Practicing Medicine in the Era of Health Reform References and … · 2018. 8. 23. · Tufts Health...
Transcript of Practicing Medicine in the Era of Health Reform References and … · 2018. 8. 23. · Tufts Health...
Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 1 of 15
Practicing Medicine in the Era of Health Reform
References and Readings
September 2015
Topics Page
Insurance and Health Plans 1
Medicare 1
Medicaid 2
Medicaid and Medicare Dual Eligibles 3
The Patient Protection and Affordable Care Act 3
Health Reform 4
Costs and Spending 5
Payment Reform 6
Delivery System Reform 9
Patient-Centered Medical Homes 10
Accountable Care Organizations 11
Community Health Centers 12
Health Disparities 12
Health Care Quality & Safety 13
Chronic Care Management 14
Career Paths 15
Insurance and Health Plans
American Academy of Actuaries. Drivers of 2015 Health Insurance Premium Changes.
Issue Brief, June 2014.
http://actuary.org/files/2015_Premium_Drivers_Updated_060414.pdf
Kaiser Family Foundation. Understanding Health Insurance. 2014.
http://kff.org/understanding-health-insurance/
Boisson S. Dr. Shadid’s Maverick Medicine. American History. April 2008.
http://www.historynet.com/dr-shadids-maverick-medicine.htm
Medicare:
Blumenthal D, Davis K, Guterman S. Medicare at 50 – origins and evolution. New
England Journal of Medicine. January 29, 2015;372(5):470-486. (part 1 of 2)
http://www.nejm.org/doi/full/10.1056/NEJMhpr1414856 … and … Blumenthal D,
Davis K, Guterman S. Medicare at 50 – moving forward. New England Journal of
Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 2 of 15
Medicine. February 12, 2015;372(7):671-677. (part 2 of 2)
http://www.nejm.org/doi/full/10.1056/NEJMhpr1414856
Centers for Medicare and Medicaid Services. Medicare. The Official U.S. Government
Site for Medicare. http://www.medicare.gov/
Kaiser Family Foundation. Medicare. http://kff.org/medicare/ … Medicare at a Glance.
2014. http://kff.org/medicare/fact-sheet/medicare-at-a-glance-fact-sheet/ … . Medicare:
A Primer. 2015.http://kff.org/medicare/report/a-primer-on-medicare-key-facts-about-the-
medicare-program-and-the-people-it-covers/
Kaiser Family Foundation. Medicare Advantage: Take Another Look. May 2014.
http://kff.org/medicare/perspective/medicare-advantage-take-another-look/ … Medicare
Advantage Fact Sheet. May 2014. http://kff.org/medicare/fact-sheet/medicare-advantage-
fact-sheet/ … Medicare Advantage 2015 Data Spotlight: Overview of Plan Changes.
2014.http://kff.org/medicare/issue-brief/medicare-advantage-2015-data-spotlight-
overview-of-plan-changes/
Newhouse JP; McGuire TG. How successful is Medicare Advantage? Milbank Quarterly.
June 2014;92(2):351-94.http://onlinelibrary.wiley.com/doi/10.1111/1468-
0009.12061/abstract
Medicaid:
Centers for Medicare and Medicaid Services. Medicaid. The Official U.S. Government
Site for Medicare. http://www.medicaid.gov/
Crowley R, Golden W. Health policy basics: Medicaid expansion. Annals of Internal
Medicine. March 18, 2014;160(6):423-425.
http://annals.org/article.aspx?articleid=1791502
Iglehart J, Sommers B. Medicaid at 50 — From welfare program to nation’s largest
health insurer. New England Journal of Medicine. May 28, 2015;372(22):2152-2159.
http://www.nejm.org/doi/full/10.1056/NEJMhpr1500791
Kaiser Family Foundation. Medicaid. http://kff.org/medicaid/ … Medicaid at 50. 2015.
http://kff.org/medicaid/report/medicaid-at-50/ … Medicaid Moving Forward. Issue Brief.
March 2015. http://kff.org/health-reform/issue-brief/medicaid-moving-forward/ …
Medicaid Financing: How Does it Work and What are the Implications? 2015.
http://kff.org/medicaid/issue-brief/medicaid-financing-how-does-it-work-and-what-are-
the-implications/
Kaiser Family Foundation.Key Findings on Medicaid Managed Care: Highlights from the
Medicaid Managed Care Market Tracker. 2014. http://kff.org/medicaid/report/key-
findings-on-medicaid-managed-care-highlights-from-the-medicaid-managed-care-
market-tracker/
Medicaid: Health Affairs, July 2015;34(7). Several articles.
http://content.healthaffairs.org/content/34/7.toc
Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 3 of 15
(Massachusetts) Boozang P, Anthony S, Glanz D. The Future of MassHealth: Five
Priority Issues for the New Administration. December 2014.
