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American Journal of Managed Care

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https://www.readbyqxmd.com/read/27982673/us-hospital-engagement-in-core-domains-of-interoperability
#1
A Jay Holmgren, Vaishali Patel, Dustin Charles, Julia Adler-Milstein
OBJECTIVES: To assess US hospital engagement in the 4 core domains of interoperability (find, send, receive, integrate) and whether engaging in these domains is associated with electronic availability of clinical data from outside providers. STUDY DESIGN: Retrospective analysis of survey data. METHODS: Analysis of the American Hospital Association (AHA) Annual Survey of Hospitals and the American Hospital Association (AHA) Annual Survey of Hospitals - IT Supplement datasets for 2014...
December 1, 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27982672/the-effect-of-ehr-integrated-patient-reported-outcomes-on-satisfaction-with-chronic-pain-care
#2
Christopher A Harle, Nicole M Marlow, Siegfried O F Schmidt, Jonathan J Shuster, Alyson Listhaus, Roger B Fillingim, Robert W Hurley
OBJECTIVES: Given its complexity, chronic noncancer pain presents an opportunity to use health information technology (IT) to improve care experiences. The objective of this study was to assess whether integrating patient-reported outcomes (PROs) data in an electronic health record (EHR) affects provider and patient satisfaction with chronic noncancer pain care. STUDY DESIGN: We conducted a pragmatic cluster randomized trial involving 4 family medicine clinics. METHODS: We enrolled primary care providers (PCPs) and their patients with chronic noncancer pain...
December 1, 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27982671/payer-provider-patient-registry-utilized-in-a-behavioral-health-home
#3
Michele Mesiano, Meghna Parthasarathy, Shari L Hutchison, David Salai, Suzanne Daub, Mary Doyle, James M Schuster
OBJECTIVES: As defined by the Affordable Care Act, health homes seek to improve healthcare coordination through data exchange and health information technologies; however, few examples of how to use such technology are available. The present effort describes a payer-provider patient registry for behavioral health home service. STUDY DESIGN: An observational study design was used to describe characteristics of individuals identified by the payer-provider patient registry...
December 1, 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27982670/telemedicine-and-the-sharing-economy-the-uber-for-healthcare
#4
Brian J Miller, Derek W Moore, Chester W Schmidt
Telehealth platforms, which include both competitors and complements to traditional care delivery, will offer many benefits for both consumers and clinicians, and may promote increased specialization and competition in service delivery. Traditional medical services providers face a challenge similar to that faced by traditional taxicabs after Uber entered the marketplace: how to compete with a connection services platform that threatens to disrupt existing, regulated, and licensed service providers.
December 1, 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27982669/assessing-electronic-health-record-implementation-challenges-using-item-response-theory
#5
Kitty S Chan, Hadig Kharrazi, Megha A Parikh, Eric W Ford
OBJECTIVES: To assess the importance of commonly identified issues in electronic health record (EHR) implementation using item response theory (IRT). STUDY DESIGN: Secondary data from the 2012 American Hospital Association's Annual Survey Information Technology Supplement were used in the analyses. Results were compared and contrasted with the standard descriptive statistic frequencies that have been used to guide most recommendations made using the same data. METHODS: IRT was used to measure the magnitude of difficulty that particular challenges pose in implementing EHRs that meet federal guidelines for Meaningful Use...
December 1, 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27982668/data-driven-clinical-and-cost-pathways-for-chronic-care-delivery
#6
Yiye Zhang, Rema Padman
OBJECTIVES: This study illustrates a systematic methodology to embed medical costs into the exact flow of clinical events associated with chronic care delivery. We summarized and visualized the results using clinical and cost data, with the goal of empowering patients and care providers with actionable information as they navigate through a multitude of clinical events and medical expenses. STUDY DESIGN: We analyzed the electronic health records (EHRs) and medication cost data of 288 patients from 2009 to 2011, whose initial diagnoses included chronic kidney disease stage 3, hypertension, and diabetes...
December 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27982667/accountable-care-organization-hospitals-differ-in-health-it-capabilities
#7
Daniel M Walker, Arthur M Mora, Ann Scheck McAlearney
OBJECTIVES: The aim of this study was to evaluate health information technology (IT) adoption in hospitals participating in accountable care organizations (ACOs) and compare this adoption to non-ACO hospitals. STUDY DESIGN: A cross-sectional sample of US nonfederal, acute care hospitals with data from 3 matched sources: the 2013 American Hospital Association (AHA) Annual Survey, the 2013 AHA Survey of Care Systems and Payments (CSP), and the 2014 AHA Information Technology Supplement...
