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  • Time to Reassess the Cancer Compendia for Off-label Drug Coverage in Oncology

    Abstract Full Text
    JAMA. 2016; 316(15):1541-1542. doi: 10.1001/jama.2016.12770

    This Viewpoint argues that the current model of payment coverage decisions for oncology drugs based on third-party drug compendia is outdated and should be abandoned for a new approach.

  • The CMS Comprehensive Care Model and Racial Disparity in Joint Replacement

    Abstract Full Text
    JAMA. 2016; 316(12):1258-1259. doi: 10.1001/jama.2016.12330

    This Viewpoint discusses possible effects of the Centers for Medicare & Medicaid’s (CMS’s) 2016 comprehensive care for joint replacement payment model on racial disparities in joint replacement utilization.

  • Changing Physician Behavior Is Harder Than We Thought

    Abstract Full Text
    free access
    JAMA. 2016; 316(1):21-22. doi: 10.1001/jama.2016.8019
  • Medicare’s Vision for Advanced Primary Care: New Directions for Care Delivery and Payment

    Abstract Full Text
    JAMA. 2016; 315(24):2665-2666. doi: 10.1001/jama.2016.4472

    This Viewpoint discusses alternative payment models that reward value and quality, focusing on the Centers for Medicare & Medicaid Services’ Comprehensive Primary Care Plus model for advanced primary care medical homes.

  • Toward an Integrated Federal Health System

    Abstract Full Text
    JAMA. 2016; 315(23):2521-2522. doi: 10.1001/jama.2016.4641

    This Viewpoint discusses the fragmented nature of the current US federal health system and proposes approaches for achieving a more integrated and efficient system.

  • Implementing MACRA: Implications for Physicians and for Physician Leadership

    Abstract Full Text
    JAMA. 2016; 315(22):2397-2398. doi: 10.1001/jama.2016.7041

    This Viewpoint discusses the Medicare Access and CHIP Reauthorization Act and the key features of the law and the opportunities it presents to shape the future of payment and medical practice.

  • JAMA June 7, 2016

    Figure: Payment Models in the Traditional Medicare Program

    aAs of January 1, 2016, participants included 337 awardees and 1237 episode initiators (including 409 acute care hospitals, 700 skilled nursing facilities, 288 physician group practices, 100 home health agencies, 9 inpatient rehabilitation facilities, and 1 long-term care hospital) according to the CMS.bThe Merit-Based Incentive Payment System (MIPS) will adjust physician fees up or down based on quality, electronic health record adoption, and other factors as part of the Medicare Access and Children's Health Insurance Program Reauthorization Act of 2015 (MACRA).
  • JAMA June 7, 2016

    Figure: Five-Year Modeled Outcomes From Different Risk-Based CT Lung Cancer Screening Strategies in US Ever-Smokers Aged 50 to 80 Years

    As an example of a screening strategy (highlighted data), a lung cancer risk threshold of 0.7% and a lung cancer death threshold of 0.4% are estimated to screen 49% (21 million) of ever-smokers aged 50 to 80 years, prevent 90% (74 021) of preventable deaths over 5 years, screen 287 people to prevent 1 death, result in 185 false-positive computed tomography (CT) screening examinations per prevented death, and diagnose 0.94 extra lung cancers per prevented death. Data markers indicate data points for current US Preventive Services Task Force (USPSTF) and Centers for Medicare & Medicaid Services (CMS) recommendations, but the only axis data that apply to these 2 points are the estimated number of prevented deaths over 5 years and preventable lung cancer deaths over 5 years (vertical) and the estimated number and percent of ever-smokers screened (horizontal). USPSTF recommendations are estimated to screen 9.0 million (21%) of ever-smokers aged 50 to 80 years, might prevent 46 488 lung cancer deaths over 5 years (57% of the preventable deaths), screen 194 people to prevent 1 death, result in 133 false-positive CT screening examinations per prevented death, and diagnose 0.93 extra lung cancers per prevented death. CMS recommendations are estimated to screen 8.7 million (20%) of ever-smokers aged 50 to 80 years, might prevent 41 559 lung cancer deaths over 5 years (51% of the preventable deaths), screen 208 people to prevent 1 death, result in 142 false-positive CT screening examinations per prevented death, and diagnose 0.94 extra lung cancers per prevented death. Strategies below the curve, such as USPSTF and CMS recommendations, are estimated as having less screening effectiveness than risk-based strategies. USPSTF recommendations are estimated as having more screening effectiveness than CMS recommendations because CMS recommendations exclude older smokers (78-80 years), who can have higher risks of lung cancer.
  • Era 3 for Medicine and Health Care

