VALUE AND PERFORMANCE OF ACCOUNTABLE CARE ORGANIZATIONS: A COST-MINIMIZATION ANALYSIS

2018 ◽  
Vol 34 (4) ◽  
pp. 388-392
Author(s):  
Sonal Parasrampuria ◽  
Allison H. Oakes ◽  
Shannon S. Wu ◽  
Megha A. Parikh ◽  
William V. Padula
Keyword(s):  
Cost Minimization ◽  
Cost Savings ◽  
Quality Data ◽  
Quality Level ◽  
Care Organization ◽  
Coordination Of Care ◽  
Accountable Care ◽  
Cost Minimization Analysis

Objectives:Determine the relationship between quality of an accountable care organization (ACO) and its long-term reduction in healthcare costs.Methods:We conducted a cost minimization analysis. Using Centers for Medicare and Medicaid cost and quality data, we calculated weighted composite quality scores for each ACO and organization-level cost savings. We used Markov modeling to compute the probability that an ACO transitioned between different quality levels in successive years. Considering a health-systems perspective with costs discounted at 3 percent, we conducted 10,000 Monte Carlo simulations to project long-term cost savings by quality level over a 10-year period. We compared the change in per-member expenditures of Pioneer (early-adopters) ACOs versus Medicare Shared Savings Program (MSSP) ACOs to assess the impact of coordination of care, the main mechanism for cost savings.Results:Overall, Pioneer ACOs saved USD 641.24 per beneficiary and MSSP ACOs saved USD 535.59 per beneficiary. By quality level: (a) high quality organizations saved the most money (Pioneer: USD 459; MSSP: USD 816); (b) medium quality saved some money (Pioneer: USD 222; MSSP: USD 105); and (c) low quality suffered financial losses (Pioneer: USD -40; MSSP: USD -386).Conclusions:Within the existing fee-for-service healthcare model, ACOs are a mechanism for decreasing costs by improving quality of care. Higher quality organizations incorporate greater levels of coordination of care, which is associated with greater cost savings. Pioneer ACOs have the highest level of integration of services; hence, they save the most money.

scholarly journals A Model-Based Cost-Minimization Analysis as a Decision Tool in Obstetric Care in Helgeland, Northern Norway

2016 ◽  
Vol 9 (1) ◽  
pp. 191
Author(s):  
Halvard Angelsen ◽  
Jan Norum ◽  
Villy Angelsen ◽  
Fred A. Mürer ◽  
Randi Erlandsen
Keyword(s):  
Quality Of Care ◽  
Maternity Care ◽  
Cost Minimization ◽  
Cost Savings ◽  
Obstetric Care ◽  
Birth Registry ◽  
Cost Minimization Analysis ◽  
Model Based ◽  
Hospital Trust

BACKGROUND: Quality of care is of utmost importance in maternity care. Today, we base the choice of institution on risk factors. Recently, a Norwegian national plan introduced new guidelines concerning quality and staffing. Consequently, the hospital trusts had to increase the number of obstetricians and midwives and handle raised costs. One way to meet such challenges is to reduce the number of delivery units.OBJECTIVES: We aimed to clarify the costs and benefits of two alternative strategies in obstetric care in Helgeland hospital trust using a model-based cost-minimization analysis (CMA).METHODS: The consequences, in terms of cost/savings and mothers´ time of travelling, by closing two midwife-administered maternity units (MAMUs) and keeping the two departments of obstetrics (DOGs) running was analyzed. We implemented data from the Helgeland hospital trust and the Medical Birth Registry of Norway (MBRN) and the selected period was 2010-2012. The comparator was today’s organization. Costs were converted into Euros at the rate of € 1 = NOK 9.527.RESULTS: The model concluded the closing of two MAMUs created an annual net saving of € 584,346. The mothers´ mean time of travelling increased by 11 minutes and by 91 minutes for those directly affected by the closure. The organizational changes were concluded safe and of low risk with regard to quality of care. A sensitivity analysis revealed the number of midwives dismissed being the most important variable. CONCLUSION: A model-based CMA may be a supportive tool when evaluating maternity care.

