Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 1 of 15

Practicing Medicine in the Era of Health Reform

References and Readings

September 2015

Topics Page

Insurance and Health Plans 1

Medicare 1

Medicaid 2

Medicaid and Medicare Dual Eligibles 3

The Patient Protection and Affordable Care Act 3

Health Reform 4

Costs and Spending 5

Payment Reform 6

Delivery System Reform 9

Patient-Centered Medical Homes 10

Accountable Care Organizations 11

Community Health Centers 12

Health Disparities 12

Health Care Quality & Safety 13

Chronic Care Management 14

Career Paths 15

Insurance and Health Plans

American Academy of Actuaries. Drivers of 2015 Health Insurance Premium Changes.

Issue Brief, June 2014.

http://actuary.org/files/2015_Premium_Drivers_Updated_060414.pdf

Kaiser Family Foundation. Understanding Health Insurance. 2014.

http://kff.org/understanding-health-insurance/

Boisson S. Dr. Shadid’s Maverick Medicine. American History. April 2008.

http://www.historynet.com/dr-shadids-maverick-medicine.htm

Medicare:

Blumenthal D, Davis K, Guterman S. Medicare at 50 – origins and evolution. New

England Journal of Medicine. January 29, 2015;372(5):470-486. (part 1 of 2)

http://www.nejm.org/doi/full/10.1056/NEJMhpr1414856 … and … Blumenthal D,

Davis K, Guterman S. Medicare at 50 – moving forward. New England Journal of

Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 2 of 15

Medicine. February 12, 2015;372(7):671-677. (part 2 of 2)

http://www.nejm.org/doi/full/10.1056/NEJMhpr1414856

Centers for Medicare and Medicaid Services. Medicare. The Official U.S. Government

Site for Medicare. http://www.medicare.gov/

Kaiser Family Foundation. Medicare. http://kff.org/medicare/ … Medicare at a Glance.

2014. http://kff.org/medicare/fact-sheet/medicare-at-a-glance-fact-sheet/ … . Medicare:

A Primer. 2015.http://kff.org/medicare/report/a-primer-on-medicare-key-facts-about-the-

medicare-program-and-the-people-it-covers/

Kaiser Family Foundation. Medicare Advantage: Take Another Look. May 2014.

http://kff.org/medicare/perspective/medicare-advantage-take-another-look/ … Medicare

Advantage Fact Sheet. May 2014. http://kff.org/medicare/fact-sheet/medicare-advantage-

fact-sheet/ … Medicare Advantage 2015 Data Spotlight: Overview of Plan Changes.

2014.http://kff.org/medicare/issue-brief/medicare-advantage-2015-data-spotlight-

overview-of-plan-changes/

Newhouse JP; McGuire TG. How successful is Medicare Advantage? Milbank Quarterly.

June 2014;92(2):351-94.http://onlinelibrary.wiley.com/doi/10.1111/1468-

0009.12061/abstract

Medicaid:

Centers for Medicare and Medicaid Services. Medicaid. The Official U.S. Government

Site for Medicare. http://www.medicaid.gov/

Crowley R, Golden W. Health policy basics: Medicaid expansion. Annals of Internal

Medicine. March 18, 2014;160(6):423-425.

http://annals.org/article.aspx?articleid=1791502

Iglehart J, Sommers B. Medicaid at 50 — From welfare program to nation’s largest

health insurer. New England Journal of Medicine. May 28, 2015;372(22):2152-2159.

http://www.nejm.org/doi/full/10.1056/NEJMhpr1500791

Kaiser Family Foundation. Medicaid. http://kff.org/medicaid/ … Medicaid at 50. 2015.

http://kff.org/medicaid/report/medicaid-at-50/ … Medicaid Moving Forward. Issue Brief.

March 2015. http://kff.org/health-reform/issue-brief/medicaid-moving-forward/ …

Medicaid Financing: How Does it Work and What are the Implications? 2015.

http://kff.org/medicaid/issue-brief/medicaid-financing-how-does-it-work-and-what-are-

the-implications/

Kaiser Family Foundation.Key Findings on Medicaid Managed Care: Highlights from the

Medicaid Managed Care Market Tracker. 2014. http://kff.org/medicaid/report/key-

findings-on-medicaid-managed-care-highlights-from-the-medicaid-managed-care-

market-tracker/

Medicaid: Health Affairs, July 2015;34(7). Several articles.

http://content.healthaffairs.org/content/34/7.toc

Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 3 of 15

(Massachusetts) Boozang P, Anthony S, Glanz D. The Future of MassHealth: Five

Priority Issues for the New Administration. December 2014.

http://bluecrossmafoundation.org/publication/future-masshealth-five-priority-issues-new-

administration

Medicaid and Medicare Dual Eligibles:

Centers for Medicare and Medicaid Dual Eligibles under the Medicare and Medicaid

Programs. November 2014. http://www.cms.gov/Outreach-and-Education/Medicare-

Learning-Network-

MLN/MLNProducts/downloads/Medicare_Beneficiaries_Dual_Eligibles_At_a_Glance.p

df

Kaiser Family Foundation. Dual Eligible Resources. http://kff.org/tag/dual-eligible/