    Abstract Full Text
    JAMA. 2016; 315(13):1329-1330. doi: 10.1001/jama.2016.1509

    In this Viewpoint, Berwick discusses 2 “eras” of the medical profession and offers changes that would be useful to move into a new “moral era.”

  • JAMA March 15, 2016

    Figure: Rate of Inpatient Hepatitis C Diagnoses Before and After Implementation of CMS Suppression Procedures

    CMS indicates Centers for Medicare & Medicaid Services. The “predicted trend” was the projected rate of diagnoses in the absence of the CMS suppression procedures, based on a continuation of the baseline trend. The shaded area indicates the 95% confidence band for the modeled trend.
  • CMS Grants to Address Social Needs of Beneficiaries

    Abstract Full Text
    JAMA. 2016; 315(8):741-741. doi: 10.1001/jama.2016.1077
  • CMS Reports Uptick in Health Care Spending

    Abstract Full Text
    JAMA. 2016; 315(4):336-336. doi: 10.1001/jama.2015.19189
  • Learning Systems at Scale: Where Policy Meets Practice

    Abstract Full Text
    JAMA. 2015; 314(20):2131-2132. doi: 10.1001/jama.2015.15079

    This Viewpoint discusses a learning system framework developed by the Center for Medicare & Medicaid Innovation to manage changes across multiple health systems in complex delivery and payment settings.

  • JAMA October 27, 2015

    Figure: Medicare ACOs Improving Quality of Care: CMS Report

    The CMS reports that Medicare ACOs are improving quality of care.
  • Medicare ACOs Improving Quality of Care: CMS Report

    Abstract Full Text
    JAMA. 2015; 314(16):1683-1683. doi: 10.1001/jama.2015.12840
  • CMS Proposes Payment for Advance Care Planning Discussions

    Abstract Full Text
    JAMA. 2015; 314(8):761-761. doi: 10.1001/jama.2015.9962
  • Hospital Characteristics Associated With Penalties in the Centers for Medicare & Medicaid Services Hospital-Acquired Condition Reduction Program

    Abstract Full Text
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    JAMA. 2015; 314(4):375-383. doi: 10.1001/jama.2015.8609

    This study uses CMS Hospital Compare data to characterize hospitals penalized financially for preventable adverse events and investigates associations between financial penalties and quality scores.

  • Guiding Principles for Center for Medicare & Medicaid Innovation Model Evaluations

    Abstract Full Text
    JAMA. 2015; 313(23):2317-2318. doi: 10.1001/jama.2015.2902

    This Viewpoint discusses the Innovation Center of the Centers for Medicare & Medicaid Services (CMS), which was created to evaluate new health care payment and delivery models.

  • The Repeal of Medicare's Sustainable Growth Rate for Physician Payment

    Abstract Full Text
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    JAMA. 2015; 313(20):2025-2026. doi: 10.1001/jama.2015.4550

    This Viewpoint discusses the repeal of Medicare’s sustainable growth rate formula for controlling physician payment and the implications for health care spending.

  • State Innovation Model Initiative: A State-Led Approach to Accelerating Health Care System Transformation

    Abstract Full Text
    JAMA. 2015; 313(13):1317-1318. doi: 10.1001/jama.2015.2017

    This Viewpoint describes the State Innovation Model initiative, including innovations states have made for health care delivery systems as well as lessons learned.