Cost-minimization analysis of drugs used in the treatment of Asthma and COPD diseases in India

2020 ◽  
Vol 15 ◽  
Author(s):  
Billu Payal ◽  
Anoop Kumar ◽  
Harsh Saxena
Keyword(s):  
Generic Drugs ◽  
Cost Minimization ◽  
Cost Savings ◽  
Chronic Obstructive ◽  
Pulmonary Medicine ◽  
Potential Cost ◽  
Maximum Cost ◽  
Cost Minimization Analysis ◽  
Cost Variation ◽  
The Cost

Background: Asthma and Chronic Obstructive Pulmonary Diseases (COPD) are well known respiratory diseases affecting millions of peoples in India. In the market, various branded generics, as well as generic drugs, are available for their treatment and how much cost will be saved by utilizing generic medicine is still unclear among physicians. Thus, the main aim of the current investigation was to perform cost-minimization analysis of generic versus branded generic (high and low expensive) drugs and branded generic (high expensive) versus branded generic (least expensive) used in the Department of Pulmonary Medicine of Era Medical University, Lucknow for the treatment of asthma and COPD. Methodology: The current index of medical stores (CIMS) was referred for the cost of branded drugs whereas the cost of generic drugs was taken from Jan Aushadi scheme of India 2016. The percentage of cost variation particularly to Asthma and COPD regimens on substituting available generic drugs was calculated using standard formula and costs were presented in Indian Rupees (as of 2019). Results: The maximum cost variation was found between the respules budesonide high expensive branded generic versus least expensive branded generic drugs and generic versus high expensive branded generic. In combination, the maximum cost variation was observed in the montelukast and levocetirizine combination. Conclusion: In conclusion, this study inferred that substituting generic antiasthmatics and COPD drugs can bring potential cost savings in patients.

Pharmacoeconomic features of the use of drugs used in the treatment of allergic rhinitis

2021 ◽  
pp. 9-16
Author(s):  
Afanasyeva T.G. ◽  
Lavrova N.N. ◽  
Tumentseva V.R.
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Nasal Mucosa ◽  
Generic Drugs ◽  
Cost Minimization ◽  
Nasal Congestion ◽  
World Health ◽  
Cost Minimization Analysis ◽  
Wide Range

Rhinitis is an inflammation of the nasal mucosa; today, according to the World Health Organization, the prevalence of the disease is 40% of the world's population. Allergic rhinitis is the most common type of chronic rhinitis, affecting 10–20% of the world's population, and the severity of the disease is associated with a significant deterioration in the quality of life, sleep and performance. Allergic rhinitis is an inflammatory disease of the nasal mucosa caused by exposure to an allergen, causing IgE-mediated inflammation. Clinically, the disease is characterized by the following main symptoms: rhinorrhea, sneezing, itching and nasal congestion. Despite the general symptoms of allergic rhinitis, its impact on the quality of life of patients and the significant cost of treatment, including pharmacotherapy, many patients do not adhere to drug treatment regimens due to their insufficient effectiveness in eliminating the emerging symptoms. Pharmacoeconomic research identifies, measures and compares the costs and effects of drug use. This framework includes research methods related to cost minimization, cost-effectiveness, decision analysis, cost of illness, and patient quality of life. This article will consider one of the four main methods for assessing pharmacoeconomics - cost minimization analysis. A cost-minimization analysis is a pharmacoeconomic assessment by comparing the costs of two or more drug alternatives regardless of outcome. Since the pharmaceutical market is represented by a wide range of original, reference and generic drugs for the treatment of allergic rhinitis, an important aspect of our research is the selection of effective and economically acceptable therapy for outpatients.

scholarly journals Global AgeWatch Index and Insights

2020 ◽  
Author(s):  
Gibran Cruz-Martinez ◽  
Gokce Cerev
Keyword(s):  
Older People ◽  
Composite Index ◽  
Quality Data ◽  
Transformative Change ◽  
Middle Income ◽  
Middle Income Countries ◽  
Good Quality Data ◽  
Low And Middle Income

Global AgeWatch Index and Insights by HelpAge International aim to contribute to achievement of long-term transformative change in respect to ageing and the lives of older people by advocating for better production of timely and good quality data to inform policy and program response.The Global AgeWatch Index is a composite index that measures quality of life of older people, and ranks countries based on four domains – income security, health status, enabling environment and capability. The index was developed in partnership with Professor Asghar Zaidi. The index was published during 2013-2015.The Global AgeWatch Insights is a research-based advocacy tool that examines situation of older people in low- and middle-income countries, assesses availability of relevant data and evidence to support the analysis, and identification of policy actions. The Insights are produced in partnership with AARP. The reports were launched in 2018 are planned to be released every three years with a different thematic focus. The first report focuses on the inequities of the health systems in twelve low- and middle-income countries.