JAMA. Theme: Medicare and Medicaid at 50. (also includes articles on the Affordable

Care Act) JAMA. July 28, 2015;314(4).

http://jama.jamanetwork.com/Issue.aspx?journalid=67&issueID=934258&direction=P

The Patient Protection and Affordable Care Act (PPACA)

Blavin D, Shartzer A, et al. An early look at changes in employer-sponsored insurance

under the Affordable Care Act. Health Affairs. January 2015;34(1):170-177.

http://content.healthaffairs.org/content/34/1/170.abstract

Blumenthal D, Abrams M, Nuzum R. The Affordable Care Act at 5 Years. New England

Journal of Medicine. June 18, 2015;372(25):2451-2458.

http://www.nejm.org/doi/full/10.1056/NEJMhpr1503614

Commonwealth Fund. The Affordable Care Act: A Look Back at the First 5 Years. May

2015. http://www.commonwealthfund.org/publications/other/2015/may/aca-at-five

Kaiser Family Foundation, Health Reform and the Affordable Care Act.

http://kff.org/health-reform/

Cheng T, Wise P, Halfon N. Promise and perils of the Affordable Care Act for children.

JAMA. May 7, 2014;311(17):1733-1734.

Crowley R, Tape T. Health policy basics: Health insurance marketplaces. Annals of IM.

Dec. 3. 2013;159(11):784-786. http://annals.org/article.aspx?articleid=1741855

HealthCare.gov. A federal government Website managed by the U.S. DHHS.

http://www.hhs.gov/healthcare/ ... The Affordable Care Act, section by section.

http://www.healthcare.gov/law/introduction/index.html

Kaiser Family Foundation. The Uninsured: A Primer - Key Facts about Health Insurance

and the Uninsured in America. 2015. http://kff.org/uninsured/report/the-uninsured-a-

primer/

Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 4 of 15

Kaiser Family Foundation. How will the uninsured fare under the Affordable Care Act?

Fact Sheet. Apr 7, 2014. http://kff.org/health-reform/fact-sheet/how-will-the-uninsured-

fare-under-the-affordable-care-act/

Kingsdale J. After the false start — what can we expect from the new health insurance

marketplaces? New England Journal of Medicine. January 30, 2014; 370(5):393-396.

http://www.nejm.org/doi/full/10.1056/NEJMp1315956

Kaiser Family Foundation. Women and Health Care in the Early Years of the ACA: Key

Findings from the 2013 Kaiser Women's Health Survey May 15, 2014.

http://kff.org/womens-health-policy/report/women-and-health-care-in-the-early-years-of-

the-aca-key-findings-from-the-2013-kaiser-womens-health-survey/

Health Reform

Abrams A, Nuzum R, et al.The Affordable Care Act's Payment and Delivery System

Reforms: A Progress Report at Five Years. May 2015. Issue Brief. The Commonwealth

Fund. http://www.commonwealthfund.org/publications/issue-briefs/2015/may/aca-

payment-and-delivery-system-reforms-at-5-years

America’s Health Insurance Plans (AHIP). A Roadmap to High Quality Affordable

Health Care for All Americans. November 2013.http://www.ahip.org/Roadmap-

Affordable-Health-Care/

Blumenthal D. Big: Grappling with the Size of U.S. Health Care. Commonwealth Fund,

July 9, 2014. http://www.commonwealthfund.org/publications/blog/2014/jul/big-

grappling-with-the-size-of-the-us-health-system

Ignagni K. Health plan innovations in delivery system reforms. The American Journal of

Managed Care. April 2013;19(4):260-262.

http://www.ajmc.com/publications/issue/2013/2013-1-vol19-n4/Health-Plan-Innovations-

in-Delivery-System-Reforms/

Institute for Healthcare Improvement. The Triple Aim.

http://www.ihi.org/Engage/Initiatives/TripleAim/Pages/default.aspx

JAMA issue, November 13, 2013;310(18). Critical Issues in US Health Care. Several

articles by leading health care professionals.

http://jama.jamanetwork.com/issue.aspx?journalid=67&issueid=928805&direction=P

Oberlander J. Unfinished journey – a century of health care reform in the United States.