http://bluecrossmafoundation.org/publication/future-masshealth-five-priority-issues-new-
administration
Medicaid and Medicare Dual Eligibles:
Centers for Medicare and Medicaid Dual Eligibles under the Medicare and Medicaid
Programs. November 2014. http://www.cms.gov/Outreach-and-Education/Medicare-
Learning-Network-
MLN/MLNProducts/downloads/Medicare_Beneficiaries_Dual_Eligibles_At_a_Glance.p
df
Kaiser Family Foundation. Dual Eligible Resources. http://kff.org/tag/dual-eligible/
JAMA. Theme: Medicare and Medicaid at 50. (also includes articles on the Affordable
Care Act) JAMA. July 28, 2015;314(4).
http://jama.jamanetwork.com/Issue.aspx?journalid=67&issueID=934258&direction=P
The Patient Protection and Affordable Care Act (PPACA)
Blavin D, Shartzer A, et al. An early look at changes in employer-sponsored insurance
under the Affordable Care Act. Health Affairs. January 2015;34(1):170-177.
http://content.healthaffairs.org/content/34/1/170.abstract
Blumenthal D, Abrams M, Nuzum R. The Affordable Care Act at 5 Years. New England
Journal of Medicine. June 18, 2015;372(25):2451-2458.
http://www.nejm.org/doi/full/10.1056/NEJMhpr1503614
Commonwealth Fund. The Affordable Care Act: A Look Back at the First 5 Years. May
2015. http://www.commonwealthfund.org/publications/other/2015/may/aca-at-five
Kaiser Family Foundation, Health Reform and the Affordable Care Act.
http://kff.org/health-reform/
Cheng T, Wise P, Halfon N. Promise and perils of the Affordable Care Act for children.
JAMA. May 7, 2014;311(17):1733-1734.
Crowley R, Tape T. Health policy basics: Health insurance marketplaces. Annals of IM.
Dec. 3. 2013;159(11):784-786. http://annals.org/article.aspx?articleid=1741855
HealthCare.gov. A federal government Website managed by the U.S. DHHS.
http://www.hhs.gov/healthcare/ ... The Affordable Care Act, section by section.
http://www.healthcare.gov/law/introduction/index.html
Kaiser Family Foundation. The Uninsured: A Primer - Key Facts about Health Insurance
and the Uninsured in America. 2015. http://kff.org/uninsured/report/the-uninsured-a-
primer/
Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 4 of 15
Kaiser Family Foundation. How will the uninsured fare under the Affordable Care Act?
Fact Sheet. Apr 7, 2014. http://kff.org/health-reform/fact-sheet/how-will-the-uninsured-
fare-under-the-affordable-care-act/
Kingsdale J. After the false start — what can we expect from the new health insurance
marketplaces? New England Journal of Medicine. January 30, 2014; 370(5):393-396.
http://www.nejm.org/doi/full/10.1056/NEJMp1315956
Kaiser Family Foundation. Women and Health Care in the Early Years of the ACA: Key
Findings from the 2013 Kaiser Women's Health Survey May 15, 2014.
http://kff.org/womens-health-policy/report/women-and-health-care-in-the-early-years-of-
the-aca-key-findings-from-the-2013-kaiser-womens-health-survey/
Health Reform
Abrams A, Nuzum R, et al.The Affordable Care Act's Payment and Delivery System
Reforms: A Progress Report at Five Years. May 2015. Issue Brief. The Commonwealth
Fund. http://www.commonwealthfund.org/publications/issue-briefs/2015/may/aca-
payment-and-delivery-system-reforms-at-5-years
America’s Health Insurance Plans (AHIP). A Roadmap to High Quality Affordable
Health Care for All Americans. November 2013.http://www.ahip.org/Roadmap-
Affordable-Health-Care/
Blumenthal D. Big: Grappling with the Size of U.S. Health Care. Commonwealth Fund,
July 9, 2014. http://www.commonwealthfund.org/publications/blog/2014/jul/big-
grappling-with-the-size-of-the-us-health-system
Ignagni K. Health plan innovations in delivery system reforms. The American Journal of
Managed Care. April 2013;19(4):260-262.
http://www.ajmc.com/publications/issue/2013/2013-1-vol19-n4/Health-Plan-Innovations-
in-Delivery-System-Reforms/
Institute for Healthcare Improvement. The Triple Aim.
http://www.ihi.org/Engage/Initiatives/TripleAim/Pages/default.aspx
JAMA issue, November 13, 2013;310(18). Critical Issues in US Health Care. Several
articles by leading health care professionals.
http://jama.jamanetwork.com/issue.aspx?journalid=67&issueid=928805&direction=P
Oberlander J. Unfinished journey – a century of health care reform in the United States.
