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Population Health Management

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https://www.readbyqxmd.com/read/30648928/effect-of-patient-care-coordination-on-hospital-encounters-and-related-costs
#1
Ellen D Breckenridge, Bobbie Kite, Rebecca Wells, Tenaya M Sunbury
Given high costs of hospital encounters, providers have increasingly turned to patient-centered health care programs to improve cost-effectiveness and population health for patients with high needs. Yet, evidence is mixed about program effectiveness. This pre-post comparative analysis assessed whether the number of hospital encounters and related costs decreased for patients who received care coordination services funded through Texas's 1115(a) Medicaid waiver incentive-based payment model, under which providers created new programs to improve care quality, population health, and cost-effectiveness...
January 16, 2019: Population Health Management
https://www.readbyqxmd.com/read/30628868/comparative-effectiveness-of-metformin-dosage-uptitration-versus-adding-another-antihyperglycemic-medication-on-glycemic-control-in-type-2-diabetes-patients-failing-initial-metformin-monotherapy-a-retrospective-cohort-study
#2
Rohan Mahabaleshwarkar, Tsai-Ling Liu, Holly Mulder
Metformin is recommended as first-line treatment for type 2 diabetes (T2D). A disadvantage of metformin is the possibility of gastrointestinal adverse effects in some patients. Many T2D patients are not able to achieve/maintain glycemic control from initial metformin treatment and receive treatment intensification by means of metformin dosage uptitration or addition of a T2D drug. This retrospective study evaluated the comparative effectiveness of these 2 treatment intensification strategies. The study cohort included T2D patients at a US integrated health care system who: were initiated on metformin monotherapy (MM) during January 2009 - September 2013; had an uncontrolled HbA1c (≥7%) after at least 90 days of MM; and received metformin dosage uptitration or an additional T2D medication within 6 months of the uncontrolled HbA1c reading...
January 10, 2019: Population Health Management
https://www.readbyqxmd.com/read/30614761/systematic-review-of-community-paramedicine-and-ems-mobile-integrated-health-care-interventions-in-the-united-states
#3
Abbey Gregg, Joshua Tutek, Matthew D Leatherwood, William Crawford, Richard Friend, Martha Crowther, Robert McKinney
Emergency medical services (EMS) in the United States are frequently used for nonurgent medical needs. Use of 911 and the emergency department (ED) for primary care-treatable conditions is expensive, inefficient, and undesirable for patients and providers. The objective is to describe the outcomes from community paramedicine (CP) and mobile integrated health care (MIH) interventions related to the Quadruple Aim. Three electronic databases were searched for peer-review literature on CP-MIH interventions in the United States...
January 7, 2019: Population Health Management
https://www.readbyqxmd.com/read/30589614/identifying-older-patients-at-high-risk-for-emergency-department-visits-and-hospitalization
#4
Brooke E Salzman, Rachel V Knuth, Amy T Cunningham, Marianna D LaNoue
Hospitalizations are costly, potentially hazardous for older patients, and sometimes preventable. With Medicare's implementation of hospital penalties for 30-day readmissions on certain index conditions, health care organizations have prioritized addressing those issues that lead to avoidable hospitalizations. Little is known about the utility and feasibility of using standardized tools to identify adults at risk for hospitalizations in primary care. In this study, the goal was to determine, from a sample of 60 adults aged 65 and older, whether the Probability of Repeat Admission (PRA), the Vulnerable Elders Survey (VES-13), or a provider estimate of likelihood of hospitalization could identify patients at high risk for emergency department (ED) visits or hospitalization at 6 and 12 months, while being feasible to administer in a primary care setting...
December 27, 2018: Population Health Management
https://www.readbyqxmd.com/read/30589613/reducing-emergency-department-visits-among-dual-eligible-patients-via-a-comprehensive-wellness-assessment
#5
Barbara Guerard, Vincent Omachonu, Bisakha Sen
The objective was to assess whether a Comprehensive Wellness Assessment (CWA) is associated with reduced emergency department (ED) visits for Special Needs Program (SNP) enrollees with diabetes. This retrospective panel study used a Medicare Advantage plan's administrative claims data for 2010-2017 and pooled member-month observations. Multivariate regression and individual fixed-effects regression models were estimated. The outcome was ED visits measured as binary and continuous outcomes. Data were derived from claims data that included at least 1 ICD-9 or 10 code between January 2010 and December 2017...