New England Journal of Medicine. Aug 16, 2012;367(7):585-590.

http://www.nejm.org/doi/full/10.1056/NEJMp1202111

Porter M, Lee T. Why strategy matters now. New England Journal of Medicine. April 30,

2015;372(18):1681-1684. http://www.nejm.org/doi/full/10.1056/NEJMp1502419

PwC. PricewaterhouseCoopers LLP, Top Health Industry Issues of 2015.

http://www.pwc.com/us/en/health-industries/top-health-industry-issues/index.jhtml

Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 5 of 15

The Commonwealth Fund. Health Reform & You. … Better Care at Lower Cost: Is It

Possible? November 2013. http://www.commonwealthfund.org/publications/health-

reform-and-you/better-care-at-lower-cost or

http://www.commonwealthfund.org/~/media/files/publications/health-reform-and-

you/health_reform_and_you_costs_11_22_2013_web_final.pdf

(Massachusetts) Blue Cross Blue Shield Massachusetts Foundation. Health Reform in

Massachusetts: Assessing the Results. Updated March, 2014

http://bluecrossmafoundation.org/publication/updated-health-reform-massachusetts-

assessing-results

o Chapter 224: What Does It Mean for Hospitals, Health Plans, Consumers, and

Clinicians? November 2012.

http://bluecrossmafoundation.org/publication/chapter-224-what-does-it-mean-

hospitals-health-plans-consumers-and-clinicians

o Reaching the Remaining Uninsured in Massachusetts: Challenges and

Opportunities. March 2013.

http://bluecrossmafoundation.org/publication/reaching-remaining-uninsured-

massachusetts-challenges-and-opportunities

Costs and Spending

Bradley E, Elkins B, et al. Health and social services expenditures: associations with

health outcomes. BMJ Quality & Safety. Oct. 2011;20(10):826-31.

http://qualitysafety.bmj.com/content/20/10/826.abstract

Cassel C, Brennan T. Managing medical resources: return to the commons? JAMA. June

13, 2007;297(22):2518-21. http://jama.jamanetwork.com/article.aspx?articleid=207406

Fuchs V. Major concepts of health care economics. Annals of Internal Medicine. March

3, 2015;162(5):380-383. http://annals.org/article.aspx?articleid=2173507

Fuchs VR. Major trends in the U.S. health economy since 1950. New England Journal of

Medicine. March 15, 2012;366(11):973-977.

http://www.nejm.org/doi/full/10.1056/NEJMp1200478

Hartman M, Martin A, et al, the National Health Expenditure Accounts Team. National

health spending in 2013: growth slows, remains in step with the overall economy. Health

Affairs. January 2015;34(1):150-160.

http://content.healthaffairs.org/content/34/1/150.abstract

Holahan J, McMorros S. The Widespread Slowdown in Health Spending Growth.

Implications for Future Spending Projections and the Cost of the Affordable Care Act.

Urban Institute & Robert Wood Johnson Fdtn. April 2015.

http://www.rwjf.org/en/library/research/2015/04/the-widespread-slowdown-in-health-

spending-growth.html

Kaiser Family Foundation. Health Care Costs. A Primer. May 2012. http://kff.org/health-

costs/report/health-care-costs-a-primer/

Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 6 of 15

Keehan S, Cuckler G, et al. National health expenditure projections, 2014-2024:

Spending growth faster than recent trends. Health Affairs. August 2015;34(8):1407-1417.

http://content.healthaffairs.org/content/34/8/1407

PwC. PricewaterhouseCoopers Health Industries. Behind the Numbers: Medical Cost

Trends for 2015. http://www.pwc.com/us/en/health-industries/behind-the-

numbers/index.jhtml

Robertson T, Lofgren R. Where population health misses the mark: breaking the 80/20

rule. Academic Medicine. March 2015;90(3):277-278.

http://journals.lww.com/academicmedicine/Fulltext/2015/03000/Where_Population_Heal

th_Misses_the_Mark___Breaking.11.aspx

Sisko A, Keehan S, et al. National health expenditure projections, 2013-23: faster growth

expected with expanded coverage and improving economy. Health Affairs. October

2014;33(10):1841-1850.

http://content.healthaffairs.org/content/early/2014/08/27/hlthaff.2014.0560.abstract

The Peterson-Kaiser Health System Tracker. Chart collection: How has health spending

changed over time? http://www.healthsystemtracker.org/chart-collection/how-has-health-

spending-changed-over-time/

(Massachusetts) Gyurina C, Rosinski J, Seifert R. Rising Health Care Costs in

Massachusetts: What It Means for Consumers. April 2015.

http://bluecrossfoundation.org/publication/rising-health-care-costs-massachusetts-what-

it-means-consumers

International:

Davis K, Stremikis K, et al. Mirror, Mirror on the Wall, 2014 Update: How the U.S.

Health Care System Compares Internationally, The Commonwealth Fund, June 2014.

http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror

Kaiser Family Foundation. Health Care Spending in the United States and Selected

OECD Countries. April 2011. http://kff.org/health-costs/issue-brief/snapshots-health-

care-spending-in-the-united-states-selected-oecd-countries/

Payment Reform

Antos J, Pauly M, Wilensky G. Bending the cost curve through market-based incentives.

