Payment & Delivery

How insurers and providers are organized and paid to deliver care. Research by LDI Senior Fellows examines the shift from fee-for-service payments to newer models of paying for and delivering value, such as Accountable Care Organizations and Patient-Centered Medical Homes.

Do Patient-Centered Medical Homes Reduce Emergency Department Visits?

Aug. 12, 2014

Guy David, Candace Gunnarsson, Philip A. Saynisch, Ravi Chawla, Somesh Nigam

In Health Services Research, Guy David and colleagues evaluate whether patient-centered medical homes (PCMHs) reduce emergency department (ED) visits among patients  with and without chronic conditions. The authors use data from approximately 460,000 Independence Blue Cross patients enrolled in 280 primary care practices, all of which converted to PCMH status between 2008 and 2012. PCMH certification was associated with a 5-8% reduction in ED visits among a practice's chronically ill patients, but had no effect on patients without chronic medical conditions. These findings were...

Photo Page: SUMR14 at The Morris Arboretum

Jul. 31, 2014
Photography by Hoag Levins and Megan Pellegrino [Click images for larger] Lounging in the 50-foot-high nets (above left) that provide a bird's eye view of a heavily wooded section of the Morris Arboretum are Summer Undergraduate Minority Research (SUMR) scholars Sarah Appeadu, Nehanda Khemet, Karena Taylor, Shamarlon Yates, Siya Ndwandwe and Tyler Chavez. Above right, Arboretum guide Jim Diamond explains the Katsura tree, a 90-foot high, 67-foot wide botanical behemoth imported from Japan in the early 1900s. Originally created in the 1880s for the personal pleasure of two heirs to a...

Insourcing Innovation: Harnessing The strengths Within

May. 8, 2014

It’s not easy to make the case that health care innovation can come from within…from the physicians and nurses on the front lines of patient care. Clinically-trained, path-driven, and time-starved, these clinicians may not appear to be the best source of disruptive change in health care.

A ‘Quality Storm’ Brewing around NHS Nurses

May. 5, 2014

It seems that nurses are getting a lot of bad press in England lately, coming under fire recently for being “uncaring.” In an article published in Nursing Standard, Linda Aiken of Penn’s School of Nursing contends that this erosion of public trust is the result of high workloads and low investment in nursing education, rather than any attitudes held by English nurses.

The Exnovation Conundrum

Apr. 29, 2014

How do we get people and organizations to change, especially when what they are currently doing adds little value, is very costly, is perhaps outmoded, and may, at worst, be dangerous? This is the question Benjamin Roman and David Asch raise in their new Annals of Internal Medicine piece on "Faded Promises".

The Way Forward for Integrated Care

Mar. 31, 2014

As health care reform rolls out, there is a growing focus on restructuring the health service delivery system in the hope of improving health care quality and "bending the cost curve." A key part of this focus has been on physician organization and, in particular, moving toward large, multispecialty physician groups or hospital-physician systems that can provide integrated, coordinated patient care (e.g., through "Accountable Care Organizations").

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