Delivery Innovation

The search for new and innovative ways to deliver health care more efficiently and effectively. 

Issues at the Heart of Advancing the De-Adoption of Low-Value Care

Issue Brief
Apr. 18, 2017

A diverse set of national leaders and stakeholders representing industry, think-tanks, provider and patient groups, and academic experts discussed how health systems, payers, and providers can spur the ‘de-adoption’ of medical practices and technologies no longer considered valuable.

Using Active Choice Within the Electronic Health Record to Increase Influenza Vaccination Rates

Apr. 1, 2017

Mitesh S. Patel, Kevin G. Volpp, Dylan S. Small, Craig Wynn, Jingsan Zhu, Lin Yang, Steven Honeywell Jr., Susan C. Day

In the Journal of General Internal Medicine, Mitesh Patel and colleagues, including Kevin Volpp ​and Dylan Small, evaluate the association between an active choice intervention in the electronic health record and changes in influenza vaccination rates. Despite the benefits of influenza vaccination, each year more than half of adults in the U.S. do not receive it. In this study, the “active choice intervention” was a best practice alert in the electronic health record system, which prompted the provider to actively “accept” or “cancel” an order for the influenza vaccine. The study...

Giving Patients a Ride: a Tricky Legal Line

Mar. 23, 2017

What if health systems provided rides for elderly patients with limited transportation options or poor patients unable to access public transportation? We might applaud them for a creative strategy to improve access for vulnerable populations. However, their actions might be illegal.

Effects of the ACA on Health Care Cost Containment

Issue Brief
Mar. 2, 2017

This brief reviews the evidence on how key ACA provisions have affected the growth of health care costs. Coverage expansions produced a predictable jump in health care spending, amidst a slowdown that began a decade ago. Although we have not returned to the double-digit increases of the past, the authors find little evidence that ACA cost containment provisions produced changes necessary to “bend the cost curve.” Cost control will likely play a prominent role in the next round of health reform and will be critical to sustaining coverage gains in the long term.

43 Ways to Leave Your Technology

Feb. 14, 2017

We recently convened an expert roundtable to tackle how health systems, payers, and providers can spur the ‘de-adoption’ of medical practices and technologies no longer considered valuable. This got us thinking - while the process by which ineffective practices or technologies are abandoned is neither simple nor automatic, even the language used to describe it is not clear. And language matters. It often reflects an unstated focus on one mechanism or one level of decision-making. Here we review, and potentially clarify, the terminology.

The Emerging Market of Smartphone-Integrated Infant Physiologic Monitors

Jan. 27, 2017

Christopher P. Bonafide,  David T. Jamison,  Elizabeth E. Foglia, 

In a JAMA Viewpoint, Christopher Bonafide and colleagues discuss the efficacy and safety of smartphone apps integrated with sensors that monitor infants’ vital signs. While the performance characteristics of these sensors are unknown to the public and the regulations around them are scarce, their sales have skyrocketed, reaching 40,000 units for a single brand of “smart sock” monitors. These companies use direct-to-parent advertising to portray their products as necessary to alert parents when something is wrong with their infants’ cardiorespiratory health, even though there are...

New Study Details Savings from Bundled Payments

Jan. 13, 2017

This is the way it is supposed to work. You develop policy and processes to drive innovation. You design and test innovative ideas in a small, efficient way. You learn and adapt. Successful innovation drives new policy. Rinse and repeat.

And this is the way it appears to have worked, in the case of Medicare bundled payment. Start small with a pilot. Expand in reach and scope if promising. Scale up if successful.

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