New England Journal of Medicine. Aug 16, 2012;367(7):585-590.
http://www.nejm.org/doi/full/10.1056/NEJMp1202111
Porter M, Lee T. Why strategy matters now. New England Journal of Medicine. April 30,
2015;372(18):1681-1684. http://www.nejm.org/doi/full/10.1056/NEJMp1502419
PwC. PricewaterhouseCoopers LLP, Top Health Industry Issues of 2015.
http://www.pwc.com/us/en/health-industries/top-health-industry-issues/index.jhtml
Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 5 of 15
The Commonwealth Fund. Health Reform & You. … Better Care at Lower Cost: Is It
Possible? November 2013. http://www.commonwealthfund.org/publications/health-
reform-and-you/better-care-at-lower-cost or
http://www.commonwealthfund.org/~/media/files/publications/health-reform-and-
you/health_reform_and_you_costs_11_22_2013_web_final.pdf
(Massachusetts) Blue Cross Blue Shield Massachusetts Foundation. Health Reform in
Massachusetts: Assessing the Results. Updated March, 2014
http://bluecrossmafoundation.org/publication/updated-health-reform-massachusetts-
assessing-results
o Chapter 224: What Does It Mean for Hospitals, Health Plans, Consumers, and
Clinicians? November 2012.
http://bluecrossmafoundation.org/publication/chapter-224-what-does-it-mean-
hospitals-health-plans-consumers-and-clinicians
o Reaching the Remaining Uninsured in Massachusetts: Challenges and
Opportunities. March 2013.
http://bluecrossmafoundation.org/publication/reaching-remaining-uninsured-
massachusetts-challenges-and-opportunities
Costs and Spending
Bradley E, Elkins B, et al. Health and social services expenditures: associations with
health outcomes. BMJ Quality & Safety. Oct. 2011;20(10):826-31.
http://qualitysafety.bmj.com/content/20/10/826.abstract
Cassel C, Brennan T. Managing medical resources: return to the commons? JAMA. June
13, 2007;297(22):2518-21. http://jama.jamanetwork.com/article.aspx?articleid=207406
Fuchs V. Major concepts of health care economics. Annals of Internal Medicine. March
3, 2015;162(5):380-383. http://annals.org/article.aspx?articleid=2173507
Fuchs VR. Major trends in the U.S. health economy since 1950. New England Journal of
Medicine. March 15, 2012;366(11):973-977.
http://www.nejm.org/doi/full/10.1056/NEJMp1200478
Hartman M, Martin A, et al, the National Health Expenditure Accounts Team. National
health spending in 2013: growth slows, remains in step with the overall economy. Health
Affairs. January 2015;34(1):150-160.
http://content.healthaffairs.org/content/34/1/150.abstract
Holahan J, McMorros S. The Widespread Slowdown in Health Spending Growth.
Implications for Future Spending Projections and the Cost of the Affordable Care Act.
Urban Institute & Robert Wood Johnson Fdtn. April 2015.
http://www.rwjf.org/en/library/research/2015/04/the-widespread-slowdown-in-health-
spending-growth.html
Kaiser Family Foundation. Health Care Costs. A Primer. May 2012. http://kff.org/health-
costs/report/health-care-costs-a-primer/
Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 6 of 15
Keehan S, Cuckler G, et al. National health expenditure projections, 2014-2024:
Spending growth faster than recent trends. Health Affairs. August 2015;34(8):1407-1417.
http://content.healthaffairs.org/content/34/8/1407
PwC. PricewaterhouseCoopers Health Industries. Behind the Numbers: Medical Cost
Trends for 2015. http://www.pwc.com/us/en/health-industries/behind-the-
numbers/index.jhtml
Robertson T, Lofgren R. Where population health misses the mark: breaking the 80/20
rule. Academic Medicine. March 2015;90(3):277-278.
http://journals.lww.com/academicmedicine/Fulltext/2015/03000/Where_Population_Heal
th_Misses_the_Mark___Breaking.11.aspx
Sisko A, Keehan S, et al. National health expenditure projections, 2013-23: faster growth
expected with expanded coverage and improving economy. Health Affairs. October
2014;33(10):1841-1850.
http://content.healthaffairs.org/content/early/2014/08/27/hlthaff.2014.0560.abstract
The Peterson-Kaiser Health System Tracker. Chart collection: How has health spending
changed over time? http://www.healthsystemtracker.org/chart-collection/how-has-health-
spending-changed-over-time/
(Massachusetts) Gyurina C, Rosinski J, Seifert R. Rising Health Care Costs in
Massachusetts: What It Means for Consumers. April 2015.
http://bluecrossfoundation.org/publication/rising-health-care-costs-massachusetts-what-
it-means-consumers
International:
Davis K, Stremikis K, et al. Mirror, Mirror on the Wall, 2014 Update: How the U.S.
Health Care System Compares Internationally, The Commonwealth Fund, June 2014.
http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror
Kaiser Family Foundation. Health Care Spending in the United States and Selected
OECD Countries. April 2011. http://kff.org/health-costs/issue-brief/snapshots-health-
care-spending-in-the-united-states-selected-oecd-countries/
Payment Reform
Antos J, Pauly M, Wilensky G. Bending the cost curve through market-based incentives.
