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The book "Defining the Value of Spine Care" discuses the concepts of value-based spinal care to the spine care provider. The spinal care coverage and payment are linked increasingly to the value of care. Hence the spine care provider can easily understand the concepts of value in the context of spinal care, outcome measures and cost measures. Initial chapters provide detail information on understanding the value of spine care and definition of common terminology. This is followed by the use of process measures in measuring the quality of spine care and disease-specific health-related quality of life measures in lumbar degenerative disease and cervical degenerative disease. It also discusses the numerical rating scales, the quality-adjusted life year, decision tree analysis and simulation modeling in spine care, etc. The last few chapters explain about value-based evaluation of new spine-related technology, determining value with outcome measures in perspectives from each of the stakeholders of spine care delivery, developing value-based guidelines for the treatment of spinal disorders and comparative effectiveness research in spine care using SPORT. Spine care providers need to measure the quality and value of the treatment and provide tools necessary for understanding the task.
This book is a comprehensive guide to defining the value of spine care. Beginning with an introduction and definition of common terminology, the following chapters evaluate the processes and outcomes of spinal surgery. Written by recognised, US-based experts in the field, this practical manual provides spine care specialists with an in depth understanding of the key concepts, measurement tools and methods for value-based spine care.
Quality reporting is a rapidly growing area. Each year, new regulations in the US from the Council of Medicare and Medicaid Services make quality reporting a larger factor in determining reimbursement practices. Quality metrics are common parts of European clinical practice. Value of care is a focus of all payers, with specific interest directed at assessing the quality of care provided by a given healthcare team. While there are many publications in this space, no text has sought to provide an overview of quality in spine care. Quality measurement and quality reporting are ever growing aspects of the healthcare environment. Quality assessment is valuable to all healthcare stakeholders: patients, physicians, facilities, and payers. Patients are drawn to facilities that provide high value care; public reporting systems and grading systems for hospitals offer one opinion with regard to “high quality care.” Most physicians email inboxes are inundated with offers of recognition for being a “Top Doc” for a nominal fee. Some payers offer incentives to patients who chose to be treated at “Centers of Excellence” or similar facilities; the definition of “Excellence” may be unclear. There is little consensus on how to measure quality, how to incorporate patient and procedure factors and achieve accurate risk adjustment, and how to define value of care. Regardless of these challenges, regulatory efforts in the US, as well as numerous international efforts, make quality assessment and quality reporting an important part of physician behaviour. Physician and facility reimbursement for procedures are often tied to quality metrics. Spine procedures are costly, elective, and are a focus of many payer-based programs. Hence, spine care is often a focus of quality reporting efforts. This text summarizes the state of the art with regard to quality measurement, reporting, and value assessment in spine care. We will review quality reporting in the US and internationally. Chapters will outline how quality improvement efforts have achieved success in hospital systems. The reader will be provided with insights in how to achieve success incorporating quality metrics into spine care. Features: 1. Illustrates the state of the art in spine quality reporting: There is no text that thoroughly addresses quality assessment and quality reporting in spine care; there are, however, numerous articles in this space. This book provides a definitive text covering the state of the art for quality reporting in spine care and will be of value to the international orthopedic and neurosurgical spine community. 2. Provides insight on quality reporting in different healthcare systems: The text will allow for comparison of different quality reporting systems from different health care systems. This will provide practitioners with insight into the strengths and weaknesses of different approaches to quality reporting, and may drive improvement in quality assessment and reporting systems. A single text that features review of US, European, and Australia/Asian health care systems’ quality reporting is novel and will be thought provoking for readers. 3. Describes the US and international Healthcare reimbursement systems: Practicing physicians are provided with little information and less insight into the vagaries of the US and other healthcare systems. The text will provide insight into code development, valuation, and how quality reporting affects physician reimbursement 4. Explains risk adjustment: Appropriate risk adjustment and assessing patient and procedure factors that may impact quality reporting are invaluable to accurate quality measurement. The text will review risk adjustment, different approaches to risk assessment/mitigation, and provide physicians with insights into appropriate measures to capture in their clinical practices 5. Provides a foundation for improved quality assessment in spine care: While there are many disparate elements and differing approaches to capturing spine quality metrics, no definitive text has attempted to summarize these efforts in a single volume. By synthesizing these variable approaches, the reader may be provided with insights into superior approaches to quality assessment and a foundation will be provided for improving healthcare systems.
America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost. The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009-roughly $750 billion-was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances. About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care. This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.
This study measures the incidence and prevalence of musculoskeletal conditions and projects trends, presenting the latest national data illuminating the physical and economic costs. Several professional organizations concerned with musculoskeletal health and the mission of the U.S. Bone and Joint Decade collaborated to tabulate the data, to educate health care professionals, policy makers and the public.--Publisher's description.