New England Journal of Medicine. September 6, 2012;367:954-958.

http://www.nejm.org/doi/full/10.1056/NEJMsb1207996

Catalyst for Payment Reform. 2014 National Scorecard on Payment Reform.

http://www.catalyzepaymentreform.org/how-we-catalyze/national-scorecard

See press release, Sept. 30, 2014.

http://www.catalyzepaymentreform.org/images/documents/scorecard2014release ,

See summary:

http://www.catalyzepaymentreform.org/images/documents/nationalscorecard2014.pdf

Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 7 of 15

Friedberg M, Chen P, et al. Effects of Health Care Payment Models on Physician Practice

in the United States. Santa Monica, CA: RAND Corporation, 2015.

http://www.rand.org/pubs/research_reports/RR869 ... Full report (download) has

summary, pages 6-17 (or xi-xvii)

Gawande A. The Hot Spotters. (Can we lower medical costs by giving the neediest

patients better care?) The New Yorker. January 24, 2011.

http://www.newyorker.com/magazine/2011/01/24/the-hot-spotters Plus Dr. Gawande’s

follow-up commentary: Seeing Spots. January 27, 2011.

http://www.newyorker.com/news/news-desk/seeing-spots

Ginsburg P. Achieving health care cost containment through provider payment reform

that engages patients and providers. Health Affairs. May 2013;32(5):929-934.

http://www.hschange.org/CONTENT/1350/

Hostetter M, Klein S. Health Care Price Transparency: Can It Promote High-Value Care?

Quality Matters, April/May 2012. Commonwealth Fund.

http://www.commonwealthfund.org/Newsletters/Quality-Matters/2012/April-May/In-

Focus.aspx

Khullar D, Chokshi D, et al. Behavioral economics and physician compensation –

promise and challenges. New England Journal of Medicine. June 11, 2015;372(24):2281-

2283. http://www.nejm.org/doi/full/10.1056/NEJMp1502312

Landon B, Roberts D. Reenvisioning specialty care and payment under global payment

systems. JAMA. July 24/31, 2013;310(4):371-372.

McDonough J. The demise of Vermont’s single-payer plan. New England Journal of

Medicine. April 23, 2015;372(17):1584-1585.

http://www.nejm.org/doi/full/10.1056/NEJMp1501050

Mechanic R, Altman S, McDonough J. The new era of payment reform, spending targets,

and cost containment in Massachusetts: early lessons for the nation. Health Affairs.

October 2012;31(10):2334-2342.

http://healthforum.brandeis.edu/publications/pdf/Mechanic.Altman.Oct.2012.HIF.Site.Ve

rsion.pdf

Mechanic R, Zinner D. Many large medical groups will need to acquire new skills and

tools to be ready for payment reform. Health Affairs. Sept. 2012;31(9):1984-92.

http://healthforum.brandeis.edu/publications/pdf/Mechanic.Zinner.Sept.2012.HIF.Site.Ve

rsion.pdf

Network for Regional Healthcare Improvement, Center for Healthcare Quality and

Payment Reform, and Robert Wood Johnson Foundation. The Building Blocks of

Successful Payment Reform: Designing Payment Systems that Support Higher–Value

Health Care. Payment Reform Series Number 3. April 2015.

http://www.nrhi.org/uploads/nrhi_pymntrfrm_3_r10.pdf or link from

http://www.nrhi.org/work/implementing-payment-reform/

Quinn K. The 8 basic payment methods in health care. Annals of Internal Medicine.

Aug. 18, 2015;163(4):300-306. http://annals.org/article.aspx?articleid=2424877

Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 8 of 15

Schroeder S, Frist W, for the National Commission on Physician Payment Reform.

Phasing out fee-for-service payment. New England Journal of Medicine. May 23,

2013;368(21):2029-2032. http://www.nejm.org/doi/full/10.1056/NEJMsb1302322 and

http://physicianpaymentcommission.org/report/

Seidman J, Ganesan N. Payment Reform on the Ground: Lessons Learned from the

Alternative Quality Contract. Avalere Health. March 2015.

http://avalere.com/expertise/managed-care/insights/lessons-learned-from-blue-cross-blue-

shield-of-massachusetts-alternative-qu

Song Z, Rose S, Safran D, Landon B, et al. Changes in health care spending and quality 4

years into global payment. New England Journal of Medicine. October 30,

2014;371(18):1704-1714.http://www.nejm.org/doi/full/10.1056/NEJMsa1404026

Steinbrook R. Controlling health care costs in Massachusetts with a global spending

target. JAMA. Sept 26, 2012;308 (12):1215-1216.

VanLare J, Conway P. Value-based purchasing — national programs to move from

volume to value. New England Journal of Medicine. July 26, 2012; 367(4):292-295.

http://www.nejm.org/doi/full/10.1056/NEJMp1204939

Wehrwein P. Value = (Quality + Outcomes) / Cost. Managed Care. August 2015. (and

related articles on reimbursement methods)

http://www.managedcaremag.com/issue/2015/August

US Dept. of Health and Human Services, Centers for Medicare & Medicaid Services.

