare’s Frail Elders

By Joanne Lynn In late January, Department of Health and Human Services Secretary Sylvia Matthews Burwell announced that Medicare would purchase most services on the basis of value rather than volume, aiming for 90% of fee-for-service payments by 2018 [http://www.hhs.gov/blog/2015/01/26/progress-towards-better-care-smarter-spending-healthier-people.html]. Of course, paying on the basis of value is much better than paying on the […]

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Feb 022015
 
High and Worsening Symptom Prevalence in the Last Year of Life

by Adam Singer Symptoms such as pain and confusion are very distressing for those nearing the end of life and their families. That’s why increasing attention to end-of-life care is spurring greater interest in alleviating such symptoms as a critical component of quality of life. Yet there is still a long way to go: a […]

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Jan 262015
 
Initial CMS Evaluations of Readmissions Have Serious Flaws

by Joanne Lynn The Centers for Medicare and Medicaid Services (CMS) has quietly put out two evaluations of the readmissions work– and both documents are remarkable for their failure to evaluate the programs fairly or to provide insights as to what works in what circumstances. The Community-Based Care Transitions Program (CCTP) pays community-based organizations (often […]

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Dec 222014
 

By Elizabeth Rolf Take a look at the Swedish national dashboard for eldercare. It’s a great model. An analytics approach that works, Senior Alert (http://plus.lj.se/senioralert) takes the preventive care of every individual patient and inputs the data outcomes in a quality dashboard for each municipality, accessible to doctors, patients, and the public. The civic leader […]

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Dec 162014
 
Protecting Hospitals That Improve Population Health

by Stephen F. Jencks, M.D., M.P.H. [Also see companion post by Joanne Lynn, M.D.] Issue. The Medicare Readmission Reduction Program (MRRP) encourages hospitals to reduce readmissions within 30 days of discharge by imposing substantial financial penalties on hospitals with more readmissions than would be expected if the same patients were discharged from an average hospital.[1] […]

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Dec 082014
 
The Evidence That the Readmissions Rate (Readmissions/Hospital Discharges) Is Malfunctioning as a Performance Measure

By Joanne Lynn M.D. [Also see companion post by Stephen F. Jencks, M.D., M.P.H.] Care transitions improvement programs have been effective in helping the health care system both become more effective in serving people living with serious chronic conditions and reduce costs. However, the key metric used to measure performance is seriously malfunctioning in at […]

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Oct 282014
 
IMPACT’s Impact on Quality Measurement for Frail Elders

By Joanne Lynn What matters in the lives of frail elders centers on function — and understanding an elderly person’s course, over time, requires that everyone involved learn to measure functioning in the same way. That’s the core of the new Improved Medicare Post-Acute Care Transformation (IMPACT) Act, passed by Congress in September 2014. Within […]

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Sep 232014
 
IOM Supports Strengthening Social Services near EOL

The Institute of Medicine (IOM) report “Dying in America,” issued September 17, concludes that public and private insurance programs should integrate medical and social services in order to provide care consistent with people’s individual values, goals, and preferences as they approach the end of life. The IOM report underscores that, as currently configured, gaps in […]

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Aug 262014
 
A Dangerous Malfunction in the Measure of Readmission Reduction

By Joanne Lynn and Steve Jencks Work to reduce readmissions has started to yield remarkable improvements in integration of care for frail elderly people – by prompting hospital personnel to talk with community-based service providers, by teaching patients and families how to manage conditions and navigate the health care system more easily, and by paying […]

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Jul 302014
 
Include Family Caregiving in the White House Working Families Initiative

by Janice Lynch Schuster Age-related issues, including family caregiving, must become integral to the domestic policy agenda. Until now, they have received lip service. But here’s our opening to push for real conversation: The Obama Administration has declared a domestic policy focus on improving the lives of working families. At a June White House Summit […]

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