Like the private managed care plans offered under Medicare Advantage, private fee-for-service (PFFS) plans are paid more per beneficiary than those individuals would be expected to cost if they were enrolled in traditional fee-for-service Medicare. However, PFFS plans are not required to provide the same type of coordinated care required of Medicare Advantage plans. Payments to PFFS plans in 20...

A new approach to mental health nursing has reduced violent incidents on acute wards and cut the average length of stay by a quarter, according to research published today in Nursing Standard.

Despite its theoretical appeal, integrated care remains a new frontier for health and social care systems in many countries. A key motivation for increasing the integration of a range of health care services with socialor community-based services is the imperative to improve the patient experience, particularly for individuals with ongoing multiple and complex health care and functional needs. ...

Patient engagement has been identified as a key strategy for improving patient outcomes. In this paper, we describe the development and pilot testing of a web-based patient centered toolkit (PCTK) prototype to improve access to health information and to engage hospitalized patients and caregivers in the plan of care. Individual and group interviews were used to identify plan of care functional ...

Many purchasers and consumers of health care have become concerned about the quality of care being delivered in managed care plans. Little is known, however, about the health plan characteristics that are associated with better performance. We used survey responses from 82,583 Medicare beneficiaries from 182 health plans to study the association of consumers' assessments of care with health pla...

Widespread adoption of healthcare information systems has led to large amounts of patient care data with the potential for improvements in the cost and quality of patient care. However, extracting useful information from these large data sets using current systems is a cumbersome process and it is difficult to effectively utilize the data. This paper addresses is the creation of a multidimensio...

Purpose For the treatment of chronic back pain, it has been theorized that integrative care plans can lead to better outcomes than those achieved by monodisciplinary care alone, especially when using a collaborative, interdisciplinary, and non-hierarchical team approach. This paper describes the development and implementation of a care pathway designed to guide treatment by an integrative group...

• SPDs are the primary source of health plan information: The summary plan description (SPD) is the primary source of information for workers who participate in an employment-based health care plan. This study investigates whether private-sector employers' SPDs are written so that an average plan participant can identify and read important information contained in the document, as required by f...

OBJECTIVE To analyze the mechanisms employed by health plan operators for microregulation of clinical management and health care qualification within care-providing hospitals. METHODS A nation-wide cross-sectional study was carried out. The universe consisted of hospitals which provided care to health plan operators in 2006. A sample of 83 units was selected, stratified by Brazilian macroregi...

In Finland, a standardized data structure for continuous health and care planning is implemented as a Health and Care Plan (HCP) module in all electronic health record systems (EHR). The structure was initially published in 2011 and gradually implemented in the various EHR systems. In this study, the focus is on comparing the specifications of the data structure and the responses to a spring 20...