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Population Health Strategies for Reducing Surgical Costs

Population Health Strategies for Reducing Surgical Costs
降低手术费用的人口健康策略
批准号:
9752432
负责人:
Hari Nathan
金额:
$15.2万
依托单位国家:
美国
项目类别:
财政年份:
2016
资助国家:
美国
项目状态:
已结题
起止时间:
2016-08-01 至 2020-07-31

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英文摘要
PROJECT SUMMARY One of the provisions of the Affordable Care Act was to establish Accountable Care Organizations (ACOs) in the Medicare program. ACOs assume financial responsibility for large populations of patients. ACOs become eligible to receive bonuses by meeting specific quality and savings benchmarks. Over 23 million Americans are now covered by more than 740 ACOs. The early experience with ACOs suggests a “triple win”—lower costs, higher quality, and better patient experience—and the ACO model continues to grow rapidly. Over 51 million inpatient surgical procedures are performed annually in the United States at a cost of over $500 billion, accounting for 40% of all hospital and physician spending. Despite this, ACOs leaders have largely ignored surgical care. With this research, we aim to better understand surgical cost variation within ACOs. For example, a common ACO strategy (dubbed “hot-spotting”) is to try to reduce costs for the most expensive medical patients. However, we do not know whether “hot-spotting” is a viable strategy for reducing surgical costs. Second, while we know that surgical costs can vary significantly between hospitals,we do not know whether ACOs could save money by referring patients from high-cost to low-cost hospital for their surgical procedures. Finally, there is not yet any evidence that ACOs can reduce surgical costs. If certain ACOs do succeed in reducing surgical costs, it would be useful to know whether they use “hot-spotting” and selective referral to do so. We will address all of these questions through a series of studies using payment data for Medicare patients in ACOs who are undergoing 18 surgical procedures over the years 2012-2016. This research is the first step towards identifying strategies that ACOs can use to reduce surgical costs and will enable future work aimed at implementing such strategies. Furthermore, the research project, highly experienced multidisciplinary mentorship team, and unparalleled research environment are ideally suited to address the career goals and educational needs of the candidate, Hari Nathan, MD, PhD. The proposal includes a detailed educational plan with training that will be essential both for successful completion of this research and toward Dr. Nathan's career development. The training includes graduate level courses in econometrics and policy analysis. This career development award will lay the groundwork for Dr. Nathan to perform ongoing, innovative health services research, and to become an independent investigator and national leader in understanding and improving surgical cost variation.
期刊论文(8)
专著(0)
科研奖励(0)
会议论文
Hospital quality, patient risk, and Medicare expenditures for cancer surgery.
医院质量、患者风险和癌症手术的医疗保险支出。
DOI: 10.1002/cncr.31120
发表时间: 2018
期刊: Cancer
影响因子: 6.2
作者: [Shubeck,SarahP, Thumma,JyothiR, Dimick,JustinB, Nathan,Hari]
通讯作者: Nathan,Hari
Opportunities for Surgical Leadership in Managing Population Health Costs.
管理人口健康成本的外科领导机会。
DOI: 10.1097/sla.0000000000001759
发表时间: 2016
期刊: Annals of surgery
影响因子: 9
作者: [Nathan,Hari, Dimick,JustinB]
通讯作者: Dimick,JustinB
Medicare's Shift to Mandatory Alternative Payment Models: Why Surgeons Should Care.
医疗保险向强制性替代支付模式的转变:为什么外科医生应该关心。
DOI: 10.1001/jamasurg.2016.4005
发表时间: 2017
期刊: JAMA surgery
影响因子: 16.9
作者: [Nathan,Hari, Dimick,JustinB]
通讯作者: Dimick,JustinB
Assessing the Effect of the Affordable Care Act on Surgical Populations.
评估《平价医疗法案》对手术人群的影响。
DOI: 10.1001/jamasurg.2016.3635
发表时间: 2016
期刊: JAMA surgery
影响因子: 16.9
作者: [Nathan,Hari, Dimick,JustinB]
通讯作者: Dimick,JustinB
共 8 条
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      省市级项目
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      2025
    • 负责人:
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    人兽共患病One Health防控决策路径研究
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      5.0万元
    • 批准年份:
      2024
    • 负责人:
      张晓溪
    • 依托单位:
    基于 One Health 策略的 mcr 阳性多重耐药 ST34 型沙门菌的流行传播机制及溯源研究
    • 批准号:
      Y24H190002
    • 项目类别:
      省市级项目
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      --
    • 批准年份:
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    • 负责人:
      罗琦霞
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