Clinical Response and Cost-Savings Associated With Generic Fluticasone Propionate/Salmeterol Multidose, Dry-Powder Inhaler in Asthma Patients Managed in an Ambulatory Care Practice Setting

2020 ◽  
pp. 089719002096925
Author(s):  
Patrick McCarthy ◽  
Tanya Iliadis ◽  
Kathy Zaiken
Keyword(s):  
Fluticasone Propionate ◽  
Ambulatory Care ◽  
Clinical Response ◽  
Asthma Control ◽  
Dry Powder Inhaler ◽  
Cost Savings ◽  
Care Organization ◽  
Accountable Care ◽  
Brand Name ◽  
Prescription Cost

Background: Fluticasone propionate/salmeterol multidose, dry powder inhaler (MDPI) was the first and only authorized generic inhaled corticosteroid/long-acting beta agonist (ICS/LABA) combination inhaler at the time of this study. This offers the potential for significant prescription cost-savings for both patients and accountable care organizations. The objective of the study was to demonstrate patients’ clinical response to generic fluticasone propionate/salmeterol MDPI when switched from one of its brand name competitors. Methods: The study was approved by the Institutional Review Board at MCPHS University. This was a prospective chart review of a large, multi-center ambulatory care organization in the Greater Boston area. Patients 12 years of age or older who were switched from a brand-name ICS/LABA inhaler to the generic fluticasone/salmeterol MDPI were included in the study. The primary endpoint was worsened asthma control requiring a change in therapy, oral corticosteroid therapy, or hospitalization at or before 12 weeks after the inhaler was switched. Results: In total, 203 patients met inclusion criteria. Of those 203 patients, 35 had a change in therapy due to worsened asthma control (17.2% of patients, 95% CI 12.0% to 22.4%) within 12 weeks. Total projected yearly prescription cost-savings for patients who were switched and remained on the generic inhaler was $581,628. Conclusion: Eighty-three percent of patients maintained appropriate asthma control after switching from a brand ICS/LABA inhaler to the generic fluticasone/salmeterol MDPI for 12 weeks. Switching to the generic inhaler resulted in significant prescription cost-savings for the accountable care organization.

scholarly journals Application-Oriented Description of the Quality of Electronic Components (ppm Concept)

1981 ◽  
Vol 9 (2) ◽  
pp. 153-156
Author(s):  
Wolfgang Junghans
Keyword(s):  
Production Quality ◽  
Quality Data ◽  
Quality Level ◽  
Electronic Components ◽  
Acceptable Quality ◽  
Sample Testing ◽  
New Interpretation ◽  
Definition Of ◽  
True Values

Traditionally the production quality of components is described by “acceptable quality levels” (AQL). Agreements, referring to this principle, determine the acceptance or refusal of batches that have been sample tested. An acceptable quality of level is interpreted as a tolerated limit. In reality true values of quality must be better. An AQL value cannot define a real quality level. Furthermore, increasing requirements for component quality lead to low figures for the permissible amount of faulty devices in batches, and the method of sample testing becomes insufficient.For these reasons it seems to be of major importance to establish a better standard for the definition of quality. The application oriented description of quality data offers a possible solution. A good exchange of experience between supplier and user, based on a close and quality loop, is necessary.For contractual purposes AQL values remain important, but their meaning needs a new interpretation.

scholarly journals Anthropogenic and catchment characteristic signatures in the water quality of Swiss rivers: a quantitative assessment

2018 ◽  
Author(s):  
Martina Botter ◽  
Paolo Burlando ◽  
Simone Fatichi
Keyword(s):  
Water Quality ◽  
Anthropogenic Impacts ◽  
Stream Water ◽  
Anthropogenic Activities ◽  
Quality Data ◽  
Anthropogenic Factors ◽  
Water Quality Data ◽  
Natural And Anthropogenic Factors

Abstract. The hydrological and biogeochemical response of rivers carries information about solute sources, pathways, and transformations in the catchment. We investigate long-term water quality data of eleven Swiss catchments with the objective to discern the influence of catchment characteristics and anthropogenic activities on delivery of solutes in stream water. Magnitude, trends and seasonality of water quality samplings of different solutes are evaluated and compared across catchments. Subsequently, the empirical dependence between concentration and discharge is used to classify different solute behaviors. Although the influence of catchment geology, morphology and size is sometime visible on in-stream solute concentrations, anthropogenic impacts are much more evident. Solute variability is generally smaller than discharge variability. The majority of solutes shows dilution with increasing discharge, especially geogenic species, while sediment-related solutes (e.g. Total Phosphorous and Organic Carbon species) show higher concentrations with increasing discharge. Both natural and anthropogenic factors impact the biogeochemical response of streams and, while the majority of solutes show identifiable behaviors in individual catchments, only a minority of behaviors can be generalized across catchments that exhibit different natural, climatic and anthropogenic features.

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