Skip to main content
Top
Published in: Journal of Medical Systems 8/2018

01-08-2018 | Systems-Level Quality Improvement

Medicare, Metrics and Trust in the Future

Author: Julie Babyar

Published in: Journal of Medical Systems | Issue 8/2018

Login to get access

Abstract

System improvements to Medicare are critical to ensure a stable and sustainable future. Measures and outcomes in Medicare are collaborative in foundation and have the potential to become even stronger. Utilization research, comparative effectiveness research and regulatory considerations must strive for best practice for the Medicare population. Government, regulatory, industry and academia should continue to work together for cost effective approaches that yield evidence-based interventions for positive health outcomes. Recommendations for improvements to the Medicare program are abundant and show strong potential to positively impact all of healthcare. These improvements will establish and maintain an even greater trust and positive view on what many consider a popular, vital social healthcare program in the U.S.
Literature
1.
go back to reference Levey, N. N., Medical professionalism and the future of public Trust in Physicians. JAMA 313(18):1827–1828, May 2015.CrossRefPubMed Levey, N. N., Medical professionalism and the future of public Trust in Physicians. JAMA 313(18):1827–1828, May 2015.CrossRefPubMed
2.
go back to reference National Academies Press, “What do we know about Trust In Government,” 2016. National Academies Press, “What do we know about Trust In Government,” 2016.
5.
go back to reference Blendon, R. J., and Benson, J. M., The public and the conflict over future Medicare spending. N. Engl. J. Med. 369(11):1066–1073, Sep. 2013.CrossRefPubMed Blendon, R. J., and Benson, J. M., The public and the conflict over future Medicare spending. N. Engl. J. Med. 369(11):1066–1073, Sep. 2013.CrossRefPubMed
13.
go back to reference “10 FAQs: Medicare’s Role in End-of-Life Care,” Kaiser Family Foundation, 2015. “10 FAQs: Medicare’s Role in End-of-Life Care,” Kaiser Family Foundation, 2015.
14.
go back to reference McClellan, M., Berenson, R., Chernew, M., Kramer, W., Lansky, D., and Milstein, A., Medicare physician payment reform: securing the connection between value and payment. Brookings Instsiute, 2015. McClellan, M., Berenson, R., Chernew, M., Kramer, W., Lansky, D., and Milstein, A., Medicare physician payment reform: securing the connection between value and payment. Brookings Instsiute, 2015.
17.
go back to reference Goldman, T. R., “Eliminating fraud and abuse,” Health Aff., 2012. Goldman, T. R., “Eliminating fraud and abuse,” Health Aff., 2012.
18.
go back to reference Duru, O. K., Ettner, S. L., Vassar, S. D., Chodosh, J., and Vickrey, B. G., Cost evaluation of a coordinated care management intervention for dementia. Am. J. Manag. Care 15(8):521–528, Aug. 2009.PubMedPubMedCentral Duru, O. K., Ettner, S. L., Vassar, S. D., Chodosh, J., and Vickrey, B. G., Cost evaluation of a coordinated care management intervention for dementia. Am. J. Manag. Care 15(8):521–528, Aug. 2009.PubMedPubMedCentral
19.
go back to reference Goodwin, S. M., and Anderson, G. F., Effect of cost-sharing reductions on preventive service use among Medicare fee-for-service beneficiaries. Medicare Medicaid Res. Rev. 2(1), Feb. 2012. Goodwin, S. M., and Anderson, G. F., Effect of cost-sharing reductions on preventive service use among Medicare fee-for-service beneficiaries. Medicare Medicaid Res. Rev. 2(1), Feb. 2012.
20.
go back to reference Jungerwirth, R., Wheeler, S. B., and Paul, J. E., Association of hospitalist presence and hospital-level outcome measures among Medicare patients. J. Hosp. Med. 9(1):1–6, Jan. 2014.CrossRefPubMed Jungerwirth, R., Wheeler, S. B., and Paul, J. E., Association of hospitalist presence and hospital-level outcome measures among Medicare patients. J. Hosp. Med. 9(1):1–6, Jan. 2014.CrossRefPubMed
21.
go back to reference Schell, W., A review: Discharge navigation and its effect on heart failure readmissions. Prof. Case Manag. 19(5):224–234, Sep. 2014.CrossRefPubMed Schell, W., A review: Discharge navigation and its effect on heart failure readmissions. Prof. Case Manag. 19(5):224–234, Sep. 2014.CrossRefPubMed
22.