December 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27982666/getting-from-here-to-there-health-it-needs-for-population-health
#8
Joshua R Vest, Christopher A Harle, Titus Schleyer, Brian E Dixon, Shaun J Grannis, Paul K Halverson, Nir Menachemi
The United States' decade-long transition from a paper- to technology-based information infrastructure has always been recognized as an initial step-a laying of the foundation-for future changes to the delivery of care. An increasingly important focal area for improvement is population health. Numerous policies and programs now require healthcare organizations to manage the risks, outcomes, utilization, and health of entire groups of individuals. Nonetheless, current health information technology (IT) systems are not ready to support population health improvements effectively and efficiently...
December 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27982665/building-health-it-capacity-to-improve-hiv-infection-health-outcomes
#9
Hannah Rettler, Monina Klevens, Gillian Haney, Liisa Randall, Alfred DeMaria, Johanna Goderre
Eighty-six percent of those engaged in HIV medical care in Massachusetts achieved viral suppression, making Massachusetts's long-term goal of eliminating new infections of HIV a real possibility. In order to achieve this goal, Massachusetts is working to engage all individuals living with HIV/AIDS in HIV medical care, keep them retained in care, and render their viral load non-detectable. Currently, in Massachusetts, the data elements necessary to monitor the HIV care continuum are documented in siloed health information systems that do not communicate with each other...
December 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27982664/the-health-information-technology-special-issue-current-trends-and-future-directions
#10
Joshua R Vest
No abstract text is available yet for this article.
December 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27982663/how-health-plans-promote-health-it-to-improve-behavioral-health-care
#11
Amity E Quinn, Sharon Reif, Brooke Evans, Timothy B Creedon, Maureen T Stewart, Deborah W Garnick, Constance M Horgan
OBJECTIVES: Given the large numbers of providers and enrollees with which they interact, health plans can encourage the use of health information technology (IT) to advance behavioral health care. The manner and extent to which commercial health plans promote health IT to improve behavioral health care is unknown. This study aims to address that gap. STUDY DESIGN: Cross-sectional study. METHODS: Data are from a nationally representative survey of commercial health plans regarding administrative and clinical dimensions of behavioral health services in 2010...
December 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27870547/prescribers-perceptions-of-medication-discontinuation-survey-instrument-development-and-validation
#12
Amy Linsky, Steven R Simon, Kelly Stolzmann, Barbara G Bokhour, Mark Meterko
OBJECTIVES: Primary care providers (PCPs) and clinical pharmacists have concerns about the adverse consequences of using medications inappropriately and generally support the notion of reducing unnecessary drugs. Despite this attitude, many factors impede clinicians' ability to discontinue medication in clinical settings. We sought to develop a survey instrument that assesses PCPs' and pharmacists' experiences, attitudes, and beliefs toward medication discontinuation. STUDY DESIGN: Survey development and psychometric assessment...
November 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27870546/integrated-care-organizations-medicare-financing-for-care-at-home
#13
Karen Davis, Amber Willink, Cathy Schoen
OBJECTIVES: As the boomer population ages, there is a growing need for integrated care organizations (ICOs) that can integrate both medical care and long-term services and supports in the home. This paper presents a policy proposal to support the creation of ICOs, redesign care, and provide financing for home- and community-based services (HCBS), with the goal of enhancing financial protection for beneficiaries, coordinating care, and preventing costly hospital and nursing home use. METHODS: This study used the 2012 Medicare Current Beneficiary Survey (MCBS) Cost and Use File, inflated to 2016 figures, to describe the characteristics of Medicare beneficiaries and their healthcare utilization and spending...
