Pay for performance and the management of hypertension

Foskett-Tharby, Rachel; Hex, Nick; Gill, Paramjit

doi:10.1515/jtim-2016-0004

Cited by 7 publications

(4 citation statements)

References 22 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Care coordination around patients’ needs has been acknowledged as a core dimension of integration that facilitates the provision of comprehensive and seamless care [ 10 ]. It has also been recognized as a key responsibility for primary healthcare [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Nursing Care Coordination for Patients with Complex Needs in Primary Healthcare: A Scoping Review

et al. 2021

View full text Add to dashboard Cite

Introduction: Millions of people worldwide have complex health and social care needs. Care coordination for these patients is a core dimension of integrated care and a key responsibility for primary healthcare. Registered nurses play a substantial role in care coordination. This review draws on previous theoretical work and provides a synthesis of care coordination interventions as operationalized by nurses for complex patient populations in primary healthcare. Methodology: We followed Arksey and O'Malley's methodological framework for scoping reviews. We carried out a systematic search across CINAHL, MEDLINE, Scopus and ProQuest. Only empirical studies were included. We performed a thematic analysis using deductive (the American Nurses Association Framework) and inductive approaches. Findings were discussed with a group of experts. Results: Thirty-four articles were included in the synthesis. Overall, nursing care coordination activities were synthesized into three categories: those targeting the patient, family and caregivers; those targeting health and social care teams; and those bringing together patients and professionals. Interpersonal communication and information transfer emerged as cross-cutting activities that support every other activity. Our results also brought to light the nurses' contribution to care coordination efforts for patients with complex needs as well as critical components that should be present in every care coordination intervention for this clientele. These include an increased intensity and frequency of activities, relational continuity of care, and home visits. Conclusion: With the growing complexity of patient's needs, efforts must be directed towards enabling the primary healthcare level to effectively play its substantial role in care coordination. This includes finding primary care employment models that would facilitate multidisciplinary teamwork and the delivery of integrated care, and guarantee the delivery of intensive yet efficient coordinated care.

show abstract

Section: Introductionmentioning

confidence: 99%

Nursing Care Coordination for Patients with Complex Needs in Primary Healthcare: A Scoping Review

et al. 2021

View full text Add to dashboard Cite

show abstract

“…In the general population, healthcare payers can influence the provision of preventative services by clinical providers and the adoption of preventive behaviors by patients. Initiatives to increase payments for cardiovascular quality measures and performance in the primary care setting, rather than solely for services rendered, have demonstrated reductions in hypertension, obesity, and blood glucose [ 10 , 11 ]. This work indicates that no matter how it is paid for, CVD prevention requires tailoring at clinic and patient levels in order to be effective [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Initiatives to increase payments for cardiovascular quality measures and performance in the primary care setting, rather than solely for services rendered, have demonstrated reductions in hypertension, obesity, and blood glucose [ 10 , 11 ]. This work indicates that no matter how it is paid for, CVD prevention requires tailoring at clinic and patient levels in order to be effective [ 10 ]. As the largest provider of HIV/AIDS services in the U.S., the Ryan White HIV/AIDS program has significant influence on HIV care, yet for CVD prevention, there are only two performance indicators that they measure- annual lipid screening and tobacco use screening and cessation [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

The influence of healthcare financing on cardiovascular disease prevention in people living with HIV

et al. 2020

View full text Add to dashboard Cite

Background People living with HIV are diagnosed with age-related chronic health conditions, including cardiovascular disease, at higher than expected rates. Medical management of these chronic health conditions frequently occur in HIV specialty clinics by providers trained in general internal medicine, family medicine, or infectious disease. In recent years, changes in the healthcare financing for people living with HIV in the U.S. has been dynamic due to changes in the Affordable Care Act. There is little evidence examining how healthcare financing characteristics shape primary and secondary cardiovascular disease prevention among people living with HIV. Our objective was to examine the perspectives of people living with HIV and their healthcare providers on how healthcare financing influences cardiovascular disease prevention. Methods As part of the EXTRA-CVD study, we conducted in-depth, semi-structured interviews with 51 people living with HIV and 34 multidisciplinary healthcare providers and at three U.S. HIV clinics in Ohio and North Carolina from October 2018 to March 2019. Thematic analysis using Template Analysis techniques was used to examine healthcare financing barriers and enablers of cardiovascular disease prevention in people living with HIV. Results Three themes emerged across sites and disciplines (1): healthcare payers substantially shape preventative cardiovascular care in HIV clinics (2); physician compensation tied to relative value units disincentivizes cardiovascular disease prevention efforts by HIV providers; and (3) grant-based services enable tailored cardiovascular disease prevention, but sustainability is limited by sponsor priorities. Conclusions With HIV now a chronic disease, there is a growing need for HIV-specific cardiovascular disease prevention; however, healthcare financing complicates effective delivery of this preventative care. It is important to understand the effects of evolving payer models on patient and healthcare provider behavior. Additional systematic investigation of these models will help HIV specialty clinics implement cardiovascular disease prevention within a dynamic reimbursement landscape. Trial registration Clinical Trial Registration Number: NCT03643705.

show abstract

“…Ultimately pay for performance incentives can be quite diverse in their design and implementation within a health care system. As such, the success of these types of incentives is largely dependent on the local context [34]. …”

Section: Introductionmentioning

confidence: 99%

Therapeutic Inertia and Treatment Intensification

et al. 2018

View full text Add to dashboard Cite

Studies reveal that the therapeutic inertia is quite common and contributes to suboptimal blood pressure control. Quality improvement programs and standardized approaches to support antihypertensive treatment intensification are ways to combat therapeutic inertia. Furthermore, programs that utilize non-physician medical professionals such as pharmacists and nurses demonstrate promise in mitigating the effects of this important problem. Therapeutic inertia impedes antihypertensive management and requires a broad effort to reduce its effects. There is an ongoing need for renewed focus and research in this area to improve hypertension control.

show abstract

Pay for performance and the management of hypertension

Cited by 7 publications

References 22 publications

Nursing Care Coordination for Patients with Complex Needs in Primary Healthcare: A Scoping Review

Nursing Care Coordination for Patients with Complex Needs in Primary Healthcare: A Scoping Review

The influence of healthcare financing on cardiovascular disease prevention in people living with HIV

Therapeutic Inertia and Treatment Intensification

Contact Info

Product

Resources

About