Three Fact sheets: Better Care, Smarter Spending, Healthier People. January 26, 2015:

Improving Our Health Care Delivery System.

http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-

sheets-items/2015-01-26.html

Paying Providers for Value, Not Volume.

http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-

sheets-items/2015-01-26-3.html

Why It Matters. http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-

sheets/2015-Fact-sheets-items/2015-01-26-2.html

Related: Burwell SM. Setting value-based payment goals – HHS efforts to

improve U.S. health care. New England Journal of Medicine. March 5,

2015;372(10):897-899. http://www.nejm.org/doi/full/10.1056/NEJMp1500445

and

Cutler D. Payment reform is about to become a reality. JAMA. April 18,

2015;313(16):1606-07.

http://jama.jamanetwork.com/article.aspx?articleid=2279699

Re: MACRA (Medicare Access and CHIP Reauthorization Act), enacted April 2015; and

MIPS (Merit-Based Incentive Payment System) and APM (alternative payment models).

Summaries: Doherty R. Goodbye, Sustainable Growth Rate – Hello, Merit-based

Incentive Payment System. Annals of Internal Medicine. Published online, May 12, 2015.

http://annals.org/article.aspx?articleid=2292049 … National Association of ACOs

Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 9 of 15

https://www.naacos.com/pdf/MACRASummary050415.pdf ... Mintz Levin

http://www.healthlawpolicymatters.com/2015/04/20/with-sgr-repealed-replacement-

policy-creates-new-priorities/ … McClellan M, Berenson R, Chernew M, Kramer W,

Lansky D, Milstein A. Health Policy Issue Brief: Medicare Physician Payment Reform:

Securing Connection Between Value and Payment. Washington, DC: The Brookings

Institution; January 2015. http://www.brookings.edu/research/papers/2015/01/27-

medicare-physician-payment-reform-mcclellan

Delivery System Reform

America’s Health Insurance Plans (AHIP). High Value Provider Networks. December

2013. http://www.ahip.org/Issues/Health-Care-Quality.aspx

Baron R, Davis K. Accelerating the adoption of high-value primary care — a new

provider type under Medicare? New England Journal of Medicine. January 9,

2014;370(2):99-101. http://www.nejm.org/doi/full/10.1056/NEJMp1314933

Berwick D, Hackbarth A. Eliminating waste in US health care. JAMA. Apr 11,

2012;307(14):1513-6. http://jama.jamanetwork.com/article.aspx?articleid=1148376

Cosgrove D, Fisher M, Gabow P, et al. A CEO Checklist for High-Value Health Care.

Discussion paper. Washington, DC: Institute of Medicine; 2012.

http://www.iom.edu/Global/Perspectives/2012/CEOChecklist.aspx and related: Gabow P,

Halvorson G, Kaplan G. Marshaling leadership for high-value health care: an Institute of

Medicine discussion paper. JAMA. July 18, 2012;308(3):239-240.

http://jama.jamanetwork.com/article.aspx?articleid=1172505

Daschle T, Domenici P, Frist W, Rivlin A. The Bipartisan Policy Center. Prescription for

patient-centered care and cost containment. New England Journal of Medicine. August 1,

2013;369(5):471-474. http://www.nejm.org/doi/full/10.1056/NEJMsb1306639 or

http://bipartisanpolicy.org/news/articles/2013/06/prescription-patient-centered-care-and-

cost-containment

Fineberg H. A successful and sustainable health system — how to get there from here.

New England Journal of Medicine. March 15, 2012;366(11):1020-1027.

http://www.nejm.org/doi/full/10.1056/NEJMsa1114777

Gawande A. Overkill. (An avalanche of unnecessary medical care is harming patients

physically and financially. What can we do about it?) The New Yorker. May 11,

2015.http://www.newyorker.com/magazine/2015/05/11/overkill-atul-gawande

Gawande A. Big Med. The New Yorker. August 13, 2012.

http://www.newyorker.com/reporting/2012/08/13/120813fa_fact_gawande

Goldsmith J. A Blueprint for a More Effective, Physician-Directed Health System. The

Physicians Foundation. May 2013. http://www.physiciansfoundation.org/healthcare-

research/a-blueprint-for-a-more-effective-physician-directed-health-system

Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 10 of 15

Hussey P, Armstrong C, Schneider E. Paths to Sustainability for Innovative Delivery

System Programs. Santa Monica, CA: RAND Corporation, 2015.

http://www.rand.org/pubs/research_reports/RR1090

Institute of Medicine. Best Care at Lower Cost: The Path to Continuously Learning

Health Care in America. September 6, 2012. http://www.iom.edu/Reports/2012/Best-

Care-at-Lower-Cost-The-Path-to-Continuously-Learning-Health-Care-in-America.aspx

and Report Brief http://www.iom.edu/Reports/2012/Best-Care-at-Lower-Cost-The-Path-

to-Continuously-Learning-Health-Care-in-America/Report-Brief.aspx

Marcotte L, Moriates C, Milstein A. Professional organizations’ role in supporting

physicians to improve value in health care. JAMA. July 16, 2014; 312(3):231-232.