New England Journal of Medicine. September 6, 2012;367:954-958.
http://www.nejm.org/doi/full/10.1056/NEJMsb1207996
Catalyst for Payment Reform. 2014 National Scorecard on Payment Reform.
http://www.catalyzepaymentreform.org/how-we-catalyze/national-scorecard
See press release, Sept. 30, 2014.
http://www.catalyzepaymentreform.org/images/documents/scorecard2014release ,
See summary:
http://www.catalyzepaymentreform.org/images/documents/nationalscorecard2014.pdf
Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 7 of 15
Friedberg M, Chen P, et al. Effects of Health Care Payment Models on Physician Practice
in the United States. Santa Monica, CA: RAND Corporation, 2015.
http://www.rand.org/pubs/research_reports/RR869 ... Full report (download) has
summary, pages 6-17 (or xi-xvii)
Gawande A. The Hot Spotters. (Can we lower medical costs by giving the neediest
patients better care?) The New Yorker. January 24, 2011.
http://www.newyorker.com/magazine/2011/01/24/the-hot-spotters Plus Dr. Gawande’s
follow-up commentary: Seeing Spots. January 27, 2011.
http://www.newyorker.com/news/news-desk/seeing-spots
Ginsburg P. Achieving health care cost containment through provider payment reform
that engages patients and providers. Health Affairs. May 2013;32(5):929-934.
http://www.hschange.org/CONTENT/1350/
Hostetter M, Klein S. Health Care Price Transparency: Can It Promote High-Value Care?
Quality Matters, April/May 2012. Commonwealth Fund.
http://www.commonwealthfund.org/Newsletters/Quality-Matters/2012/April-May/In-
Focus.aspx
Khullar D, Chokshi D, et al. Behavioral economics and physician compensation –
promise and challenges. New England Journal of Medicine. June 11, 2015;372(24):2281-
2283. http://www.nejm.org/doi/full/10.1056/NEJMp1502312
Landon B, Roberts D. Reenvisioning specialty care and payment under global payment
systems. JAMA. July 24/31, 2013;310(4):371-372.
McDonough J. The demise of Vermont’s single-payer plan. New England Journal of
Medicine. April 23, 2015;372(17):1584-1585.
http://www.nejm.org/doi/full/10.1056/NEJMp1501050
Mechanic R, Altman S, McDonough J. The new era of payment reform, spending targets,
and cost containment in Massachusetts: early lessons for the nation. Health Affairs.
October 2012;31(10):2334-2342.
http://healthforum.brandeis.edu/publications/pdf/Mechanic.Altman.Oct.2012.HIF.Site.Ve
rsion.pdf
Mechanic R, Zinner D. Many large medical groups will need to acquire new skills and
tools to be ready for payment reform. Health Affairs. Sept. 2012;31(9):1984-92.
http://healthforum.brandeis.edu/publications/pdf/Mechanic.Zinner.Sept.2012.HIF.Site.Ve
rsion.pdf
Network for Regional Healthcare Improvement, Center for Healthcare Quality and
Payment Reform, and Robert Wood Johnson Foundation. The Building Blocks of
Successful Payment Reform: Designing Payment Systems that Support Higher–Value
Health Care. Payment Reform Series Number 3. April 2015.
http://www.nrhi.org/uploads/nrhi_pymntrfrm_3_r10.pdf or link from
http://www.nrhi.org/work/implementing-payment-reform/
Quinn K. The 8 basic payment methods in health care. Annals of Internal Medicine.
Aug. 18, 2015;163(4):300-306. http://annals.org/article.aspx?articleid=2424877
Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 8 of 15
Schroeder S, Frist W, for the National Commission on Physician Payment Reform.
Phasing out fee-for-service payment. New England Journal of Medicine. May 23,
2013;368(21):2029-2032. http://www.nejm.org/doi/full/10.1056/NEJMsb1302322 and
http://physicianpaymentcommission.org/report/
Seidman J, Ganesan N. Payment Reform on the Ground: Lessons Learned from the
Alternative Quality Contract. Avalere Health. March 2015.
http://avalere.com/expertise/managed-care/insights/lessons-learned-from-blue-cross-blue-
shield-of-massachusetts-alternative-qu
Song Z, Rose S, Safran D, Landon B, et al. Changes in health care spending and quality 4
years into global payment. New England Journal of Medicine. October 30,
2014;371(18):1704-1714.http://www.nejm.org/doi/full/10.1056/NEJMsa1404026
Steinbrook R. Controlling health care costs in Massachusetts with a global spending
target. JAMA. Sept 26, 2012;308 (12):1215-1216.
VanLare J, Conway P. Value-based purchasing — national programs to move from
volume to value. New England Journal of Medicine. July 26, 2012; 367(4):292-295.
http://www.nejm.org/doi/full/10.1056/NEJMp1204939
Wehrwein P. Value = (Quality + Outcomes) / Cost. Managed Care. August 2015. (and
related articles on reimbursement methods)
http://www.managedcaremag.com/issue/2015/August
US Dept. of Health and Human Services, Centers for Medicare & Medicaid Services.
