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https://www.readbyqxmd.com/read/29031914/bringing-the-medical-home-back-home-in-the-context-of-population-health-home-based-primary-care-and-home-based-palliative-care
#1
Christine S Ritchie, Bruce Leff
With the growth of value-based care, payers and health systems have begun to appreciate the need to provide enhanced services to homebound adults. Recent studies have shown that home-based medical services for this high-cost, high-need population reduce costs and improve outcomes. Home-based medical care services have two flavors that are related to historical context and specialty background-home-based primary care and home-based palliative care. While the type of services provided by home-based primary care and home-based palliative care (together termed "home-based medical care") overlap, home-based primary care tends to encompass longitudinal and preventive care, while home-based palliative care often provides services for shorter durations focused more on distress management and goals of care clarification...
October 11, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29027824/a-computable-phenotype-for-asthma-case-identification-in-adult-and-pediatric-patients-external-validation-in-the-chicago-area-patient-outcomes-research-network-capricorn
#2
Majid Afshar, Valerie G Press, Rachel G Robison, Abel N Kho, Sindhura Bandi, Ashvini Biswas, Pedro C Avila, Harsha Vardhan Madan Kumar, Byung Yu, Edward T Naureckas, Sharmilee M Nyenhuis, Christopher D Codispoti
OBJECTIVE: Comprehensive, rapid, and accurate identification of patients with asthma for clinical care and engagement in research efforts is needed. The original development and validation of a computable phenotype for asthma case identification occurred at a single institution in Chicago and demonstrated excellent test characteristics. However, its application in a diverse payer mix, across different health systems and multiple electronic health record vendors, and in both children and adults was not examined...
October 13, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29025957/admissions-to-acute-care-within-30-and-90-days-of-discharge-home-from-a-pediatric-post-acute-care-hospital
#3
Jane E O'Brien, Helene M Dumas, Maria A Fragala-Pinkham, Jay G Berry
OBJECTIVES: Of all hospitalized children, those with medical complexity have the highest likelihood of hospital readmission. Post-acute hospital care could potentially help stabilize the health of these children. We examined the frequency of acute care hospital admissions after discharge home from a post-acute care hospital (PACH). METHODS: A retrospective cohort analysis of 448 children with medical complexity discharged from a PACH from January 1, 2010, to December 31, 2015, with the main outcomes of acute care hospital readmissions 0 to 30 and 31 to 90 days after discharge home from a PACH...
October 12, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29024036/how-and-why-do-countries-differ-in-their-governance-and-financing-related-administrative-expenditure-in-health-care-an-analysis-of-oecd-countries-by-health-care-system-typology
#4
Luc L Hagenaars, Niek S Klazinga, Michael Mueller, David J Morgan, Patrick P T Jeurissen
INTRODUCTION: Administration is vital for health care. Its importance may increase as health care systems become more complex, but academic attention has remained minimal. We investigated trends in administrative expenditure across OECD countries, cross-country spending differences, spending differences between health care system typologies, and differences in the scale and scope of administrative functions across typologies. METHODS: We used OECD data, which include health system governance and financing-related administrative activities by regulators, governance bodies, and insurers (macrolevel), but exclude administrative expenditure by health care providers (mesolevel and microlevel)...
October 12, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/29023215/cost-effectiveness-analysis-of-monthly-zoledronic-acid-zoledronic-acid-every-3-months-and-monthly-denosumab-in-women-with-breast-cancer-and-skeletal-metastases-calgb-70604-alliance
#5
Charles L Shapiro, James P Moriarty, Stacie Dusetzina, Andrew L Himelstein, Jared C Foster, Stephen S Grubbs, Paul J Novotny, Bijan J Borah
Purpose Skeletal-related events (SREs) such as pathologic fracture, spinal cord compression, or the necessity for radiation or surgery to bone metastasis cause considerable morbidity, decrements in quality of life, and costs to the health care system. The results of a recent large randomized trial (Cancer and Leukemia Group B/Alliance for Clinical Trials in Oncology [CALGB/Alliance 70604]) showed that zoledronic acid (ZA) every 3 months was noninferior to monthly ZA in reducing the risks of SREs. We sought to determine the cost-effectiveness (CE) of monthly ZA, ZA every 3 months, and monthly denosumab in women with breast cancer and skeletal metastases...