November 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27870545/does-medicare-advantage-enrollment-affect-home-healthcare-use
#14
Daniel A Waxman, Lillian Min, Claude M Setodji, Mark Hanson, Neil S Wenger, David A Ganz
OBJECTIVES: To compare home health utilization and clinical outcomes between Medicare beneficiaries in the fee-for-service (FFS) and Medicare Advantage (MA) programs, and to compare regional variation. STUDY DESIGN: We used the 2010 and 2011 Outcome and Assessment Information Set to identify all home health episodes begun in 2010 and to measure 7 clinical home health outcomes that are defined by CMS for public reporting. METHODS: We modeled the probability of home health use, the duration of home health episodes, and each clinical outcome measure as a function of MA versus FFS enrollment and model-specific risk adjustors...
November 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27870544/referrals-and-the-pcmh-how-well-do-we-know-our-neighborhood
#15
Andrew Schreiner, Patrick Mauldin, Jingwen Zhang, Justin Marsden, William Moran
OBJECTIVES: Characterize patterns of referral from a patient-centered medical home (PCMH) and observe the association of provider experience, patient chronic disease burden, and risk of utilization on referral placement. STUDY DESIGN: Descriptive analysis of referral patterns in an academic, internal medicine PCMH. METHODS: We examined referrals (eg, specialist visit, testing, ancillary services) placed between July and December of 2014 in an academic PCMH caring for a total of 12,000 patients...
November 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27870543/enhancing-patient-and-family-engagement-through-meaningful-use-stage-3-opportunities-and-barriers-to-implementation
#16
Jaclyn Rappaport, Sara Galantowicz, Andrea Hassol, Anisha Illa, Sid Thornton, Shan He, Jean Adams, Charlie Sawyer
OBJECTIVES: The proposed Patient and Family Engagement objectives for Meaningful Use Stage 3 (MU3) seek to provide patients with increased access to, and control over, the content and dissemination of their electronic health record (EHR) information. STUDY DESIGN: Implementation study conducted from 2013-2014. METHODS: In this study, 2 leading US health systems attempted to implement 4 draft MU3 objectives within their current EHR system. Senior staff provided qualitative feedback on their implementation experience; researchers used content analysis to identify major themes and implementation challenges...
November 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27870542/a-new-chapter-in-health-reform
#17
Michael E Chernew, A Mark Fendrick
No abstract text is available yet for this article.
November 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27849352/medical-home-transformation-and-breast-cancer-screening
#18
Amy W Baughman, Phyllis Brawarsky, Tracy Onega, Tor D Tosteson, Qianfei Wang, Anna N A Tosteson, Jennifer S Haas
OBJECTIVES: The patient-centered medical home (PCMH) continues to gain momentum as a primary care delivery system. We evaluated whether medical home transformation of primary care practices is associated with the use of breast cancer screening, a broadly endorsed preventive service. STUDY DESIGN: Retrospective cohort study evaluating 12 Brigham and Women's Hospital (BWH)-affiliated primary care clinics in greater Boston, Massachusetts. METHODS: Practice transformation was measured quarterly using a continuous PCMH transformation score (range = 0-100) modeled after National Committee for Quality Assurance recognition requirements...
November 1, 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27849351/the-role-of-internal-medicine-subspecialists-in-patient-care-management
#19
Jonathan L Vandergrift, Bradley M Gray, James D Reschovsky, Eric S Holmboe, Rebecca D Lipner
OBJECTIVES: To understand the clinical roles in which internal medicine (IM) subspecialists engage, especially those involving ongoing patient management. STUDY DESIGN: Measures of physician clinical roles were based on survey responses collected from 8020 mid-career IM subspecialists who registered for the American Board of Internal Medicine maintenance of certification program (86% registration/response rate) between 2009 and 2013. METHODS: Each subspecialist reported their percentage of clinical time in 5 clinical roles: primary, principal, longitudinal consultative, medical consultative, and procedural care...
November 1, 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27849350/maternal-mental-health-and-infant-mortality-for-healthy-weight-infants
#20
Susan E White, Robert W Gladden
OBJECTIVES: The objective of this study was to determine if severe mental illness and/or a history of substance use in mothers of babies of a healthy weight was associated with infant mortality. STUDY DESIGN: This was a cross-sectional observational study using CareSource historical billed Medicaid Managed Care plan (MMC) claims in Ohio. METHODS: CareSource is Ohio's largest MMCP, serving approximately 1.2 million Medicaid consumers. Claims from 89,159 babies of a healthy weight (≥ 2500 grams) and their mothers were selected from the CareSource Ohio MMCP population from January 2011 through December 2014...
November 1, 2016: American Journal of Managed Care
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