Payment Reform for Better Value and Medical Innovation

2017 ◽  
Vol 7 (3) ◽  
Author(s):  
Mark B. McClellan ◽  
◽  
David T. Feinberg ◽  
Peter B. Bach ◽  
Paul Chew ◽  
...  
Keyword(s):  
Medical Innovation ◽  
Payment Reform

Medicare Payment Reform: Aligning Incentives for Better Care

2015 ◽  
Author(s):  
Gerard F. Anderson Anderson ◽  
Karen Davis Davis ◽  
Stuart Guterman Guterman
Keyword(s):  
Medicare Payment ◽  
Payment Reform

scholarly journals May I have your uterus? The contribution of considering complexities preceding live uterus transplantation

2021 ◽  
pp. medhum-2020-011864
Author(s):  
Lisa Guntram
Keyword(s):  
Medical Humanities ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
In Vitro Fertilisation ◽  
Medical Innovation ◽  
Uterus Transplantation ◽  
Ethical Debate ◽  
Care And Support ◽  
Different Dimensions

Uterus transplantation combined with in vitro fertilisation (IVF) (henceforth called UTx-IVF) as a treatment for infertility caused by an absence or malfunction of the uterus is advancing. About 50 transplantations have been conducted worldwide and at least 14 children have been born—9 of them by women taking part in a Swedish research project on UTx-IVF. The Swedish research protocol initially stated that the potential recipient must ‘have her own donor’ who is preferably related to the recipient. But what does it mean to ask someone for a uterus? What challenges does this question instigate? And what norms may it enact? In this article, I explore how 10 women—who have considered, and sometimes pursued, UTx-IVF—describe their experiences of searching for a donor. I aim to show how an analysis of such accounts can help us unpack some of the specific relational and gendered dimensions of UTx-IVF and by doing so enrich discussions of risks, benefits, care and support in UTx-IVF. Drawing on research in social sciences and medical humanities that has demonstrated how assisted reproductive technologies and organ donation can provoke social and familial conundrums, with respect to such topics as embodiment and identity, I present three patterns that describe different dimensions of the interviewees’ quest for a uterus donor. I discuss the negotiations that took place, how expectations unfolded and how entanglements were managed as the interviewees considered asking someone for a donation. Such an examination, I suggest, contributes to make care and support more attuned to the experiences and entanglements that UTx-IVF entails for those pursuing it. This will become increasingly important if (or when) UTx-IVF becomes part of general healthcare. To conclude, I problematise responsibilities and relational challenges in medical innovation, and in this way provide insights into how the ethical debate over UTx-IVF can broaden its scope.

Physician Payment Reform

JAMA ◽  
1994 ◽  
Vol 272 (24) ◽  
pp. 1890
Author(s):  
Bruce C. Vladeċk
Keyword(s):  
Physician Payment ◽  
Payment Reform

Perspectives: Physician Payment Reform: Lessons From Abroad

1989 ◽  
Vol 8 (4) ◽  
pp. 76-83 ◽  
Author(s):  
Victor G. Rodwin
Keyword(s):  
Physician Payment ◽  
Payment Reform

scholarly journals A Case-Mix System for Children and Youth With Developmental Disabilities

2020 ◽  
Vol 13 ◽  
pp. 117863292097789
Author(s):  
Shannon L Stewart ◽  
Angela Celebre ◽  
Michael J Head ◽  
Mary L James ◽  
Lynn Martin ◽  
...  
Keyword(s):  
Developmental Disabilities ◽  
Prospective Payment System ◽  
Individual Characteristics ◽  
Children And Youth ◽  
Case Mix ◽  
Care Needs ◽  
Payment Reform ◽  
Home Setting ◽  
Service Programs ◽  
The Cost

Limited funding across health and social service programs presents a challenge regarding how to best match resources to the needs of the population. There is increasing consensus that differences in individual characteristics and care needs should be reflected in variations in service costs, which has led to the development of case-mix systems. The present study sought to develop a new approach to allocate resources among children and youth with intellectual and developmental disabilities (IDD) as part of a system-wide Medicaid payment reform initiative in Arkansas. To develop the system, assessment data collected using the interRAI Child and Youth Mental Health-Developmental Disability instrument was matched to paid service claims. The sample consisted of 346 children and youth with developmental disabilities in the home setting. Using automatic interactions detection, individuals were sorted into unique, clinically relevant groups (ie, based on similar resource use) and a standardized relative measure of the cost of services provided to each group was calculated. The resulting case-mix system has 8 distinct, final groups and explains 30% of the variance in per diem costs. Our analyses indicate that this case-mix classification system could provide the foundation for a future prospective payment system that is centered around stability and equitability in the allocation of limited resources within this vulnerable population.

Coronaviruses: A Scientist’s Race Against Time

2020 ◽  
Author(s):  
Saloni Chaurasia ◽  
Keyword(s):  
Healthcare Workers ◽  
Vaccine Development ◽  
Drug Repurposing ◽  
Alveolar Epithelial Cells ◽  
Contact Tracing ◽  
Medical Innovation ◽  
Alveolar Epithelial ◽  
Treatment And Prevention ◽  
Scientific World ◽  
Respiratory Droplets

As the clock ticks, more and more people are falling victim to COVID-19, and scientists are racing against time to find treatment and prevention strategies. But what’s stopping them? The answer comes from two primary problems. Firstly, coronaviruses (CoVs) are transmitted from person-to-person via respiratory droplets from an infected person’s coughs or sneezes, which makes them highly contagious (CDC, How COVID-19 Spreads, 2020). This can happen in minutes, and up to 25% of patients remain asymptomatic (Du, et al., 2020). This makes it difficult for healthcare workers and researchers to contain patients and establish contact tracing to isolate the infected population. Secondly, it is hard to target CoVs without damaging our cells. CoVs infect via spike protein, which binds to the ACE2 receptor located on the lung alveolar epithelial cells (Hoffmann, et al., 2020). Once they invade the cell, CoVs hijack the host cell’s mechanisms to replicate. Thus, it is hard to combat the virus without damaging the host cell. On the other hand, recent understanding of CoVs structure and mechanism of action enables the scientific world to create a cure or vaccine. The bad news is that these efforts will likely face the perennial hurdles of medical innovation and discovery, long timelines of clinical trials for drug repurposing, and vaccine development, sometimes fickle funding, and changing governmental priorities.

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