National Patient Safety Foundation, Lucien Leape Institute. Order from Chaos:

Accelerating Care Integration.2012. http://www.npsf.org/?page=orderfromchaos

Partnership for Sustainable Health Care. Strengthening Affordability and Quality in

America's Health Care System. April 2013. Summary: http://www.rwjf.org/en/research-

publications/find-rwjf-research/2013/04/strengthening-affordability-and-quality-in-

america-s-health-care.html and Full report:

http://www.rwjf.org/content/dam/farm/reports/reports/2013/rwjf405432

Tilburt J, Wynia M, et al. Views of US physicians about controlling health care costs.

JAMA. July 24/31, 2013;310(4):380-388.

http://jama.jamanetwork.com/article.aspx?articleid=1719740

Torchiana D, Colton D, et al. Massachusetts General Physicians Organization’s quality

incentive program produces encouraging results. Health Affairs. October

2013;32(10):1748-1756. http://content.healthaffairs.org/content/32/10/1748.abstract

Patient-Centered Medical Homes

Agency for Healthcare Research and Quality. The Patient Centered Medical Home

Resource Center. http://www.pcmh.ahrq.gov/

Huang X, Rosenthal M. Transforming specialty practice – the patient-centered medical

neighborhood. New England Journal of Medicine, April 10, 2014;370(15):1376-1379.

http://www.nejm.org/doi/full/10.1056/NEJMp1315416

National Committee for Quality Assurance (NCQA). Patient-Centered Medical Home

Recognition Program.

http://www.ncqa.org/Programs/Recognition/Practices/PatientCenteredMedicalHomePCM

H.aspx … The Future of Patient-Centered Medical Homes. March 2014.

http://www.ncqa.org/Portals/0/Public%20Policy/2014%20Comment%20Letters/The_Fut

ure_of_PCMH.pdf

Patient-Centered Primary Care Collaborative (PCPCC). The Medical Home.

https://www.pcpcc.org/about/medical-home

Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 11 of 15

Schneider E. Strengthening Primary Care amid the Hype. June 1, 2015. Commonwealth

Fund. http://www.commonwealthfund.org/publications/blog/2015/jun/strengthening-

primary-care-amid-the-hype

Accountable Care Organizations

Calandra R. The ACO Gamble. Managed Care Magazine. June 2015;24(6):20-25.

http://managedcaremag.com/archives/2015/6/aco-gamble

Casalino L. Accountable Care Organizations – The risk of failure and the risks of

success. New England Journal of Medicine. October 30, 2014;371(18):1750-1751.

http://www.nejm.org/doi/full/10.1056/NEJMe1410660

Centers for Medicare & Medicaid Services. Innovation Center. Accountable Care

Organizations. http://innovation.cms.gov/initiatives/ACO/… Next Generation ACO

Model. March 2015. http://innovation.cms.gov/initiatives/Next-Generation-ACO-Model/

Colla C, Lewis V, et al. First national survey of ACOs finds that physicians are playing

strong leadership and ownership roles. Health Affairs. June 2014;33(6):964-971.

http://content.healthaffairs.org/content/33/6/964.abstract

Epstein A, Jha A, et al. The Care Span: Analysis of early Accountable Care

Organizations defines patient, structural, cost, and quality-of-care characteristics. Health

Affairs. January 2014;33(1):95-102.

http://content.healthaffairs.org/content/33/1/95.abstract

Gold J. FAQ On ACOs: Accountable Care Organizations, Explained. Kaiser Health

News. April 16, 2014. http://www.kaiserhealthnews.org/stories/2011/january/13/aco-

accountable-care-organization-faq.aspx?referrer=search

McCarthy D, Klein S, Cohen A. The Road to Accountable Care: Building Systems for

Population Health Management. The Commonwealth Fund, October 2014.

http://www.commonwealthfund.org/publications/case-studies/2014/oct/road-to-

accountable-care-synthesis and

http://www.commonwealthfund.org/~/media/files/publications/case-

study/2014/oct/1768_mccarthy_road_to_accountable_care_case_studies_synthesis.pdf

McClellan M. Accountable Care Organizations and evidence-based payment reform.

JAMA. June 2, 2015;313(21):2128-2129.

http://jama.jamanetwork.com/article.aspx?articleid=2290607

McWilliams J, Landon B, et al. Changes in patients’ experiences in Medicare

Accountable Care Organizations. New England Journal of Medicine. October 30,

2014;371(18):1715-1724. http://www.nejm.org/doi/full/10.1056/NEJMsa1406552

Mostashari F, Sanghavi D, McClellan M. Health reform and physician-led accountable

care: The paradox of primary care physician leadership. JAMA. May 14,

2014;311(18):1855-1856.

Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 12 of 15

National Committee for Quality Assurance. Accountable Care Organization

Accreditation.

http://www.ncqa.org/Programs/Accreditation/AccountableCareOrganizationACO.aspx

Nyweide D, Lee W, et al. Association of Pioneer Accountable Care Organizations vs.

traditional Medicare fee for service with spending, utilization, and patient experience.