December 27, 2018: Population Health Management
https://www.readbyqxmd.com/read/30570425/building-a-culture-of-health-and-well-being-at-merck
#6
Cathryn E Gunther, Virginia Peddicord, Joseph Kozlowski, Yi Li, Danielle Menture, Raymond Fabius, Sharon Glave Frazee, Peter J Nigro
There is increasing evidence that a healthy and safe workforce can provide a competitive business advantage. This article shares the efforts and experience of a large global employer as it builds on existing corporate wellness and safety programs to develop a corporate culture of health and well-being. Starting with a comprehensive review of the current state of employee health and culture, a small team established the business case, aligned strategic partners, created an implementation plan, and engaged the C-Suite...
December 19, 2018: Population Health Management
https://www.readbyqxmd.com/read/30562144/primary-care-and-public-health-collaboration-reports-a-qualitative-review-of-integration-aims-participants-and-success-determinants
#7
Kimberly L McVicar, Lana V Ivanitskaya, Don W Bradley, Jose T Montero
This qualitative review of 57 published case reports aimed to analyze primary care and public health integration efforts in 45 states to summarize collaboration aims, participants, and systemic, organizational, and interactional success determinants. Chronic disease management, maternal and child health, and wellness and health promotion were the most commonly reported aims of collaboration between primary care and public health entities in the United States. Typical participants were government public health structures, health delivery systems, communities, academia, state professional medical associations, and employers and businesses...
December 18, 2018: Population Health Management
https://www.readbyqxmd.com/read/30562143/using-the-healthy-days-measure-to-assess-factors-associated-with-poor-health-related-quality-of-life-for-patients-with-metastatic-breast-lung-or-colorectal-cancer-enrolled-in-a-medicare-advantage-health-plan
#8
Adrianne Waldman Casebeer, Dana Drzayich Antol, Sari Hopson, Raya Khoury, Andrew Renda, Aparna Parikh, Alisha Stein, Todd Michael, Stephen Stemkowski, Mikele Bunce
This study investigated factors associated with patient-reported health-related quality of life (HRQoL) using the Centers for Disease Control and Prevention's Healthy Days tool for patients with Medicare Advantage undergoing treatment for metastatic breast, lung, and colorectal cancer. In 2015, a total of 6390 patients were mailed surveys regarding factors that may influence their HRQoL, including cancer-related symptoms and patient-reported medication adherence. HRQoL was measured as the number of physically and mentally unhealthy days experienced in the past 30 days and summed for the total number of unhealthy days...
December 18, 2018: Population Health Management
https://www.readbyqxmd.com/read/30562141/mechanisms-associated-with-clinical-improvement-in-interventions-that-address-health-related-social-needs-a-mixed-methods-analysis
#9
Seth A Berkowitz, Amy Catherine Hulberg, Hilary Placzek, Anya Dangora, Jason Gomez, Sara Standish, Steven J Atlas
Linking individuals to community resources in order to help meet health-related social needs, such as food, medications, or transportation, may improve clinical outcomes. However, little is known about the mechanisms whereby such linkage interventions might improve health. The authors conducted a mixed-methods analysis consisting of outcomes from a prospective cohort study of a linkage intervention and a qualitative analysis of case records from participants. The cohort study included intervention participants who first enrolled between December 2014 and March 2015...
