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What We’re Reading | Week of 2.27.2017

Healthcare is a rapidly evolving industry – it’s difficult to read up on everything that matters to you. But the success of your practice can depend on how knowledgeable you are about changes in the healthcare landscape. Privia has compiled a weekly list of important articles we are reading on healthcare industry trends, clinical best practices and legislative updates for your convenience. Here are some of the important articles and blogs on health care that stood out this week:

Interesting clip: “‘Physician-led ACOs have several advantages over those led by hospitals,’ says Sue Feldman, RN, Ph.D., an associate professor at the University of Alabama at Birmingham who conducts research on ACOs. ‘Physician-led groups can shop around for services, including shopping for diagnostics, specialists or post-acute care that a hospital cannot do,’ says Feldman. ‘If a hospital gets revenue from performing a diagnostic test, it’s hard for that hospital to negotiate with itself. Physician-led ACOs are not bound to one center and can look for a better price.’”

Interesting clip: “Population health puts people into categories by conditions (diabetes, hypertension, depression), age, lab results and medical billing data. These categories presume their own importance. When in fact, psychosocial, behavioral and environmental factors determine individual health far more.  Patient goals, preferences and barriers to care tell us what stands between that patient and better health. Without this data, population health efforts are undermined.”

Interesting clip: Expansion of MSSP and growth in the number of risk-sharing ACOs is due in large part to the passage of MACRA, which is accelerating the trend toward value-based initiatives through the Quality Payment Program. So far, it seems that MSSP has been successful saving a total of $466 million in 2015 and more than $1.29 billion total since 2012.”

Interesting clip: “A draft House Republican repeal bill would dismantle the Obamacare subsidies and scrap its Medicaid expansion, according to a copy of the proposal obtained by POLITICO. The legislation would take down the foundation of Obamacare, including the unpopular individual mandate, subsidies based on people’s income, and all of the law’s taxes. It would significantly roll back Medicaid spending and give states money to create high risk pools for some people with pre-existing conditions. Some elements would be effective right away; others not until 2020.”

  • Atul Gawande, MD, describes the differences between the two healthcare plans in Trumpcare vs. Obamacare, The New Yorker

Interesting clip: In a stalemate, Congress would likely need to delay repeal and, to reassure skittish insurers, focus on small-scale repairs, such as affirming that subsidies will continue to be funded, and either enforcing the existing mandate or revising it so that more young and healthy people sign on. (For instance, healthy people could be charged an extra ten per cent on premiums if they forgo insurance for a year, the same as the penalty for elderly people who refuse Medicare Part B.) In addition, the states that sat out the Medicaid expansion in order to thwart President Obama would be free to join in under a Republican Administration, as many would like to. “Insurance for everybody,” Trump has vowed. A Trumpcare compromise could yet bring us a step closer to it.

Findings:  This meta-analysis of 20 controlled interventions on 1550 physicians found that existing interventions were associated with small and significant reductions in burnout. The strongest evidence for effectiveness was found for organization-directed interventions, but these interventions were rare.

Meaning: More effective models of interventions are needed to mitigate risk for burnout in physicians. Such models could be organization-directed approaches that promote healthy individual-organization relationships.

>>Related blog: Are You One of 50% of Physicians Experiencing Burnout?

 

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