JAMA. June 2, 2015;313(21):2152-2161.

o Editorial: Casalino L, Pioneer Accountable Care Organizations: Traversing rough

country. JAMA. June 2, 2015;313(21):2126-2127.

Oliver Wyman Consulting. Accountable Care Organizations. ACO Update: A Slower

Pace of Growth in 2014. April 2015. … and ACO Update: Accountable Care at a

Tipping Point. April 2014.

http://www.oliverwyman.com/insights/publications/2014/may/accountable-care-strategy-

hub.html

Pham H, Cohen M, Conway P. The Pioneer Accountable Care Organization model:

improving quality and lowering costs. JAMA. Oct. 22/29, 2014;312(16):1635-6.

Pham H, Pilotte J, et al. Medicare’s vision for delivery system reform – the role of ACOs.

New England Journal of Medicine. September 10, 2015;373(11):987-990.

http://www.nejm.org/doi/full/10.1056/NEJMp1507319

Wehrwein P. An Accounting of ACOs: Where they are, what they are, and how many

there are. Managed Care. November 2014; 23(11):26-29.

http://www.managedcaremag.com/archives/2014/11/accounting-acos

Community Health Centers

National Association of Community Health Centers (NACHC). http://www.nachc.com

o Research Fact Sheets and Infographics. Including “America's Health Centers Fact

Sheet, October 2014” http://www.nachc.com/research-factsheets.cfm

o Health Center Model, Patients, and Services. Including “A Sketch of Community

Health Centers: Chartbook 2014”

http://www.nachc.com/Overview%20of%20Health%20Centers.cfm

Health Services and Resources Administration (HRSA). Bureau of Primary Health Care.

About Health Centers. http://bphc.hrsa.gov/about/

Ku L, Frogner B, et al. Community Health Centers employ diverse staffing patterns,

which can provide productivity lessons for medical practices. Health Affairs. January

2015;34(1):95-103. http://content.healthaffairs.org/content/34/1/95.abstract

Health Disparities

Agency for Healthcare Research and Quality. National Healthcare Disparities Reports.

http://www.ahrq.gov/research/findings/nhqrdr/index.html

Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 13 of 15

Institute of Medicine. How Far Have We Come in Reducing Health Disparities?:

Progress Since 2000: Workshop Summary. Washington, DC: The National Academies

Press, 2012. http://www.iom.edu/Reports/2012/How-Far-Have-We-Come-in-Reducing-

Health-Disparities.aspx

Health Care Quality & Safety

Agency for Healthcare Research and Quality. National Healthcare Quality Reports.

http://www.ahrq.gov/research/findings/nhqrdr/index.html

Berenson R, Pronovost P, Krumholz H. Achieving the Potential of Health Care

Performance Measures. Robert Wood Johnson Foundation and The Urban Institute. May

2013.http://www.rwjf.org/en/research-publications/find-rwjf-research/2013/05/achieving-

the-potential-of-health-care-performance-measures.html and

http://www.urban.org/publications/412823.html

Cassel C, Conway P, et al. Getting more performance from performance measurement.

New England Journal of Medicine. Dec. 4, 2014;371(23):2145-2147.

http://www.nejm.org/doi/full/10.1056/NEJMp1408345

Consumer Reports Health and Massachusetts Health Quality Partners. How Does Your

Doctor Compare? Special Report for Massachusetts Residents. July 2012.

http://c354183.r83.cf1.rackcdn.com/MHQP%20Consumer%20Reports%20Insert%20201

2.pdf

Hussey PS, Wertheimer S, Mehrotra A. The association between healthcare quality and

cost. Ann Intern Med. Jan 1, 2013;158(1):27-34.

http://annals.org/article.aspx?articleid=1487781 and (summary): Fiore K. High-Cost Care

Not Necessarily Quality Care. MedPage Today. January 02, 2013.

http://www.medpagetoday.com/PublicHealthPolicy/HealthPolicy/36661

Institute of Medicine. Vital Signs: Core Metrics for Health and Health Care Progress.

Washington DC, National Academies Press, 2015.

http://www.iom.edu/Reports/2015/Vital-Signs-Core-Metrics.aspx. Report Brief:

http://www.iom.edu/~/media/Files/Report%20Files/2015/Vital_Signs/VitalSigns_RB.pdf

Also: Blumenthal D, McGinnis J. Measuring Vital Signs: An IOM report on

Core Metrics for Health and Health Care Progress. JAMA. May 19,

2015;313(19):1901-1902.

Leape L. Transparency and Public Reporting Are Essential for a Safe Health Care

System. The Commonwealth Fund. Perspectives on Health Reform-Briefs. March 17,

2010;4.http://www.commonwealthfund.org/publications/perspectives-on-health-reform-

briefs/2010/mar/transparency-and-public-reporting-are-essential-for-a-safe-health-care-

system

Radley D, McCarthy D, et al. Aiming Higher: Results from a Scorecard on State Health

System Performance, 2014, The Commonwealth Fund, May 2014.

http://www.commonwealthfund.org/publications/fund-reports/2014/apr/2014-state-

scorecard

Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 14 of 15

Roan S. How data can boost the value of care. Robert Wood Johnson Foundation.

