Connecting uninsured patients to primary care could reduce emergency department use

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1. Redesigned Geriatric Emergency Care May Have Helped Reduce Admissions Of Older Adults To Intensive Care Units [Improving Care Systems] Charged with transforming geriatric emergency care by applying palliative care principles, a process improvement team at New York City’s Mount Sinai Medical Center developed the GEDI WISE (Geriatric Emergency Department Innovations in Care through Workforce, Informatics, and Structural Enhancements) model. The model introduced workforce enhancements for emergency department (ED) and adjunct staff, including role redefinition, retraining, and education in palliative care principles. Existing ED triage nurses screened patients ages sixty-five and older to identify those at high risk of ED revisit and hospital readmission. Once fully trained, these nurses screened all but 6 percent of ED visitors meeting the screening...
2. Hospital Closures Had No Measurable Impact On Local Hospitalization Rates Or Mortality Rates, 2003-11 [Access To Care] The Affordable Care Act (ACA) set in motion payment changes that could put pressure on hospital finances and lead some hospitals to close. Understanding the impact of closures on patient care and outcomes is critically important. We identified 195 hospital closures in the United States between 2003 and 2011. We found no significant difference between the change in annual mortality rates for patients living in hospital service areas (HSAs) that experienced one or more closures and the change in rates in matched HSAs without a closure (5.5 percent to 5.2 percent versus 5.4 percent to 5.4 percent, respectively). Nor was...
3. Pioneer accountable care organization model shows smaller increases in Medicare spending In the first 2 years of the Pioneer Accountable Care Organization (ACO) Model, beneficiaries aligned with these ACOs, as compared with general Medicare fee-for-service beneficiaries, showed smaller......
4. Illinois Law Opens Door To Kidney Transplants For Undocumented Immigrants [Access To Care] SOURCE: Health Affairs current issue – Read entire story here....
5. Comparative Effectiveness And Cost-Effectiveness Analyses Frequently Agree On Value [Value & Quality] The Patient-Centered Outcomes Research Institute, known as PCORI, was established by Congress as part of the Affordable Care Act (ACA) to promote evidence-based treatment. Provisions of the ACA prohibit the use of a cost-effectiveness analysis threshold and quality-adjusted life-years (QALYs) in PCORI comparative effectiveness studies, which has been understood as a prohibition on support for PCORI’s conducting conventional cost-effectiveness analyses. This constraint complicates evidence-based choices where incremental improvements in outcomes are achieved at increased costs of care. How frequently this limitation inhibits efficient cost containment, also a goal of the ACA, depends on how often more effective treatment is not...