October 12, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29017997/population-based-study-on-patterns-of-cardiac-stress-testing-after-percutaneous-coronary-intervention
#6
Akshay Bagai, Maria Eberg, Maria Koh, Asim N Cheema, Andrew T Yan, Arti Dhoot, Sanjeev P Bhavnani, Harindra C Wijeysundera, R Sacha Bhatia, Padma Kaul, Shaun G Goodman, Dennis T Ko
BACKGROUND: The appropriate use criteria considers cardiac stress testing within 2 years after percutaneous coronary intervention (PCI) to be rarely appropriate, unless prompted by symptoms or change in clinical status. Little is known about the patterns of cardiac stress testing after PCI in the single-payer Canadian healthcare system, where mechanisms for reimbursement are different from the United States. METHODS AND RESULTS: Frequency and timing of cardiac stress testing within 2 years of PCI performed between April 2004 and March 2013 in Ontario, Canada, was determined from linked provincial databases...
October 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29016515/performance-measures-for-contraceptive-care-a-new-tool-to-enhance-access-to-contraception
#7
Michelle H Moniz, Loretta E Gavin, Vanessa K Dalton
Contraception is an essential health service for reducing unintended pregnancy rates, improving health outcomes, and reducing health care costs. However, contraceptive services may not consistently provide access to the full method mix and to patient-centered care. Improving the quality of contraceptive care is a critical strategy to improve contraceptive use, health outcomes, and the patient experience of care. We here describe the three National Quality Forum-endorsed performance measures for contraceptive care, which are intended to monitor 1) provision of most and moderately effective methods, 2) access to long-acting reversible contraception, and 3) provision of most and moderately effective methods and access to long-acting reversible contraception after childbirth...
October 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28988162/organised-screening-for-cervical-cancer-in-france-a-cost-effectiveness-assessment
#8
Stéphanie Barré, Marc Massetti, Henri Leleu, Frédéric De Bels
OBJECTIVE: According to the third cancer plan, organised screening (OS) of cervical cancer (CC) among women aged 25-65 years should be implemented in France in the forthcoming years. The most efficient way to implement OS in the French healthcare system is yet to be determined. METHODS: A microsimulation model was developed adopting a collective 'all payers' perspective. A closed cohort of women eligible for CC screening and representative in terms of age and participation in individual screening (IndScr) by annual Papanicolaou (Pap) testing every 3 years was modelled on a lifetime horizon...
October 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28971720/crisis-in-u-s-health-care-corporate-power-still-blocks-reform
#9
John Geyman
The corporate, largely privatized market-based U.S. health care system is deteriorating in terms of increasing costs, decreasing access, unacceptable quality of care, inequities, and disparities. Reform efforts to establish universal insurance coverage have failed on six occasions over the last century, largely through opposition of corporate stakeholders in the medical-industrial complex. This article provides historical perspective to previous reform attempts, updates the current battle between Republicans and Democrats over repeal of the 2010 Affordable Care Act (ACA), and compares three financing alternatives-continuation of the ACA; its replacement by a Republican plan (the House's American Health Care Act or its Senate counterpart, the Better Care Reconciliation Act); and single-payer national health insurance (NHI or Medicare for All)...
January 1, 2017: International Journal of Health Services: Planning, Administration, Evaluation
https://www.readbyqxmd.com/read/28968666/stewardship-of-primary-care-physicians-to-contain-cost-in-health-care-an-international-cross-sectional-survey
#10
Philip J Van der Wees, Joost J G Wammes, Patrick P T Jeurissen, Gert P Westert
Purpose: Physician stewardship towards cost control is potentially important in enhancing the financial sustainability of health care systems. Objective: Aim of this study was to identify the level of stewardship of cost containment of primary care physicians (PCPs) and to assess the associations between stewardship and characteristics of PCPs and health care systems. Methods: Secondary analysis of data from a cross-sectional survey among 10 countries: Australia, Canada, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland, UK and USA...
