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The Effect of Value-based Payment on Heart Failure Quality of Care (Value-HF)

基于价值的支付对心力衰竭护理质量的影响 (Value-HF)

基本信息

批准号：
10652391
负责人：
Alexander Sandhu
金额：
$ 13.73万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-01 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10652391
关键词：
Adrenergic beta-Antagonists Advisory Committees Age Award Cardiac rehabilitation Cardiovascular system Caring Cessation of life Clinic Clinic Visits Clinical Clinical Trials Collection Cost Measures Data Data Collection Data Set Development EFRAC Effectiveness Electronics Enrollment Ensure Exposure to Foundations Funding Future Goals Growth Guidelines Health Policy Health Services Healthcare Heart failure Incentives Instruction Interruption Intervention Knowledge Lead Learning Measurement Measures Medicare Medicine Mentored Patient-Oriented Research Career Development Award Mentors Mentorship Methods Modality Modeling Morbidity - disease rate Multicenter Trials National Health Policy Outcome Outcome Assessment Outcome Measure Patient Care Patient Outcomes Assessments Patient-Focused Outcomes Patients Pattern Performance Pharmaceutical Preparations Policy Analysis Policy Maker Quality of Care Quality of life Randomized Recommendation Reporting Research Research Personnel Resources Sampling Series Statistical Methods Surveys System Testing Time Training Treatment Failure Treatment outcome United States Work care outcomes career clinical care clinical decision-making clinical practice cost cost-effectiveness evaluation design dosage evidence base experience health care quality health related quality of life hospital readmission implementation evaluation implementation trial improved improved outcome incentive program model design models and simulation mortality patient oriented payment programs randomized trial response skills statistics symposium tool treatment as usual trend uptake

项目摘要

PROJECT SUMMARY/ABSTRACT Heart failure causes over 80,000 deaths and $30 billion in spending annually, yet therapies that improve survival and reduce morbidity are underutilized. Insufficient healthcare quality and high costs sparked the development of value-based payment programs, such as Medicare’s Merit-based Incentive Program (MIPS). MIPS is the largest clinician value-based payment program in use in the United States. MIPS is intended to improve the quality of care while reducing costs by altering clinician payments based on clinician performance on cost and quality measures. MIPS quality measurement is increasing its focus on patient-reported outcome (PRO) measures, including for heart failure, despite limited evidence that PROs improve heart failure care. Aim 1 will be a pragmatic, single-center randomized trial evaluating whether integration of PRO assessment into the routine heart failure clinic workflow is feasible and improves health-related quality of life at one year. This patient-oriented trial will determine if the clinical impact of PRO assessment is worth the costs of data collection. Aim 2 will evaluate the association between the introduction of MIPS (in 2017) and trends in Medicare heart failure care: guideline-recommended therapy use, mortality, and costs. This study will use multiple analytic approaches and controls (VA and commercially insured heart failure patients) to develop robust estimates of these associations. This work will have a substantial impact on heart failure clinical care and patient outcomes by defining the effect of both routine PRO assessment and MIPS as a whole. It will inform the design of future clinician value-based payment models. Dr. Sandhu will use this research along with the protected time, training, and mentorship of this K23 Award to become an independent, patient-oriented health services researcher. Dr. Sandhu’s long-term research goals are to improve the quality and efficiency of heart failure patient care by evaluating the implementation of local quality improvement and national health policy. The proposed research experience and the training in clinical trials and causal inference statistics during this award is critical to achieving those goals. He will gain these skills through coursework, local research seminars, national conferences, and direct instruction from his mentorship team. His mentors are experts in implementation trials, outcomes analysis, and advanced statistical methods. They are supplemented with an exceptional advisory committee with complementary expertise in clinical trials, heart failure, and health policy. With this mentorship team and support from the Stanford Department of Medicine, Dr. Sandhu will have the tools to efficiently complete the trial in Aim 1. His rigorous training plan, the expertise of his mentors, and his experience with the data make the sophisticated policy analysis in Aim 2 feasible. Overall, the training, research, and mentorship of this award will guide Dr. Sandhu in his transition to becoming an independent, successful patient-oriented health services researcher with the skills to compete for R-level funding.

项目总结/文摘

项目成果

期刊论文数量（41）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Regional variations in the process of care for patients undergoing percutaneous coronary intervention in Japan.

DOI：
10.1016/j.lanwpc.2022.100425
发表时间：
2022-05
期刊：
The Lancet regional health. Western Pacific
影响因子：
0
作者：
Shoji S;Yamaji K;Sandhu AT;Ikemura N;Shiraishi Y;Inohara T;Heidenreich PA;Amano T;Ikari Y;Kohsaka S
通讯作者：
Kohsaka S

Predictors of Incident Heart Failure Diagnosis Setting: Insights From the Veterans Affairs Healthcare System.

心力衰竭诊断设置的预测因素：来自退伍军人事务部医疗保健系统的见解。

DOI：
10.1016/j.jchf.2022.11.013
发表时间：
2023
期刊：
JACC. Heart failure
影响因子：
0
作者：
Tisdale,RebeccaL;Fan,Jun;Calma,Jamie;Cyr,Kevin;Podchiyska,Tanya;Stafford,RandallS;Maron,DavidJ;Hernandez-Boussard,Tina;Ambrosy,Andrew;Heidenreich,PaulA;Sandhu,AlexanderT
通讯作者：
Sandhu,AlexanderT

Variability in Coronary Artery Disease Testing for Patients With New-Onset Heart Failure.

DOI：
10.1016/j.jacc.2021.11.061
发表时间：
2022-03-08
期刊：
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
影响因子：
24
作者：
Zheng, Jimmy;Heidenreich, Paul A.;Kohsaka, Shun;Fearon, William F.;Sandhu, Alexander T.
通讯作者：
Sandhu, Alexander T.

Cost-effectiveness of Empagliflozin in Patients With Heart Failure With Preserved Ejection Fraction.

恩格列净治疗射血分数保留的心力衰竭患者的成本效益。

DOI：
10.1001/jamainternmed.2022.5010
发表时间：
2022
期刊：
JAMA internal medicine
影响因子：
39
作者：
Zheng,Jimmy;Parizo,JustinT;Spertus,JohnA;Heidenreich,PaulA;Sandhu,AlexanderT
通讯作者：
Sandhu,AlexanderT

Incidental Coronary Artery Calcium: Opportunistic Screening of Previous Nongated Chest Computed Tomography Scans to Improve Statin Rates (NOTIFY-1 Project).

偶然冠状动脉钙：对以前的非门控胸部计算机断层扫描进行机会性筛查以提高他汀类药物的使用率（NOTIFY-1 项目）。

DOI：
10.1161/circulationaha.122.062746
发表时间：
2023
期刊：
Circulation
影响因子：
37.8
作者：
Sandhu,AlexanderT;Rodriguez,Fatima;Ngo,Summer;Patel,BhavikN;Mastrodicasa,Domenico;Eng,David;Khandwala,Nishith;Balla,Sujana;Sousa,Doug;Maron,DavidJ
通讯作者：
Maron,DavidJ