December 18, 2018: Population Health Management
https://www.readbyqxmd.com/read/30543495/integration-of-buprenorphine-treatment-with-primary-care-comparative-effectiveness-on-retention-utilization-and-cost
#10
Yea-Jen Hsu, Jill A Marsteller, Sarah G Kachur, Michael I Fingerhood
Opioid use disorder (OUD) is a national crisis. Health care must achieve greater success than it has to date in helping opioid users achieve recovery. Integration of comprehensive primary care with treatment for OUD has the potential to increase care access among the substance-using population, improve outcomes, and reduce costs. However, little is known about the effectiveness of such care models. The Comprehensive Care Practice (CCP), a primary care practice located in Maryland, implemented a care model that blends buprenorphine treatment for OUD with attention to primary care needs...
December 13, 2018: Population Health Management
https://www.readbyqxmd.com/read/30513073/urgent-care-center-and-emergency-department-utilization-for-non-emergent-health-conditions-analysis-of-managed-care-beneficiaries
#11
Ayoola C Adigun, Kelly Maguire, Yisong Jiang, Haiyan Qu, Shamly Austin
The objective was to identify predictors of utilization for urgent care centers (UCCs), emergency departments (EDs), or for both services for non-emergent health conditions among beneficiaries from a managed care organization (MCO) who resided within a 10-mile radius of UCCs. A cross-sectional design was used to analyze 2016 administrative claims data from an MCO that contracted with a UCC with 12 locations (n = 20,107). Outcome variables were number of visits to UCC, ED, or both. The MCO used the New York University ED algorithm to identify non-emergent health conditions...
December 4, 2018: Population Health Management
https://www.readbyqxmd.com/read/30513072/the-role-of-us-health-plans-in-identifying-and-addressing-social-determinants-of-health-rationale-and-recommendations
#12
Michele Heisler, Amol Navathe, Karen DeSalvo, Kevin G M Volpp
No abstract text is available yet for this article.
December 4, 2018: Population Health Management
https://www.readbyqxmd.com/read/30513071/utilization-of-high-cost-interventions-for-targeted-clinical-conditions-during-the-early-stages-of-aco-development-in-a-commercially-insured-population
#13
Siting Zhou, Michael Ciarametaro, Bingcao Wu, Joseph Singer, Robert W Dubois
This study compared utilization patterns of high-cost services and medications for patients receiving care from Accountable Care Organization (ACO)-participating physicians and those receiving care from non-ACO physicians during the initial phases of ACO development in a commercially insured environment. Patients ≥18 years (≥40 years for chronic obstructive pulmonary disease [COPD]) with prevalent rheumatoid arthritis, inflammatory bowel disease, multiple sclerosis, type 2 diabetes, COPD, or chronic low back pain between January 1, 2012, and August 31, 2014 were identified in the HealthCore Integrated Research DatabaseSM ...
December 4, 2018: Population Health Management
https://www.readbyqxmd.com/read/30513070/measuring-population-health-in-a-large-integrated-health-system-to-guide-goal-setting-and-resource-allocation-a-proof-of-concept
#14
Elizabeth R Stevens, Qinlian Zhou, Kimberly A Nucifora, Glen B Taksler, Marc N Gourevitch, Matthew C Stiefel, Patricia Kipnis, R Scott Braithwaite
In integrated health care systems, techniques that identify successes and opportunities for targeted improvement are needed. The authors propose a new method for estimating population health that provides a more accurate and dynamic assessment of performance and priority setting. Member data from a large integrated health system (n = 96,246, 73.8% female, mean age = 44 ± 0.01 years) were used to develop a mechanistic mathematical simulation, representing the top causes of US mortality in 2014 and their associated risk factors...
December 4, 2018: Population Health Management
https://www.readbyqxmd.com/read/30457936/did-performing-community-health-needs-assessments-increase-community-health-program-spending-by-north-carolina-s-tax-exempt-hospitals
#15
Elmer B Fos, Michael E Thompson, Christine A Elnitsky, Elena A Platonova
As of March 23, 2012, the Internal Revenue Service (IRS) requires tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every 3 years. This study assessed whether the IRS CHNA mandate incentivized North Carolina's tax-exempt hospitals to increase investments in community health programs. The authors gathered the 2012-2016 community benefit reports of 53 North Carolina private, nonprofit hospitals from the North Carolina Hospital Association. Community benefit spending data from the year of the first CHNA were compared to that 2 years later using paired t tests among matched subjects...
