Class Notes

Q1:

How are you measuring success?

From general perspective:

1) Achieving high value for patients must become the primary goal of health care delivery, with value defined as the health outcomes achieved per dollar spent. If value improves, patients, payers, providers, and suppliers can all benefit while the economic sustainability of the health care system increases.

2) Since value is defined as outcomes relative to costs, it should encompass efficiency.

The Outcome Measures Hierarch

From the specific (UCLA) perspective:

“The three-year statistics are the most important measure of patient outcomes because they include both early and late patient-survival rates, according to Dr. Gabriel Danovitch, medical director of the UCLA Kidney and Pancreas Transplant Program.”

http://www.medicalnewstoday.com/releases/223368.php

建议把Exhibit 7,8,9的相关数据想办法在PPT中用图标展示出来会比较直观

Q2:

Initial packaged pricing model covered the transplant phase beginning with the inpatient admission, the post-transplant phase until 90 days after surgery, the readmissions within 90 days, and an occasional unrelated admission. What not included: outpatient prescription medications, most of the services occurred before the transplant surgery, the pre-transplant phase, and organ acquisition cost. Considered adjusting the payments for primary and repeat transplants, and arrange for “outlier provisions”. (从11页到12页仔细找一下)

The scope of the bundle had changed since 1986. Organ procurement charges were included while readmissions and re-transplants were excluded. Continue to include stop-loss provisions coverage. (从12到14页仔细理一下)

建议这里画两个图表，一个是initial model包括和不包括的，一个是current model (since 1986)包括和不包括，以及调整的，这样老师就一目了然了。

Q3:

How they measure? (15页到16页仔细读一下)

* Data required by UNOs

* Data required by CMS

* Data tracked internally by UCLA & the kidney program

Recommendations:

1). Organize into Integrated Practice Units around the Patient’s Medical Condition

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