The third installment in the Pathways to Quality Health Care series, Rewarding Provider Performance: Aligning Incentives in Medicare, continues to address the timely topic of the quality of health care in America. Each volume in the series effectively evaluates specific policy approaches within the context of improving the current operational framework of the health care system. The theme of this particular book is the staged introduction of pay for performance into Medicare. Pay for performance is a strategy that financially rewards health care providers for delivering high-quality care. Building on the findings and recommendations described in the two companion editions, Performance Measurement and Medicare's Quality Improvement Organization Program, this book offers options for implementing payment incentives to provide better value for America's health care investments. This book features conclusions and recommendations that will be useful to all stakeholders concerned with improving the quality and performance of the nation's health care system in both the public and private sectors.
Unique resource from internationally renowned experts details the key role of sagittal spine balance Through evolution, human verticality became associated with a wide range of normal pelvic shapes and associated pelvic incidence angles (PIs). While all types of sagittal alignment generally provide adequate support to young adults, age, stress, and related degeneration can progressively lead to sagittal imbalance and contribute to various spinal pathologies. Sagittal Balance of the Spine by Pierre Roussouly, João Luiz Pinheiro-Franco, Hubert Labelle, Martin Gehrchen, and a cadre of esteemed international contributors focuses on the importance of sagittal alignment and spino-pelvic shape identification in clinical practice. Offering the most comprehensive text on sagittal balance to date, this state-of-the-art, richly illustrated book fills a void in the literature, offering clinical pearls throughout seven sections and 24 chapters. Key Highlights The biomechanics of sagittal balance including spine modeling, primary parameters, spinal curves segmentation, and lumbar lordosis classification The role of sagittal balance in low back pain and degeneration, with discussion of spinal orientation and the contact forces theory, spinal degeneration associated with spinopelvic morphotypes, and compensatory mechanisms Comprehensive analysis of the relationship between sagittal imbalance and isthmic lysis spondylolisthesis, degenerative spondylolisthesis, Scheuermann's kyphosis, adolescent idiopathic scoliosis, and adult scoliosis Posterior and anterior treatment approaches – from spinal fixation and spinal fusion – to spinal osteotomy techniques and management of surgical failure This text is essential reading for every neurosurgical and orthopaedic resident, as well as veteran surgeons who evaluate and treat patients with spine conditions. Clinicians will learn why incorporating sagittal balance evaluations into spinal exams is integral to devising more effective treatment strategies and achieving improved outcomes.
Americans should be able to count on receiving health care that is safe. To achieve this, a new health care delivery system is needed â€" a system that both prevents errors from occurring, and learns from them when they do occur. The development of such a system requires a commitment by all stakeholders to a culture of safety and to the development of improved information systems for the delivery of health care. This national health information infrastructure is needed to provide immediate access to complete patient information and decision-support tools for clinicians and their patients. In addition, this infrastructure must capture patient safety information as a by-product of care and use this information to design even safer delivery systems. Health data standards are both a critical and time-sensitive building block of the national health information infrastructure. Building on the Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Patient Safety puts forward a road map for the development and adoption of key health care data standards to support both information exchange and the reporting and analysis of patient safety data.
The U.S. health care system is in crisis. At stake are the quality of care for millions of Americans and the financial well-being of individuals and employers squeezed by skyrocketing premiums—not to mention the stability of state and federal government budgets. In Redefining Health Care, internationally renowned strategy expert Michael Porter and innovation expert Elizabeth Teisberg reveal the underlying—and largely overlooked—causes of the problem, and provide a powerful prescription for change. The authors argue that competition currently takes place at the wrong level—among health plans, networks, and hospitals—rather than where it matters most, in the diagnosis, treatment, and prevention of specific health conditions. Participants in the system accumulate bargaining power and shift costs in a zero-sum competition, rather than creating value for patients. Based on an exhaustive study of the U.S. health care system, Redefining Health Care lays out a breakthrough framework for redefining the way competition in health care delivery takes place—and unleashing stunning improvements in quality and efficiency. With specific recommendations for hospitals, doctors, health plans, employers, and policy makers, this book shows how to move health care toward positive-sum competition that delivers lasting benefits for all.
Providing a sound definition and review of the pertinent treatment goals for the management of adult lumbar scoliosis, this practical and comprehensive guide covers everything from pre-operative evaluation and radiography to post-operative management and complications. Both non-operative and operative strategies are presented, including minimally invasive techniques, decompression, anterior release, spinal osteotomy, and proximal and distal fixation, with an emphasis on clinical guidelines and management outcomes. The impact and prevention of complications following treatment are also discussed, including the prevention of proximal junctional kyphosis. Concluding with an examination of future directions for research and clinical treatment strategies, the comprehensive approach of this book provides the orthopedic surgeon, neurosurgeon and spinal practitioner with the most current evidence and expert thought about the evaluation and management of adult lumbar scoliosis.