go back to reference Saleh, S. S., Freire, C., Morris-Dickinson, G., and Shannon, T., An effectiveness and cost-benefit analysis of a hospital-based discharge transition program for elderly Medicare recipients. J. Am. Geriatr. Soc. 60(6):1051–1056, Jun. 2012.CrossRefPubMed Saleh, S. S., Freire, C., Morris-Dickinson, G., and Shannon, T., An effectiveness and cost-benefit analysis of a hospital-based discharge transition program for elderly Medicare recipients. J. Am. Geriatr. Soc. 60(6):1051–1056, Jun. 2012.CrossRefPubMed
23.
go back to reference Bielaszka-DuVernay, C., The ‘GRACE’ model: In-home assessments lead to better care for dual eligibles. Health Aff. 30(3):431–434, Mar. 2011.CrossRef Bielaszka-DuVernay, C., The ‘GRACE’ model: In-home assessments lead to better care for dual eligibles. Health Aff. 30(3):431–434, Mar. 2011.CrossRef
24.
go back to reference McCall, N., and Cromwell, J., Results of the Medicare health support disease-management pilot program. N. Engl. J. Med. 365(18):1704–1712, Nov. 2011.CrossRefPubMed McCall, N., and Cromwell, J., Results of the Medicare health support disease-management pilot program. N. Engl. J. Med. 365(18):1704–1712, Nov. 2011.CrossRefPubMed
25.
go back to reference Popejoy, L. L., Jaddoo, J., Sherman, J., Howk, C., Nguyen, R., and Parker, J. C., “Monitoring Resource Utilization in a Health Care Coordination Program,” Prof. Case Manag. vol. 20, no. 6, pp. 310–320, Nov. 15. Popejoy, L. L., Jaddoo, J., Sherman, J., Howk, C., Nguyen, R., and Parker, J. C., “Monitoring Resource Utilization in a Health Care Coordination Program,” Prof. Case Manag. vol. 20, no. 6, pp. 310–320, Nov. 15.
26.
go back to reference Ely, E. K. et al., A National Effort to prevent type 2 diabetes: Participant-level evaluation of CDC’s national diabetes prevention program. Diabetes Care 40(10):1331–1341, Oct. 2017.CrossRefPubMedPubMedCentral Ely, E. K. et al., A National Effort to prevent type 2 diabetes: Participant-level evaluation of CDC’s national diabetes prevention program. Diabetes Care 40(10):1331–1341, Oct. 2017.CrossRefPubMedPubMedCentral
27.
go back to reference Lloyd-Jones, D. M. et al., Estimating longitudinal risks and benefits from cardiovascular preventive therapies among Medicare patients: The million hearts longitudinal ASCVD risk assessment tool: A special report from the American Heart Association and American College of Cardiology. J. Am. Coll. Cardiol. 69(12):1617–1636, Mar. 2017.CrossRefPubMed Lloyd-Jones, D. M. et al., Estimating longitudinal risks and benefits from cardiovascular preventive therapies among Medicare patients: The million hearts longitudinal ASCVD risk assessment tool: A special report from the American Heart Association and American College of Cardiology. J. Am. Coll. Cardiol. 69(12):1617–1636, Mar. 2017.CrossRefPubMed
28.
go back to reference Manchikanti, L., Helm Ii, S., Benyamin, R. M., and Hirsch, J. A., Merit-based incentive payment system (MIPS): Harsh choices for interventional pain management physicians. Pain Physician 19(7):E917–E934, Sep. 2016.PubMed Manchikanti, L., Helm Ii, S., Benyamin, R. M., and Hirsch, J. A., Merit-based incentive payment system (MIPS): Harsh choices for interventional pain management physicians. Pain Physician 19(7):E917–E934, Sep. 2016.PubMed
29.
go back to reference Schrag, D., Reimbursing wisely? CMS’s trial of Medicare part B drug payment reform. N. Engl. J. Med. 374(22):2101–2105, Jun. 2016.CrossRefPubMed Schrag, D., Reimbursing wisely? CMS’s trial of Medicare part B drug payment reform. N. Engl. J. Med. 374(22):2101–2105, Jun. 2016.CrossRefPubMed
30.
go back to reference Held, K. S., New Medicare payment rule: A Trojan horse for government takeover. Journal of American Physicians and Surgeons 21(3):87–90, 2016. Held, K. S., New Medicare payment rule: A Trojan horse for government takeover. Journal of American Physicians and Surgeons 21(3):87–90, 2016.
31.
go back to reference Manchikanti, L., Falco, F. J. E., Benyamin, R. M., Helm, 2nd, S., Parr, A. T., and Hirsch, J. A., The impact of comparative effectiveness research on interventional pain management: Evolution from Medicare modernization act to patient protection and affordable care act and the Patient-Centered Outcomes Research Institute. Pain Physician 14(3):E249–E282, May 2011.PubMed Manchikanti, L., Falco, F. J. E., Benyamin, R. M., Helm, 2nd, S., Parr, A. T., and Hirsch, J. A., The impact of comparative effectiveness research on interventional pain management: Evolution from Medicare modernization act to patient protection and affordable care act and the Patient-Centered Outcomes Research Institute. Pain Physician 14(3):E249–E282, May 2011.PubMed
