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Govind Rao

North America home healthcare market: $130 billion industry by 2017 - 1 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|233679|nxbg|20130812|175322873

from heather ltc US privatization

shared by Govind Rao on 13 Aug 13 - No Cached
  • Govind Rao on 13 Aug 13
     
    CompaniesandMarkets.com Mon Aug 12 2013, 2:11pm ET The North America home healthcare market was valued at $90.9 billion in 2012; it is poised to grow at a CAGR of 7.5% to reach $130.4 billion by 2017. Home healthcare market includes products, services, and telehealth. The home care product category comprises homecare testing, screening & monitoring devices, home healthcare therapeutic equipment, mobility assist & other devices, fitness, and nutrition products. Services include unskilled care, rehabilitation therapy, infusion therapy, and respiratory therapy, while telehealth includes home telehealth monitoring devices and telehealth services.
Irene Jansen

Glazier et al. All the Right Intentions but Few of the Desired Results: Lessons on Acce... - 2 views

www.longwoods.com/...23041

ontario primary care doctors capitation payment methods chc p4p excellent

shared by Irene Jansen on 19 Sep 12 - No Cached
  • The common elements of reform include organizing physicians into groups with shared responsibilities, inter-professional teams, electronic health records, changes to physician reimbursement, incentive and bonus payments for certain services, after-hours coverage requirements, and telehealth and teletriage services.
  • Ontario's initiatives have been substantially different from those of other provinces in the scope, size of investment and structural changes that have been implemented.
  • These models have the same requirements for evening and weekend clinics, and for their physicians to be on call to an after-hours, nurse-led teletriage service.
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  • Despite this increased attachment, the chance of being seen in a timely way did not improve. Ontario's primary care models require evening and weekend clinics and on-call duties, and penalize practices for out-of-group primary care visits; therefore, these findings are unexpected. While many factors are likely involved, Ontario's auditor general noted two major faults: not establishing mechanisms for ongoing monitoring and evaluation, and not enforcing practices' contractual obligations, especially for after-hours care
  • The access bonus is reduced by outside primary care use but not by emergency department visits. Physicians responding rationally to such a financial incentive would logically direct their patients away from walk-in clinics and toward emergency departments. The access bonus also strongly discourages healthcare groups from working together to provide late evening and night coverage because all parties would lose financially. An incentive that costs more than $50 million annually should be structured to align better with health system needs.
  • A recent systematic review found insufficient evidence to support or not support the use of financial incentives to improve the quality of care (Scott et al. 2011).
  • In Ontario, there was little relationship between incentive payments and changes in diabetes care (Kiran et al. 2012), nor were there substantial improvements in most aspects of preventive care despite substantial incentives (Hurley et al. 2011). Similar cautionary tales about pay-for-performance can be found elsewhere in the health system (Jha et al. 2012).
  • Ontario adjusts capitation for only age and sex, whereas most other jurisdictions further adjust for expected healthcare needs, patient complexity and/or socioeconomic disparities (e.g., the Johns Hopkins Adjusted Clinical Groups http://www.acg.jhsph.org/). That may be why Ontario's primary care capitation models have attracted healthier and wealthier practices (Glazier et al. 2012).
  • Community health centres care for disadvantaged populations with superior outcomes (Glazier et al. 2012; Russell et al. 2009) and could play a larger role in Ontario's health system.
  • Unlike some other jurisdictions (National Health Service Information Centre for Health and Social Care 2012), Ontario has no routine measurement of primary care at the practice, group or community levels. It has no organized structures, such as the Divisions of General Practice in Australia (Australian Department of Health and Ageing 2012) or the Divisions of Family Practice in British Columbia (2010), that can help practices come together to improve care. It has also failed to hold practices accountable for their contractual obligations, including after-hours clinics.
  • Ontario's reforms occurred in the absence of routine measurement of primary care within practices, groups or communities and with limited accountability for how funds were spent.
  • Access to primary care has proven to be challenging in Canada, leaving it behind many developed countries in timely access and after-hours care, and more dependent than most on the use of emergency departments (Schoen et al. 2007).
  • A strong primary care system is consistently associated with better and more equitable health outcomes, higher patient satisfaction and lower costs (Starfield et al. 2005).
healthcare88

Funds would come with conditions: feds - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|wifp|20161019|258654570

accord

shared by healthcare88 on 19 Oct 16 - No Cached
  • Winnipeg Free Press Wed Oct 19 2016
  • OTTAWA - Provinces may get additional money for health care but only for specific initiatives such as home care or mental health, federal Health Minister Jane Philpott signalled at the end of a meeting with her provincial counterparts in Toronto. The tensions from the meeting spilled into the post-event news conference, as provincial ministers talked about federal cuts to health care and Philpott fought back, saying provinces never delivered promised health-care innovations when the 10-year health accord was signed in September 2004. That accord guaranteed six per cent annual increases in health care for a decade, and that formula was extended for two more years. The provinces argue Ottawa's plan to cut the annual increase in health transfers to the provinces from six per cent to three per cent will result in $60 billion less in federal cash going to the provinces over the next 10 years. They call that a "cut" to health care. "We are being asked to do more with less," said Quebec Health Minister Gaétan Barrette.
  • "All provinces and territories will have to make difficult choices." Philpott disagreed with his assessment. "There will be no cuts," she said. "There will be increases." Canada transferred $36.1 billion to the provinces for health care this year. A six per cent increase next year would be $2.2 billion more. The previous Conservative federal government announced intentions to reduce the increase in health transfers to three per cent, and the Liberals have taken up that plan. Additional funds will be available for health care but in targeted ways, such as for home care or mental health. During the election, the Liberals promised to spend $3 billion on home care over four years, money that has yet to materialize. "Canadians want to see their health-care system get better," said Philpott. Developing a new multi-year health accord with the provinces was the first task assigned to Philpott in her mandate letter in November 2015. Philpott said when the previous accord was signed, it put a lot of money on the table and it was negotiated in good faith by all parties involved that "there would be the changes that needed to take place."
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  • Those changes included cutting wait times, improving home care, electronic records and telehealth, better access to care in the North, a national pharmaceuticals strategy, improvements in prevention in public health and accountability and better reporting to Canadians. Philpott's assessment Tuesday was the provinces had intended to live up to their commitments but that it hadn't happened. "The transformation to the system didn't follow," she said. Philpott said Canadians want to be able to measure where new money is going, such as the number of hours of therapy delivered in a mental health program or the number of additional home care visits added. Manitoba Health Minister Kelvin Goertzen said in a later conference call he agrees there needs to be more reform and innovation, particularly when it comes to accountability and meeting specific performance targets. "I would take exception that there hasn't been any innovation," he said. "Could there have been more? Sure."
  • Goertzen said Manitoba will be announcing more health-care targets shortly, with plans to better account for the dollars spent. He said additional funding for home care or mental health would be welcome but Ottawa needs to be a better partner on the day-to-day business of health-care delivery, and the three per cent increase isn't enough. The provinces have long complained Ottawa was to contribute half the cost of medicare but its contribution is now around one-fifth. They want the accord to move Ottawa to contributing 25 per cent. "We didn't get that commitment today," said Goertzen. The provinces want to discuss the health accord with Prime Minister Justin Trudeau when they all meet in Ottawa in December. Trudeau called that meeting to discuss climate change and the new carbon price he is requiring all provinces to impose. Health care is not currently on the agenda. mia.rabson@freepress.mb.ca
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