Archive for the ‘health and health care’ Category

Health care fraud and abuse enforcement: Relationship scrutiny

July 17, 2015 Comments off

Health care fraud and abuse enforcement: Relationship scrutiny
Source: Deloitte

Where is fraud and abuse enforcement headed in health care? One emerging area of interest is relationship scrutiny. Relationships can be complex in the business of health care: tracking and analyzing them is an important part of minimizing the fraud and abuse that may result from questionable relationships and improper influence.

Many organizations depend on analytics to understand their own performance. Insights and patterns within the data are often used to inform strategy and decision making. Researchers can apply analytics to identify external trends and factors that may impact businesses. To that end, Deloitte researchers used analytics techniques to examine the text of tens of thousands of federal regulations and identify emerging trends in health care fraud and abuse enforcement. The results are telling: Federal health care regulators are emphasizing relationship scrutiny in their fraud and abuse enforcement efforts. Also, discussion of health care fraud and abuse topics – including relationship scrutiny – is recurring, as evidenced by the cyclical rise and fall in frequency and relevance of keyword groups related to “enforcement,” “value-based care,” and “fraud and abuse.” The bottom line: discussion of these topics is present; relationship scrutiny is likely here to stay.

2014 National Healthcare Quality and Disparities Report — Chartbook on Care Coordination

July 17, 2015 Comments off

2014 National Healthcare Quality and Disparities Report — Chartbook on Care Coordination (PDF)
Source: Agency for Healthcare Research and Quality

This Care Coordination Chartbook is part of a family of documents and tools that support the National Healthcare Quality and Disparities Reports (QDR). The QDR includes annual reports to Congress mandated in the Healthcare Research and Quality Act of 1999 (P.L. 106-129). These reports provide a comprehensive overview of the quality of health care received by the general U.S. population and disparities in care experienced by different racial, ethnic, and socioeconomic groups. The purpose of the reports is to assess the performance of our health system and to identify areas of strengths and weaknesses in the health care system along three main axes: access to health care, quality of health care, and priorities of the National Quality Strategy.

The reports are based on more than 250 measures of quality and disparities covering a broad array of health care services and settings. Data are generally available through 2012, although rates of uninsurance have been tracked through the first half of 2014. The reports are produced with the help of an Interagency Work Group led by the Agency for Healthcare Research and Quality (AHRQ) and submitted on behalf of the Secretary of Health and Human Services (HHS).

Improving Emergency Response at Airports

July 17, 2015 Comments off

Improving Emergency Response at Airports
Source: Transportation Research Board

The April 2015 issue of TRB’s Airport Cooperative Research Program (ACRP) Impacts on Practice highlights how airports like Grand Forks International Airport (GFK) in North Dakota have applied the findings from ACRP Report 95: Integrating Community Emergency Response Teams (A-CERTs) at Airports. Officials at GFK credit the direction provided in ACRP Report 95 with enabling the airport to build, implement, and maintain a successful response team.

Safe & Sustainable Recycling: Protecting Workers who Protect the Planet

July 16, 2015 Comments off

Safe & Sustainable Recycling: Protecting Workers who Protect the Planet
Source: GAIA, Partnership for Working Families, and National Council for Occupational Safety and Health

Recycling is the right thing to do, but we need to make it safe for recycling workers. Recycling is a key approach for waste reduction and climate action that is used by cities across the U.S. with enormous environmental and economic benefits. But a new report finds that the actual work of sorting recycling can be unnecessarily hazardous to workers’ health and safety. Seventeen recycling workers died on the job between 2011-2013, and recycling workers are more than twice as likely to be injured on the job than the average U.S. worker. These high injury and fatality rates are a result of unsafe working conditions including exposure to hazardous items on the sort line, like hypodermic needles, toxic chemicals, and animal carcasses, and working around heavy machinery. By ensuring health and safety compliance across the industry, cities can protect workers who protect our planet.

HHS OIG — Ensuring the Integrity of Medicare Part D

July 16, 2015 Comments off

Ensuring the Integrity of Medicare Part D
Source: U.S. Department of Health and Human Services, Office of Inspector General

In the 9 years since Part D began, OIG has produced a wide range of investigations, audits, evaluations, and legal guidance related to Part D program integrity. This work has resulted in the prosecution of individuals accused of defrauding Part D, as well as the identification of systemic program vulnerabilities that raise concerns related to both inappropriate payments and quality of care. OIG has made recommendations to strengthen Part D program integrity, and progress has been made. However, Part D remains vulnerable to fraud, as evidenced by ongoing investigations. OIG has prepared this portfolio to document key progress in addressing Part D program vulnerabilities and to highlight issues that need improvement.

See also: Questionable Billing and Geographic Hotspots Point to Potential Fraud and Abuse in Medicare Part D

Sources of Increasing Differential Mortality Among the Aged by Socioeconomic Status

July 16, 2015 Comments off

Sources of Increasing Differential Mortality Among the Aged by Socioeconomic Status
Source: Center for Retirement Research at Boston College

This paper uses data from the Health and Retirement Study (HRS) to explore the extent and causes of widening differences in life expectancy by socioeconomic status (SES) for older persons. We construct alternative measures of SES using educational attainment and average (career) earnings in the prime working ages of 41-50. We also use information on causes of death, health status and various behavioral indicators (smoking, drinking, and obesity) that are believed to be predictors of premature death in an effort to explain the causes of the growing disparities in life expectancy between people of high and low SES.

The paper finds that:

  • There is strong statistical evidence in the HRS of a growing inequality of mortality risk by SES among more recent birth cohorts compared with cohorts born before 1930.
  • Both educational attainment and career earnings as constructed from Social Security records are equally useful indicators of SES, although the distinction in mortality risk by education is greatest for those with and without a college degree.
  • There has been a significant decline in the risk of dying from cancer or heart conditions for older Americans in the top half of the income distribution, but we find no such reduction of mortality risk in the bottom half of the distribution.
  • The inclusion of the behavioral variables and health status result in substantial improvement in the predictions of mortality, but they do not identify the sources of the increase in differential mortality.

The Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances

July 16, 2015 Comments off

The Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances
Source: Substance Abuse and Mental Health Services Administration

Presents 2012-2013 findings from a federally funded program that supports community-based mental health services for children with serious emotional disturbances. Reports on the system of care approach, service characteristics and use, and child outcomes.


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