Aligning Forces for Quality. Journalists on Quality. July 2014.

http://www.nrhi.org/uploads/how-data-can-boost-the-value-of-care_af4q_july-2014-1.pdf

or link from http://www.rwjf.org/en/library/features/journalists-on-quality.html

Robert Wood Johnson Foundation. Quality Field Notes: Public Reporting. How to Report

on the Quality of Physician Practices. April 2015.

http://www.rwjf.org/en/library/research/2015/05/quality-field-notes--public-

reporting.html ... Issue Brief, May 2015.

http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2015/rwjf419545

US Dept of Health and Human Services (DHHS). New HHS Data Shows Major Strides

Made in Patient Safety, Leading to Improved Care and Savings. May 7, 2014.

http://innovation.cms.gov/Files/reports/patient-safety-results.pdf and

http://www.hhs.gov/news/press/2014pres/05/20140507a.html

U.S. DHHS. 2014 Annual Progress Report to Congress. National Strategy for Quality

Improvement in Health Care. http://www.ahrq.gov/workingforquality/reports/annual-

reports/nqs2014annlrpt.htm

Materials for THCI Rotation presentation by Beverly Loudin, MD, on “Providers and

Quality & Patient Safety”

1. The Medical Assistant Training Program. "Elevating the Role of the

Medical/Clinical Assistant: Maximizing Team-Based Care in the Patient-Centered

Medical Home."

http://www.safetynetmedicalhome.org/sites/default/files/Implementation-Guide-

Supplement-Team-Based-Care.pdf

Note: This curriculum, developed by Dr. Loudin, has been included as a

component of the Safety Net Medical Home Initiative, in the category

"Continuous and Team-Based Healing Relationships:" The complete Initiative is

online at http://www.safetynetmedicalhome.org/

2. The Virginia Mason Institute. Training Program: Creating Flow in the

Ambulatory Setting. http://www.virginiamasoninstitute.org/ambulatory-setting

Chronic Care Management

American Geriatrics Society Expert Panel on the Care of Older Adults with

Multimorbidity. Guiding Principles for the Care of Older Adults with Multimorbidity:

An Approach for Clinicians.J Am Geriatr Soc October 2012;60(1):E1-E25.

http://onlinelibrary.wiley.com/doi/10.1111/j.1532-5415.2012.04188.x/full

Centers for Medicare & Medicaid Services. Chronic Care Management Services. (New

CPT Code effective 2015). http://www.cms.gov/Outreach-and-Education/Medicare-

Learning-Network-MLN/MLNProducts/Downloads/ChronicCareManagement.pdf

o Related: Edwards S, Landon B. Medicare's Chronic Care Management

Payment — Payment Reform for Primary Care. New England Journal of

Medicine. November 27, 2014;371(22): 2049-2051.

http://www.nejm.org/doi/full/10.1056/NEJMp1410790

Tufts Health Care Institute. Residency Rotation Bibliography 2015. Page 15 of 15

Improving Chronic Illness Care. A national program supported by The Robert Wood

Johnson Foundation with direction and technical assistance provided by The Sandy

MacColl Institute at Group Health's Center for Health Studies.

http://www.improvingchroniccare.org/

Perrin J, Anderson LE, Van Cleave J. The rise in chronic conditions among infants,

children, and youth can be met with continued health system innovations. Health

Affairs. December 2014;33(12):2099-2105.

http://content.healthaffairs.org/content/33/12/2099.abstract

Tinetti M, Fried T, Boyd C. Designing health care for the most common chronic

condition—multimorbidity. JAMA. June 20, 2012;307(23):2493-2494.

http://jama.jamanetwork.com/article.aspx?articleid=1187936

Wiley J, Rittenhouse D, Shortell S, et al. Managing chronic illness: physician practices

increased the use of care management and medical home processes. Health Affairs.

January 2015;34(1):78-86. http://content.healthaffairs.org/content/34/1/78.abstract

Career Paths

Ackerly D, Parekh A, Stein D. A framework for career paths in health systems

improvement. Academic Medicine. January 2013;88(1):56-60.

http://journals.lww.com/academicmedicine/Fulltext/2013/01000/Perspective___A_Frame

work_for_Career_Paths_in.20.aspx

Eastwood GL. The practice of administrative medicine. Annals of Internal Medicine.

May 17, 2011;154(10):703-4.

http://annals.org/article.aspx?articleid=474765&resultClick=3

Salib S, Moreno A. Good-bye and good luck: teaching residents the business of medicine

after residency. Journal of Graduate Medical Education. September 2015;7(3):338-340.

http://www.jgme.org/doi/full/10.4300/JGME-D-14-00720.1