In healthcare, what gets measured gets done. This is particularly true as the use of value-based purchasing, alternative payment models, and consumer tools to compare quality expand in the U.S. Centering measurement on patients, and focusing on their needs, preferences, and values, ensures that what we measure really matters, not only to patients and their… Read More »
In today’s healthcare system, measurement influences everything from quality improvement to payments. So it matters greatly what gets measured. Measuring what matters to patients and their family caregivers will focus healthcare on their needs, preferences, and values. In a recent measure development effort, we brought lived and professional experience together at every stage. We found… Read More »
The current healthcare system is not built for individuals with serious illnesses. These individuals can benefit from palliative care, which focuses on quality of life and symptom relief. Alternative payment models that incorporate palliative care are in development. Yet, the challenges of expanding these models of care are substantial. Betsy recently died after a sixteen-year… Read More »
Reactions to the opioid crisis are affecting patients in need of hospice and end-of-life care in the United States. Hospice providers have been largely exempt from the increasing regulation of opioid and narcotic prescriptions, as most recent laws and regulations affecting opioid prescribing specifically exempt individuals receiving cancer treatment, palliative care, or those nearing their end-of-life. However,… Read More »
The Centers for Medicare and Medicaid Services (CMS) has a set of “Compare” websites – Hospital Compare, Nursing Home Compare, Home Health Compare, etc.; consumers and policymakers can compare physicians, long-term care hospitals, inpatient rehabilitation facilities, hospice care, and dialysis facilities today, and other settings may follow. Together with their associated health care quality measurement… Read More »
In narrative medicine, the clinician seeks to understand a patient’s story of their illness and their value system. Narrative medicine helps clinicians establish an empathic and therapeutic relationship with a patient, ideally resulting in a person-centered treatment plan. Rita Charon coined that term and approach in 2001 and expanded on it in numerous subsequent publications. Several sessions… Read More »
The population of the U.S is progressively becoming older; however, healthy aging is no longer an oxymoron. The availability of preventative medicine and health promotion programs have extended how long people can live healthy lives without chronic disability. Those aged 65 and over are projected to reach 83.7 million by 2050 [PDF]. While modern medicine has become… Read More »
The Centers for Medicare and Medicaid Services (CMS) wants to empower consumers to make informed healthcare decisions. CMS also wants providers to improve the quality of care they provide. One step towards accomplishing both of these goals is by public reporting of quality measures (QM). However, with multiple quality measures focusing on different care processes–all of which… Read More »
All falls are not equal, nor is the financial impact of how Medicare defines fall-related injuries (FRI). In a new Medical Care article published ahead of print, I worked with colleagues at UCLA’s Fielding School of Public Health to explore whether Medicare expenditures associated with fall-related injuries (FRI) depend on how FRIs are identified in… Read More »
One of the primary goals of measuring and publicly reporting quality of care is to empower consumers to make informed health care decisions. Numerous national efforts, many initiated as a result of requirements in the Affordable Care Act (ACA) of 2010, are underway to make information about quality of care available to the public. Despite… Read More »