32.
go back to reference Dummit, L. A. et al., Association Between Hospital Participation in a Medicare Bundled Payment Initiative and Payments and Quality Outcomes for Lower Extremity Joint Replacement Episodes. JAMA 316(12):1267–1278, Sep. 2016.CrossRefPubMed Dummit, L. A. et al., Association Between Hospital Participation in a Medicare Bundled Payment Initiative and Payments and Quality Outcomes for Lower Extremity Joint Replacement Episodes. JAMA 316(12):1267–1278, Sep. 2016.CrossRefPubMed
33.
go back to reference Hussey, P. S., Liu, J. L., and White, C., The Medicare access and CHIP reauthorization act: Effects on Medicare payment policy and spending. Health Aff. 36(4):697–705, Apr. 2017.CrossRef Hussey, P. S., Liu, J. L., and White, C., The Medicare access and CHIP reauthorization act: Effects on Medicare payment policy and spending. Health Aff. 36(4):697–705, Apr. 2017.CrossRef
34.
go back to reference Mechanic, R., Post-acute care—The next frontier for controlling Medicare spending. N. Engl. J. Med. 370(8):692–694, 2014.CrossRefPubMed Mechanic, R., Post-acute care—The next frontier for controlling Medicare spending. N. Engl. J. Med. 370(8):692–694, 2014.CrossRefPubMed
35.
go back to reference Ackerly, D. C., and Grabowski, D. C., Post-acute care reform—Beyond the ACA. N. Engl. J. Med. 370(8):689–691, 2014.CrossRefPubMed Ackerly, D. C., and Grabowski, D. C., Post-acute care reform—Beyond the ACA. N. Engl. J. Med. 370(8):689–691, 2014.CrossRefPubMed
36.
go back to reference Chen, H.-F., Homan, S., Carlson, E., Popoola, T., and Radhakrishnan, K., The impact of race and neighborhood racial composition on preventable readmissions for diabetic Medicare home health beneficiaries. J Racial Ethn Health Disparities 4(4):648–658, Aug. 2017.CrossRefPubMed Chen, H.-F., Homan, S., Carlson, E., Popoola, T., and Radhakrishnan, K., The impact of race and neighborhood racial composition on preventable readmissions for diabetic Medicare home health beneficiaries. J Racial Ethn Health Disparities 4(4):648–658, Aug. 2017.CrossRefPubMed
37.
go back to reference Bruce, M. L. et al., Clinical effectiveness of integrating depression care management into medicare home health: The depression CAREPATH randomized trial. JAMA Intern. Med. 175(1):55–64, Jan. 2015.CrossRefPubMedPubMedCentral Bruce, M. L. et al., Clinical effectiveness of integrating depression care management into medicare home health: The depression CAREPATH randomized trial. JAMA Intern. Med. 175(1):55–64, Jan. 2015.CrossRefPubMedPubMedCentral
38.
go back to reference Vose, C. et al., Establishing a comprehensive networkwide pressure ulcer identification process. Jt. Comm. J. Qual. Patient Saf. 37(3):131–137, Mar. 2011.CrossRefPubMed Vose, C. et al., Establishing a comprehensive networkwide pressure ulcer identification process. Jt. Comm. J. Qual. Patient Saf. 37(3):131–137, Mar. 2011.CrossRefPubMed
39.
go back to reference Wu, S., Keeler, E. B., Rubenstein, L. Z., Maglione, M. A., and Shekelle, P. G., A cost-effectiveness analysis of a proposed national falls prevention program. Clin. Geriatr. Med. 26(4):751–766, Nov. 2010.CrossRefPubMed Wu, S., Keeler, E. B., Rubenstein, L. Z., Maglione, M. A., and Shekelle, P. G., A cost-effectiveness analysis of a proposed national falls prevention program. Clin. Geriatr. Med. 26(4):751–766, Nov. 2010.CrossRefPubMed
40.
go back to reference Clemens, J., Gottlieb, J. D., Shapiro, A. H., and Others, “How much do Medicare cuts reduce inflation?,” FRBSF Economic Letter, vol. 28, 2014. Clemens, J., Gottlieb, J. D., Shapiro, A. H., and Others, “How much do Medicare cuts reduce inflation?,” FRBSF Economic Letter, vol. 28, 2014.
Metadata
Title
Medicare, Metrics and Trust in the Future
Author
Julie Babyar
Publication date
01-08-2018
Publisher
Springer US
Published in
Journal of Medical Systems / Issue 8/2018
Print ISSN: 0148-5598
Electronic ISSN: 1573-689X
DOI
https://doi.org/10.1007/s10916-018-1012-8

Other articles of this Issue 8/2018

Journal of Medical Systems 8/2018 Go to the issue