November 20, 2018: Population Health Management
https://www.readbyqxmd.com/read/30418091/complexities-of-addressing-food-insecurity-in-an-urban-population
#16
Deborah Swavely, Veronica Whyte, Joan F Steiner, Susan L Freeman
There is an association between food insecurity, poor health outcomes, and increased health care spending. The Temple Food Insecurity Program was initiated to screen patients for food insecurity as part of the post Temple University Hospital discharge process. The community is economically challenged and food insecurity is a significant problem. Food insecure patients were identified and referred to community-based resources, with a 30-day follow-up call. Screening was successful in 3655 patients, 27% (n = 987) of whom reported food insecurity...
November 10, 2018: Population Health Management
https://www.readbyqxmd.com/read/30407102/the-case-for-patient-navigation-in-lung-cancer-screening-in-vulnerable-populations-a-systematic-review
#17
Christine S Shusted, Julie A Barta, Michael Lake, Rickie Brawer, Brooke Ruane, Teresa E Giamboy, Baskaran Sundaram, Nathaniel R Evans, Ronald E Myers, Gregory C Kane
Patient navigation has been proposed to combat cancer disparities in vulnerable populations. Vulnerable populations often have poorer cancer outcomes and lower levels of screening, adherence, and treatment. Navigation has been studied in various cancers, but few studies have assessed navigation in lung cancer. Additionally, there is a lack of consistency in metrics to assess the quality of navigation programs. The authors conducted a systematic review of published cancer screening studies to identify quality metrics used in navigation programs, as well as to recommend standardized metrics to define excellence in lung cancer navigation...
November 8, 2018: Population Health Management
https://www.readbyqxmd.com/read/30403555/primary-care-providers-attitudes-and-practices-regarding-cancer-screening-in-older-adults
#18
Randa Sifri, Brooke Salzman, Amy Cunningham, Alexis Silverio, Madalene Zale, Christine Talerico
Cancer screening decisions for older adults should be individualized. However, conducting such complex shared decisions may be challenging for primary care providers (PCPs). Additionally, there is little information about how PCPs make these decisions. This study consisted of a provider survey and chart review to assess current PCP approaches to breast and colorectal cancer (CRC) screening for patients ages ≥75 years. PCP survey questions: panel age, comfort with discussion of screening harms and benefits, screening decision-making process, and discussion style...
November 7, 2018: Population Health Management
https://www.readbyqxmd.com/read/30403539/impact-of-event-severity-on-hospital-rankings-based-on-heart-failure-readmission-rates
#19
Anissa C Dallmann, Asa Wilks, Soeren Mattke
The Medicare Readmissions Reduction Program penalizes hospitals with higher than expected readmission rates after discharge for congestive heart failure (CHF). This exploratory study analyzed whether categorizing readmissions by event severity might have implications for the program. The authors used the 5% MedPAR (Medicare Provider and Analysis Review) data for 2008 to 2014 and ranked 1820 hospitals based on all readmissions, readmissions for CHF, short-stay CHF readmissions, and readmissions for severe CHF with evidence of cardiogenic shock...
November 7, 2018: Population Health Management
https://www.readbyqxmd.com/read/30383482/insights-into-the-role-of-employers-supporting-obesity-management-in-people-with-obesity-results-of-the-national-action-study
#20
Kimberly Jinnett, Theodore Kyle, Thomas Parry, Boris Stevenin, Abhilasha Ramasamy
Lack of both awareness and application of evidence-based principles for obesity care for people with obesity (PwO) limit employers' role in supporting effective obesity management among employees with obesity (EwO). The aim of the ACTION (Awareness, Care, and Treatment In Obesity maNagement) study was to explore the current state of employer wellness programs related to obesity management, evaluate the impact of obesity in the workplace, assess attitudes regarding the role of employers in managing obesity, and identify challenges in implementing workplace wellness programs as perceived by employer representatives (ERs) and EwO...
October 31, 2018: Population Health Management
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