August 31, 2017: Family Practice
https://www.readbyqxmd.com/read/28953066/maryland-s-all-payer-health-care-system-a-light-at-the-end-of-a-tunnel
#11
Lama Bakhamis, Taeko Matsumoto, Mary Tran, David P Paul, Alberto Coustasse
The state of Maryland, in collaboration with the Centers for Medicare & Medicaid Services, developed the first all-payer system model in the Unites States in 1971 and 35 years later in response to financial pressures undertook to modernize this program. The focus of the modernized program was to improve overall per-capita expenditure, quality of care, and the outcome of Marylanders' health. The financial status of Maryland hospitals was declining because of the rate setting of the Health Services Cost Review Commission while hospital admission rates and spending were increasing...
September 26, 2017: Health Care Manager
https://www.readbyqxmd.com/read/28944728/performance-based-risk-sharing-arrangements-u-s-payer-experience
#12
Joseph A Goble, Brian Ung, Sascha van Boemmel-Wegmann, Robert P Navarro, Andrew Parece
BACKGROUND: As a result of global concern about rising drug costs, many U.S. payers and European agencies such as the National Health Service have partnered with pharmaceutical companies in performance-based risk-sharing arrangements (PBRSAs) by which manufacturers share financial risk with health care purchasing entities and authorities. However, PBRSAs present many administrative and legal challenges that have minimized successful contract experiences in the United States. OBJECTIVE: To (a) identify drug and disease characteristics and contract components that contribute to successful PBRSA experiences and the primary barriers to PBRSA execution and (b) explore solutions to facilitate contract negotiation and execution...
October 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28940575/urban-and-rural-differences-in-outcomes-of-head-and-neck-cancer
#13
Jason D Kim, Aryan Firouzbakht, Jenny Y Ruan, Emily Kornelsen, Ali Moghaddamjou, Khodadad R Javaheri, Robert A Olson, Winson Y Cheung
OBJECTIVES/HYPOTHESIS: To assess for potential urban and rural disparities in head and neck cancer (HNC) outcomes within a single-payer healthcare system. STUDY DESIGN: A large retrospective population-based cohort analysis of consecutive HNC patients treated in British Columbia, Canada between 2001 and 2010 was conducted. METHODS: All patients diagnosed with HNC from 2001 to 2010 and referred to any one of five British Columbia Cancer Agency centers for management were reviewed...
September 20, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28937935/the-impact-of-the-2006-massachusetts-health-care-reform-law-on-spine-surgery-patient-payer-mix-status-and-age
#14
Nicolas W Villelli, Hong Yan, Jian Zou, Nicholas M Barbaro
OBJECTIVE Several similarities exist between the Massachusetts health care reform law of 2006 and the Affordable Care Act (ACA). The authors' prior neurosurgical research showed a decrease in uninsured surgeries without a significant change in surgical volume after the Massachusetts reform. An analysis of the payer-mix status and the age of spine surgery patients, before and after the policy, should provide insight into the future impact of the ACA on spine surgery in the US. METHODS Using the Massachusetts State Inpatient Database and spine ICD-9-CM procedure codes, the authors obtained demographic information on patients undergoing spine surgery between 2001 and 2012...
September 15, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28915973/compassionomics-hypothesis-and-experimental-approach
#15
Stephen Trzeciak, Brian W Roberts, Anthony J Mazzarelli
Recent reports indicate that healthcare is experiencing a compassion crisis - an absence of (or inconsistency in) compassionate patient care. It is currently unclear if, or to what extent, this exerts significant effects on health and healthcare. Experimental data are few, and this represents a critical knowledge gap for all health sciences. We hypothesize that compassionate care is beneficial for patients (better outcomes), healthcare systems and payers (lower costs), and healthcare providers (lower burnout)...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28910289/how-tavi-registries-report-clinical-outcomes-a-systematic-review-of-endpoints-based-on-varc-2-definitions
#16
REVIEW
Shixuan Zhang, Peter L Kolominsky-Rabas
INTRODUCTION: Transcatheter aortic valve implantation (TAVI) has been demonstrated to be an alternative treatment for severe aortic stenosis in patients considered as high surgical risk. Since its first human implantation by Cribier et al., TAVI has been shown to increase survival rate and quality of life for high surgical risks patients. The objective of this study is to provide an overview of TAVI registries and the reporting clinical outcomes based on the VARC-2 definitions. In addition, the comparability and adherence of VARC-2 reporting within the identified TAVI registries was reviewed...
