Patient-Centered Care, Cost-Sharing, Cost-Efficiency and More in these Recent Articles

The following articles from the New England Journal of Medicine highlight issues including patient safety and patient-centered care, Medicaid cost sharing, and provider cost efficiency:

• The Checklist Conundrum  (subscription only)

The use of surgical safety checklists has been mandated or strongly encouraged by several governments, including the United Kingdom, the Netherlands, and Ontario, Canada, but a recent study showed the limitations of this patient safety innovation. This editorial by health policy innovator Lucian Leape, MD, explores why surgical safety checklists did not reduce surgical mortality or complications in Ontario and highlights the need for accelerated adoption of their use.

• Pinching the Poor? Medicaid Cost Sharing under the ACA

Many states have developed proposals that include cost sharing for Medicaid program enrollees, but questions remain about whether Medicaid cost sharing is a desirable policy. This article urges policymakers to monitor cost-sharing programs to understand their impact on cost, quality, access, and health.

Financial Stewardship

• Promoting Population Health through Financial Stewardship (subscription only)

Financial stewardship can promote the health and well-being of a population and directly impact patient access to care, health care costs, and pressure on health care institutions to cut back on important services.

• Perspective Roundtable: Avoiding Low-Value Care

The cost of health care in the United States has driven efforts to assess the true value of common health care services. In a video roundtable narrated by Atul Gawande, Bruce Landon, Scott Halpern, and Carrie Colla discuss ways to avoid low-value care.

Care Coordination

• Transforming Specialty Practice — The Patient-Centered Medical Neighborhood

This brief explores the concept of the patient-centered medical neighborhood, which includes real or virtual specialty clinics, ancillary service providers, and hospitals in an expanded notion of patient-centered care.

• Redesigning Surgical Decision Making for High-Risk Patients (subscription only)

Surgical decisions are typically made after a discussion between a physician and patient with occasional input from other physicians, but this approach may not be effective for high-risk patients. This perspective explores incorporating collaboration between a multidisciplinary group of experts to achieve better outcomes in patient care.