Médecine

Paramédical

Autres domaines


S'abonner

Bundled payment for actinic keratosis management: Pilot evaluation of developed models - 11/02/19

Doi : 10.1016/j.jaad.2018.09.012 
Joslyn S. Kirby, MD, MS, MEd a, , Colleen F. Silva, MD b, Sara B. Ferguson, MD c, David Shupp, MD c, James G. Marks, MD a, Jeffrey J. Miller, MD, MBA a
a Department of Dermatology, Penn State Health, Hershey, Pennsylvania 
b St. Vincent Hospital Center, Indianapolis, Indiana 
c Department of Dermatology, Penn State Health, State College, Pennsylvania 

Correspondence to: Joslyn S. Kirby, MD, MS, MEd, Penn State Hershey Department of Dermatology, 500 University Dr, Mail Code HU14, Hershey, PA 17033-0850.Penn State Hershey Department of Dermatology500 University Dr, Mail Code HU14HersheyPA17033-0850

Abstract

Background

There is an opportunity to explore alternate payment models in dermatology.

Objective

To pilot 2 bundled payment models for actinic keratosis (AK) management.

Methods

A prospective cohort study was conducted during September 2013-June 2016. Consecutive patients were recruited from clinics of 5 dermatologists. Patients had to be adults, have ≥1 year of care at the department, and have a history of AK. A bundled payment strategy was prospectively piloted for 1 year and compared with costs in the prior year.

Results

Overall, 400 participants were enrolled, and complete data was collected for 254 participants. During the year of bundled payments, actual total annual spending on claims was $70,557, whereas model 1 and model 2 bundled payment models would have totaled $67,310 and $74,422, respectively, for the patient cohort. Patient satisfaction surveys showed no difference in the quality of care.

Limitations

Single-center study and limited sample size. International Classification of Diseases 9 and 10 codes were used to identify claims and might be inaccurate. Costs were modeled rather than fully implemented.

Conclusion

Dermatologists should be aware of bundled payment models. More work is needed to elucidate the optimal formulation of a bundled payment for AK management, including the services covered, time delimitation, and risk stratification factors.

Le texte complet de cet article est disponible en PDF.

Key words : actinic keratosis, alternative payment, bundled payment, cost, health care, health economic

Abbreviations used : AK, ICD, SCC, SD


Plan


 Funding sources: Supported in part by a Career Development Award from the Dermatology Foundation (to Dr Kirby) and a grant from the Pennsylvania Department of Health using Tobacco CURE Funds. The Department specifically disclaims responsibility for any analyses, interpretations, or conclusions.
 Conflicts of interest: None disclosed.
 Reprints not available from the authors.


© 2018  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
Ajouter à ma bibliothèque Retirer de ma bibliothèque Imprimer
Export

    Export citations

  • Fichier

  • Contenu

Vol 80 - N° 3

P. 679-684 - mars 2019 Retour au numéro
Article précédent Article précédent
  • Drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms severity score: A useful tool for assessing disease severity and predicting fatal cytomegalovirus disease
  • Yoshiko Mizukawa, Kazuhisa Hirahara, Yoko Kano, Tetsuo Shiohara
| Article suivant Article suivant
  • The role of TERT promoter mutations in differentiating recurrent nevi from recurrent melanomas: A retrospective, case-control study
  • Kara E. Walton, Erin M. Garfield, Bin Zhang, Victor L. Quan, Katherine Shi, Lauren S. Mohan, Alexandra M. Haugh, Timothy VandenBoom, Pedram Yazdan, Maria Cristina Isales, Elnaz Panah, Pedram Gerami

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

Déjà abonné à cette revue ?

Mon compte


Plateformes Elsevier Masson

Déclaration CNIL

EM-CONSULTE.COM est déclaré à la CNIL, déclaration n° 1286925.

En application de la loi nº78-17 du 6 janvier 1978 relative à l'informatique, aux fichiers et aux libertés, vous disposez des droits d'opposition (art.26 de la loi), d'accès (art.34 à 38 de la loi), et de rectification (art.36 de la loi) des données vous concernant. Ainsi, vous pouvez exiger que soient rectifiées, complétées, clarifiées, mises à jour ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est interdite.
Les informations personnelles concernant les visiteurs de notre site, y compris leur identité, sont confidentielles.
Le responsable du site s'engage sur l'honneur à respecter les conditions légales de confidentialité applicables en France et à ne pas divulguer ces informations à des tiers.