2017: PloS One
https://www.readbyqxmd.com/read/28867495/healthcare-policy-statement-on-the-utility-of-coronary-computed-tomography-for-evaluation-of-cardiovascular-conditions-and-preventive-healthcare-from-the-health-policy-working-group-of-the-society-of-cardiovascular-computed-tomography
#17
Ahmad M Slim, Scott Jerome, Ron Blankstein, Wm Guy Weigold, Amit R Patel, Dinesh K Kalra, Ryan Miller, Kelley Branch, Mark G Rabbat, Harvey Hecht, Edward D Nicol, Todd C Villines, Leslee J Shaw
The rising cost of healthcare is prompting numerous policy and advocacy discussions regarding strategies for constraining growth and creating a more efficient and effective healthcare system. Cardiovascular imaging is central to the care of patients at risk of, and living with, heart disease. Estimates are that utilization of cardiovascular imaging exceeds 20 million studies per year. The Society of Cardiovascular CT (SCCT), alongside Rush University Medical Center, and in collaboration with government agencies, regional payers, and industry healthcare experts met in November 2016 in Chicago, IL to evaluate obstacles and hurdles facing the cardiovascular imaging community and how they can contribute to efficacy while maintaining or even improving outcomes and quality...
August 31, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28865892/comparison-of-readmission-rates-after-acute-myocardial-infarction-in-3-patient-age-groups-18-to-44-45-to-64-and-%C3%A2-65-years-in-the-united-states
#18
Rohan Khera, Snigdha Jain, Ambarish Pandey, Vijay Agusala, Dharam J Kumbhani, Sandeep R Das, Jarett D Berry, James A de Lemos, Saket Girotra
Postacute myocardial infarction (AMI) readmissions are common among Medicare beneficiaries (≥65 years) and are associated with significant resource utilization. However, patterns of AMI readmissions for younger age groups in the United States are not known. In the Nationwide Readmissions Database, a nationally representative all-payer database of inpatient hospitalizations, we identified 212,171 index AMI hospitalizations in January to November 2013, weighted to represent 478,247 hospitalizations nationally (mean age 66...
August 4, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28864710/principles-of-child-health-care-financing
#19
Mark L Hudak, Mark E Helm, Patience H White
After passage of the Patient Protection and Affordable Care Act, more children and young adults have become insured and have benefited from health care coverage than at any time since the creation of the Medicaid program in 1965. From 2009 to 2015, the uninsurance rate for children younger than 19 years fell from 9.7% to 5.3%, whereas the uninsurance rate for young adults 19 to 25 years of age declined from 31.7% to 14.5%. Nonetheless, much work remains to be done. The American Academy of Pediatrics (AAP) believes that the United States can and should ensure that all children, adolescents, and young adults from birth through the age of 26 years who reside within its borders have affordable access to high-quality and comprehensive health care, regardless of their or their families' incomes...
September 2017: Pediatrics
https://www.readbyqxmd.com/read/28851374/behavioral-health-and-the-comprehensive-primary-care-cpc-initiative-findings-from-the-2014-cpc-behavioral-health-survey
#20
Kara Zivin, Benjamin F Miller, Bruce Finke, Asaf Bitton, Perry Payne, Edith C Stowe, Ashok Reddy, Timothy J Day, Pauline Lapin, Janel L Jin, Laura L Sessums
BACKGROUND: Incorporating behavioral health care into patient centered medical homes is critical for improving patient health and care quality while reducing costs. Despite documented effectiveness of behavioral health integration (BHI) in primary care settings, implementation is limited outside of large health systems. We conducted a survey of BHI in primary care practices participating in the Comprehensive Primary Care (CPC) initiative, a four-year multi-payer initiative of the Centers for Medicare and Medicaid Services (CMS)...
August 29, 2017: BMC Health Services Research
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