Three Fact sheets: Better Care, Smarter Spending, Healthier People. January 26, 2015:
Improving Our Health Care Delivery System.
http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-
sheets-items/2015-01-26.html
Paying Providers for Value, Not Volume.
http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-
sheets-items/2015-01-26-3.html
Why It Matters. http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-
sheets/2015-Fact-sheets-items/2015-01-26-2.html
Related: Burwell SM. Setting value-based payment goals – HHS efforts to
improve U.S. health care. New England Journal of Medicine. March 5,
2015;372(10):897-899. http://www.nejm.org/doi/full/10.1056/NEJMp1500445
and
Cutler D. Payment reform is about to become a reality. JAMA. April 18,
2015;313(16):1606-07.
http://jama.jamanetwork.com/article.aspx?articleid=2279699
Re: MACRA (Medicare Access and CHIP Reauthorization Act), enacted April 2015; and
MIPS (Merit-Based Incentive Payment System) and APM (alternative payment models).
Summaries: Doherty R. Goodbye, Sustainable Growth Rate – Hello, Merit-based
Incentive Payment System. Annals of Internal Medicine. Published online, May 12, 2015.
http://annals.org/article.aspx?articleid=2292049 … National Association of ACOs
Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 9 of 15
https://www.naacos.com/pdf/MACRASummary050415.pdf ... Mintz Levin
http://www.healthlawpolicymatters.com/2015/04/20/with-sgr-repealed-replacement-
policy-creates-new-priorities/ … McClellan M, Berenson R, Chernew M, Kramer W,
Lansky D, Milstein A. Health Policy Issue Brief: Medicare Physician Payment Reform:
Securing Connection Between Value and Payment. Washington, DC: The Brookings
Institution; January 2015. http://www.brookings.edu/research/papers/2015/01/27-
medicare-physician-payment-reform-mcclellan
Delivery System Reform
America’s Health Insurance Plans (AHIP). High Value Provider Networks. December
2013. http://www.ahip.org/Issues/Health-Care-Quality.aspx
Baron R, Davis K. Accelerating the adoption of high-value primary care — a new
provider type under Medicare? New England Journal of Medicine. January 9,
2014;370(2):99-101. http://www.nejm.org/doi/full/10.1056/NEJMp1314933
Berwick D, Hackbarth A. Eliminating waste in US health care. JAMA. Apr 11,
2012;307(14):1513-6. http://jama.jamanetwork.com/article.aspx?articleid=1148376
Cosgrove D, Fisher M, Gabow P, et al. A CEO Checklist for High-Value Health Care.
Discussion paper. Washington, DC: Institute of Medicine; 2012.
http://www.iom.edu/Global/Perspectives/2012/CEOChecklist.aspx and related: Gabow P,
Halvorson G, Kaplan G. Marshaling leadership for high-value health care: an Institute of
Medicine discussion paper. JAMA. July 18, 2012;308(3):239-240.
http://jama.jamanetwork.com/article.aspx?articleid=1172505
Daschle T, Domenici P, Frist W, Rivlin A. The Bipartisan Policy Center. Prescription for
patient-centered care and cost containment. New England Journal of Medicine. August 1,
2013;369(5):471-474. http://www.nejm.org/doi/full/10.1056/NEJMsb1306639 or
http://bipartisanpolicy.org/news/articles/2013/06/prescription-patient-centered-care-and-
cost-containment
Fineberg H. A successful and sustainable health system — how to get there from here.
New England Journal of Medicine. March 15, 2012;366(11):1020-1027.
http://www.nejm.org/doi/full/10.1056/NEJMsa1114777
Gawande A. Overkill. (An avalanche of unnecessary medical care is harming patients
physically and financially. What can we do about it?) The New Yorker. May 11,
2015.http://www.newyorker.com/magazine/2015/05/11/overkill-atul-gawande
Gawande A. Big Med. The New Yorker. August 13, 2012.
http://www.newyorker.com/reporting/2012/08/13/120813fa_fact_gawande
Goldsmith J. A Blueprint for a More Effective, Physician-Directed Health System. The
Physicians Foundation. May 2013. http://www.physiciansfoundation.org/healthcare-
research/a-blueprint-for-a-more-effective-physician-directed-health-system
Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 10 of 15
Hussey P, Armstrong C, Schneider E. Paths to Sustainability for Innovative Delivery
System Programs. Santa Monica, CA: RAND Corporation, 2015.
http://www.rand.org/pubs/research_reports/RR1090
Institute of Medicine. Best Care at Lower Cost: The Path to Continuously Learning
Health Care in America. September 6, 2012. http://www.iom.edu/Reports/2012/Best-
Care-at-Lower-Cost-The-Path-to-Continuously-Learning-Health-Care-in-America.aspx
and Report Brief http://www.iom.edu/Reports/2012/Best-Care-at-Lower-Cost-The-Path-
to-Continuously-Learning-Health-Care-in-America/Report-Brief.aspx
Marcotte L, Moriates C, Milstein A. Professional organizations’ role in supporting
physicians to improve value in health care. JAMA. July 16, 2014; 312(3):231-232.
