week 2

Question 1

triple aim

triple aim goal

Answer 1

better heath outcomes
improved pt experience
cost containment

right care, right place, right time, right price

Question 2

the “missing” aim

Answer 2

pt experience
population health
reducing costs

missing: care team well being

Question 3

systems thinkers

Answer 3

understanding big picture
meaningful connectd within and between systems

Question 4

value

Answer 4

health outcomes achieved/dollar spent

Question 5

value based care

Answer 5

a healthcare delivery model in which providers are based on pt health outcomes… providers are rewarded for helping pt improve their health, reduce the effects and incidence of chronic disease, and live healthier lives in an EBP way

Question 6

the new/future (value-based) business model

Answer 6

Question 7

“fee for service payment model needs reform because it ______”

Answer 7

rewards volume not value

Question 8

CMMI

Answer 8

“rules governing CMMI give the HHS secretary the authority to develop new payment and health care delivery methods, expant their scope, and increase their duration without additional legislation, provided the new models do not increase spending or compromise quality”

Question 9

role of afforadbale care act

Answer 9

established initiatives to identify payment approaches with goal of slower spending growth and improcements in quality of care

granted CMMI wide authority to design and test new models that aim to either:
- lower spending without reducing the quality of care
- improve the quality of care without increasing spending

Question 10

medical homes

Answer 10

• team based models of pt care
• rely heavily on PCP/team
• focus on coordination of the mojaority of health, illness, and wellness care for medicare beneficiairies
• more than half of states have incorporated medical homes into thier medicaid model

best serves:

Question 11

ACO
accountable care organization

Answer 11

• hospitals, doctos and other providers group together and agree to share collective accountability for the quality and cost of care delivered to the pts in their ACO
• payments to ACO incorporate finacial incentives in the form of shared savings or loses (bonuses or penalties) for perfromenace on indentified spending and quality metrics

Question 12

bundled payments

Answer 12

• focus on discrete episodes of care
• overall budget for service provided to a pt recceiving a course of treatment for a given clinical condition over a defined period of time
• provide incentives for providers to come in “under budget” for episides of care

Question 13

bundled payment equity risk

Answer 13

Question 14

what model impacts almost all PTs?

Answer 14

CJJR
comprehensive care for joint replacment model