National Patient Safety Foundation, Lucien Leape Institute. Order from Chaos:
Accelerating Care Integration.2012. http://www.npsf.org/?page=orderfromchaos
Partnership for Sustainable Health Care. Strengthening Affordability and Quality in
America's Health Care System. April 2013. Summary: http://www.rwjf.org/en/research-
publications/find-rwjf-research/2013/04/strengthening-affordability-and-quality-in-
america-s-health-care.html and Full report:
http://www.rwjf.org/content/dam/farm/reports/reports/2013/rwjf405432
Tilburt J, Wynia M, et al. Views of US physicians about controlling health care costs.
JAMA. July 24/31, 2013;310(4):380-388.
http://jama.jamanetwork.com/article.aspx?articleid=1719740
Torchiana D, Colton D, et al. Massachusetts General Physicians Organization’s quality
incentive program produces encouraging results. Health Affairs. October
2013;32(10):1748-1756. http://content.healthaffairs.org/content/32/10/1748.abstract
Patient-Centered Medical Homes
Agency for Healthcare Research and Quality. The Patient Centered Medical Home
Resource Center. http://www.pcmh.ahrq.gov/
Huang X, Rosenthal M. Transforming specialty practice – the patient-centered medical
neighborhood. New England Journal of Medicine, April 10, 2014;370(15):1376-1379.
http://www.nejm.org/doi/full/10.1056/NEJMp1315416
National Committee for Quality Assurance (NCQA). Patient-Centered Medical Home
Recognition Program.
http://www.ncqa.org/Programs/Recognition/Practices/PatientCenteredMedicalHomePCM
H.aspx … The Future of Patient-Centered Medical Homes. March 2014.
http://www.ncqa.org/Portals/0/Public%20Policy/2014%20Comment%20Letters/The_Fut
ure_of_PCMH.pdf
Patient-Centered Primary Care Collaborative (PCPCC). The Medical Home.
https://www.pcpcc.org/about/medical-home
Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 11 of 15
Schneider E. Strengthening Primary Care amid the Hype. June 1, 2015. Commonwealth
Fund. http://www.commonwealthfund.org/publications/blog/2015/jun/strengthening-
primary-care-amid-the-hype
Accountable Care Organizations
Calandra R. The ACO Gamble. Managed Care Magazine. June 2015;24(6):20-25.
http://managedcaremag.com/archives/2015/6/aco-gamble
Casalino L. Accountable Care Organizations – The risk of failure and the risks of
success. New England Journal of Medicine. October 30, 2014;371(18):1750-1751.
http://www.nejm.org/doi/full/10.1056/NEJMe1410660
Centers for Medicare & Medicaid Services. Innovation Center. Accountable Care
Organizations. http://innovation.cms.gov/initiatives/ACO/… Next Generation ACO
Model. March 2015. http://innovation.cms.gov/initiatives/Next-Generation-ACO-Model/
Colla C, Lewis V, et al. First national survey of ACOs finds that physicians are playing
strong leadership and ownership roles. Health Affairs. June 2014;33(6):964-971.
http://content.healthaffairs.org/content/33/6/964.abstract
Epstein A, Jha A, et al. The Care Span: Analysis of early Accountable Care
Organizations defines patient, structural, cost, and quality-of-care characteristics. Health
Affairs. January 2014;33(1):95-102.
http://content.healthaffairs.org/content/33/1/95.abstract
Gold J. FAQ On ACOs: Accountable Care Organizations, Explained. Kaiser Health
News. April 16, 2014. http://www.kaiserhealthnews.org/stories/2011/january/13/aco-
accountable-care-organization-faq.aspx?referrer=search
McCarthy D, Klein S, Cohen A. The Road to Accountable Care: Building Systems for
Population Health Management. The Commonwealth Fund, October 2014.
http://www.commonwealthfund.org/publications/case-studies/2014/oct/road-to-
accountable-care-synthesis and
http://www.commonwealthfund.org/~/media/files/publications/case-
study/2014/oct/1768_mccarthy_road_to_accountable_care_case_studies_synthesis.pdf
McClellan M. Accountable Care Organizations and evidence-based payment reform.
JAMA. June 2, 2015;313(21):2128-2129.
http://jama.jamanetwork.com/article.aspx?articleid=2290607
McWilliams J, Landon B, et al. Changes in patients’ experiences in Medicare
Accountable Care Organizations. New England Journal of Medicine. October 30,
2014;371(18):1715-1724. http://www.nejm.org/doi/full/10.1056/NEJMsa1406552
Mostashari F, Sanghavi D, McClellan M. Health reform and physician-led accountable
care: The paradox of primary care physician leadership. JAMA. May 14,
2014;311(18):1855-1856.
Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 12 of 15
National Committee for Quality Assurance. Accountable Care Organization
Accreditation.
http://www.ncqa.org/Programs/Accreditation/AccountableCareOrganizationACO.aspx
Nyweide D, Lee W, et al. Association of Pioneer Accountable Care Organizations vs.
traditional Medicare fee for service with spending, utilization, and patient experience.
JAMA. June 2, 2015;313(21):2152-2161.
o Editorial: Casalino L, Pioneer Accountable Care Organizations: Traversing rough
country. JAMA. June 2, 2015;313(21):2126-2127.
Oliver Wyman Consulting. Accountable Care Organizations. ACO Update: A Slower
Pace of Growth in 2014. April 2015. … and ACO Update: Accountable Care at a
Tipping Point. April 2014.
http://www.oliverwyman.com/insights/publications/2014/may/accountable-care-strategy-
hub.html
Pham H, Cohen M, Conway P. The Pioneer Accountable Care Organization model:
improving quality and lowering costs. JAMA. Oct. 22/29, 2014;312(16):1635-6.
Pham H, Pilotte J, et al. Medicare’s vision for delivery system reform – the role of ACOs.
New England Journal of Medicine. September 10, 2015;373(11):987-990.
http://www.nejm.org/doi/full/10.1056/NEJMp1507319
Wehrwein P. An Accounting of ACOs: Where they are, what they are, and how many
there are. Managed Care. November 2014; 23(11):26-29.
http://www.managedcaremag.com/archives/2014/11/accounting-acos
Community Health Centers
National Association of Community Health Centers (NACHC). http://www.nachc.com
o Research Fact Sheets and Infographics. Including “America's Health Centers Fact
Sheet, October 2014” http://www.nachc.com/research-factsheets.cfm
o Health Center Model, Patients, and Services. Including “A Sketch of Community
Health Centers: Chartbook 2014”
http://www.nachc.com/Overview%20of%20Health%20Centers.cfm
Health Services and Resources Administration (HRSA). Bureau of Primary Health Care.
About Health Centers. http://bphc.hrsa.gov/about/
Ku L, Frogner B, et al. Community Health Centers employ diverse staffing patterns,
which can provide productivity lessons for medical practices. Health Affairs. January
2015;34(1):95-103. http://content.healthaffairs.org/content/34/1/95.abstract
Health Disparities
Agency for Healthcare Research and Quality. National Healthcare Disparities Reports.
http://www.ahrq.gov/research/findings/nhqrdr/index.html
Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 13 of 15
Institute of Medicine. How Far Have We Come in Reducing Health Disparities?:
Progress Since 2000: Workshop Summary. Washington, DC: The National Academies
Press, 2012. http://www.iom.edu/Reports/2012/How-Far-Have-We-Come-in-Reducing-
Health-Disparities.aspx
Health Care Quality & Safety
Agency for Healthcare Research and Quality. National Healthcare Quality Reports.
http://www.ahrq.gov/research/findings/nhqrdr/index.html
Berenson R, Pronovost P, Krumholz H. Achieving the Potential of Health Care
Performance Measures. Robert Wood Johnson Foundation and The Urban Institute. May
2013.http://www.rwjf.org/en/research-publications/find-rwjf-research/2013/05/achieving-
the-potential-of-health-care-performance-measures.html and
http://www.urban.org/publications/412823.html
Cassel C, Conway P, et al. Getting more performance from performance measurement.
New England Journal of Medicine. Dec. 4, 2014;371(23):2145-2147.
http://www.nejm.org/doi/full/10.1056/NEJMp1408345
Consumer Reports Health and Massachusetts Health Quality Partners. How Does Your
Doctor Compare? Special Report for Massachusetts Residents. July 2012.
http://c354183.r83.cf1.rackcdn.com/MHQP%20Consumer%20Reports%20Insert%20201
2.pdf
Hussey PS, Wertheimer S, Mehrotra A. The association between healthcare quality and
cost. Ann Intern Med. Jan 1, 2013;158(1):27-34.
http://annals.org/article.aspx?articleid=1487781 and (summary): Fiore K. High-Cost Care
Not Necessarily Quality Care. MedPage Today. January 02, 2013.
http://www.medpagetoday.com/PublicHealthPolicy/HealthPolicy/36661
Institute of Medicine. Vital Signs: Core Metrics for Health and Health Care Progress.
Washington DC, National Academies Press, 2015.
http://www.iom.edu/Reports/2015/Vital-Signs-Core-Metrics.aspx. Report Brief:
http://www.iom.edu/~/media/Files/Report%20Files/2015/Vital_Signs/VitalSigns_RB.pdf
Also: Blumenthal D, McGinnis J. Measuring Vital Signs: An IOM report on
Core Metrics for Health and Health Care Progress. JAMA. May 19,
2015;313(19):1901-1902.
Leape L. Transparency and Public Reporting Are Essential for a Safe Health Care
System. The Commonwealth Fund. Perspectives on Health Reform-Briefs. March 17,
2010;4.http://www.commonwealthfund.org/publications/perspectives-on-health-reform-
briefs/2010/mar/transparency-and-public-reporting-are-essential-for-a-safe-health-care-
system
Radley D, McCarthy D, et al. Aiming Higher: Results from a Scorecard on State Health
System Performance, 2014, The Commonwealth Fund, May 2014.
http://www.commonwealthfund.org/publications/fund-reports/2014/apr/2014-state-
scorecard
Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 14 of 15
Roan S. How data can boost the value of care. Robert Wood Johnson Foundation.
Aligning Forces for Quality. Journalists on Quality. July 2014.
http://www.nrhi.org/uploads/how-data-can-boost-the-value-of-care_af4q_july-2014-1.pdf
or link from http://www.rwjf.org/en/library/features/journalists-on-quality.html
Robert Wood Johnson Foundation. Quality Field Notes: Public Reporting. How to Report
on the Quality of Physician Practices. April 2015.
http://www.rwjf.org/en/library/research/2015/05/quality-field-notes--public-
reporting.html ... Issue Brief, May 2015.
http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2015/rwjf419545
US Dept of Health and Human Services (DHHS). New HHS Data Shows Major Strides
Made in Patient Safety, Leading to Improved Care and Savings. May 7, 2014.
http://innovation.cms.gov/Files/reports/patient-safety-results.pdf and
http://www.hhs.gov/news/press/2014pres/05/20140507a.html
U.S. DHHS. 2014 Annual Progress Report to Congress. National Strategy for Quality
Improvement in Health Care. http://www.ahrq.gov/workingforquality/reports/annual-
reports/nqs2014annlrpt.htm
Materials for THCI Rotation presentation by Beverly Loudin, MD, on “Providers and
Quality & Patient Safety”
1. The Medical Assistant Training Program. "Elevating the Role of the
Medical/Clinical Assistant: Maximizing Team-Based Care in the Patient-Centered
Medical Home."
http://www.safetynetmedicalhome.org/sites/default/files/Implementation-Guide-
Supplement-Team-Based-Care.pdf
Note: This curriculum, developed by Dr. Loudin, has been included as a
component of the Safety Net Medical Home Initiative, in the category
"Continuous and Team-Based Healing Relationships:" The complete Initiative is
online at http://www.safetynetmedicalhome.org/
2. The Virginia Mason Institute. Training Program: Creating Flow in the
Ambulatory Setting. http://www.virginiamasoninstitute.org/ambulatory-setting
Chronic Care Management
American Geriatrics Society Expert Panel on the Care of Older Adults with
Multimorbidity. Guiding Principles for the Care of Older Adults with Multimorbidity:
An Approach for Clinicians.J Am Geriatr Soc October 2012;60(1):E1-E25.
http://onlinelibrary.wiley.com/doi/10.1111/j.1532-5415.2012.04188.x/full
Centers for Medicare & Medicaid Services. Chronic Care Management Services. (New
CPT Code effective 2015). http://www.cms.gov/Outreach-and-Education/Medicare-
Learning-Network-MLN/MLNProducts/Downloads/ChronicCareManagement.pdf
o Related: Edwards S, Landon B. Medicare's Chronic Care Management
Payment — Payment Reform for Primary Care. New England Journal of
Medicine. November 27, 2014;371(22): 2049-2051.
http://www.nejm.org/doi/full/10.1056/NEJMp1410790
Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 15 of 15
Improving Chronic Illness Care. A national program supported by The Robert Wood
Johnson Foundation with direction and technical assistance provided by The Sandy
MacColl Institute at Group Health's Center for Health Studies.
http://www.improvingchroniccare.org/
Perrin J, Anderson LE, Van Cleave J. The rise in chronic conditions among infants,
children, and youth can be met with continued health system innovations. Health
Affairs. December 2014;33(12):2099-2105.
http://content.healthaffairs.org/content/33/12/2099.abstract
Tinetti M, Fried T, Boyd C. Designing health care for the most common chronic
condition—multimorbidity. JAMA. June 20, 2012;307(23):2493-2494.
http://jama.jamanetwork.com/article.aspx?articleid=1187936
Wiley J, Rittenhouse D, Shortell S, et al. Managing chronic illness: physician practices
increased the use of care management and medical home processes. Health Affairs.
January 2015;34(1):78-86. http://content.healthaffairs.org/content/34/1/78.abstract
Career Paths
Ackerly D, Parekh A, Stein D. A framework for career paths in health systems
improvement. Academic Medicine. January 2013;88(1):56-60.
http://journals.lww.com/academicmedicine/Fulltext/2013/01000/Perspective___A_Frame
work_for_Career_Paths_in.20.aspx
Eastwood GL. The practice of administrative medicine. Annals of Internal Medicine.
May 17, 2011;154(10):703-4.
http://annals.org/article.aspx?articleid=474765&resultClick=3
Salib S, Moreno A. Good-bye and good luck: teaching residents the business of medicine
after residency. Journal of Graduate Medical Education. September 2015;7(3):338-340.
http://www.jgme.org/doi/full/10.4300/JGME-D-14-00720.1