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Medicare part d

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https://www.readbyqxmd.com/read/29227444/the-association-between-local-economic-conditions-and-opioid-prescriptions-among-disabled-medicare-beneficiaries
#1
Chao Zhou, Ning Neil Yu, Jan L Losby
BACKGROUND: This paper concerns public health crises today-the problem of opioid prescription access and related abuse. Inspired by Case and Deaton's seminal work on increasing mortality among white Americans with lower education, this paper explores the relationship between opioid prescribing and local economic factors. OBJECTIVE: We examined the association between county-level socioeconomic factors (median household income, unemployment rate, Gini index) and opioid prescribing...
January 2018: Medical Care
https://www.readbyqxmd.com/read/29227443/associations-between-medicare-part-d-and-out-of-pocket-spending-hiv-viral-load-adherence-and-adap-use-in-dual-eligibles-with-hiv
#2
Nadya Belenky, Brian W Pence, Stephen R Cole, Stacie B Dusetzina, Andrew Edmonds, Jonathan Oberlander, Michael W Plankey, Adebola Adedimeji, Tracey E Wilson, Jennifer Cohen, Mardge H Cohen, Joel E Milam, Elizabeth T Golub, Adaora A Adimora
BACKGROUND: The implementation of Medicare part D on January 1, 2006 required all adults who were dually enrolled in Medicaid and Medicare (dual eligibles) to transition prescription drug coverage from Medicaid to Medicare part D. Changes in payment systems and utilization management along with the loss of Medicaid protections had the potential to disrupt medication access, with uncertain consequences for dual eligibles with human immunodeficiency virus (HIV) who rely on consistent prescription coverage to suppress their HIV viral load (VL)...
January 2018: Medical Care
https://www.readbyqxmd.com/read/29224686/estimating-public-and-patient-savings-from-basic-research-a-study-of-optical-coherence-tomography-in-managing-antiangiogenic-therapy
#3
Matthew A Windsor, Sissi J J Sun, Kevin D Frick, Eric A Swanson, Philip J Rosenfeld, David Huang
PURPOSE: To compare patient and Medicare savings from the use of optical coherence tomography (OCT) in guiding therapy for neovascular age-related macular degeneration (nvAMD) to the research investments made in developing OCT by the National Institutes of Health (NIH) and the National Science Foundation (NSF). DESIGN: Observational cohort study. METHODS: Main outcome measures were spending by Medicare as tracked by Current Procedural Terminology codes on intravitreal injections (67028), retinal OCT imaging (92134), and anti-vascular endothelial growth factor (anti-VEGF) treatment-specific J-codes (J0178, J2778, J9035, J3490, and J3590)...
December 1, 2017: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/29223989/geographic-variation-of-adjuvant-breast-cancer-therapy-initiation-in-the-united-states-lessons-from-medicare-part-d
#4
John A Charlson, Emily L McGinley, Ann B Nattinger, Joan M Neuner, Liliana E Pezzin
Background: Drug utilization under Medicare Part D varies significantly by geographic region. This study examined the extent to which geographic variation in Part D plan characteristics contributes to the variation in choice of initial endocrine therapy agent among women with incident breast cancer. Methods: Two-stage multivariate regression analyses were applied to the 16,541 women identified from Medicare claims as having incident breast cancer in 2006-2007. The first stage determined the effect of state of residence on the probability of having an aromatase inhibitor (AI), as opposed to tamoxifen, as initial endocrine therapy...
December 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29222354/students-help-medicare-beneficiaries-optimize-their-part-d-benefit
#5
Cheryl A Thompson
No abstract text is available yet for this article.
December 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29214512/anticholinergic-prescribing-in-medicare-part-d-beneficiaries-residing-in-nursing-homes-results-from-a-retrospective-cross-sectional-analysis-of-medicare-data
#6
Joshua Niznik, Xinhua Zhao, Tao Jiang, Joseph T Hanlon, Sherrie L Aspinall, Joshua Thorpe, Carolyn Thorpe
BACKGROUND: Prescribing of medications with anticholinergic properties in older nursing home residents is relatively common, despite an association with an increased risk for falls, delirium, and other outcomes. Few studies have investigated what factors influence different levels of prescribing of these agents. OBJECTIVES: The primary objective was to identify factors associated with low- and high-level anticholinergic burden in nursing home residents. A secondary objective was to examine in detail the contribution of different medications to low versus high burden to aid in determining which drugs to target in interventions...
December 6, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29195858/phosphate-binder-use-in-us-dialysis-patients-prevalence-costs-evidence-and-policies
#7
Wendy L St Peter, Lori D Wazny, Eric D Weinhandl
Medicare costs for phosphate binders for US dialysis patients and patients with chronic kidney disease enrolled in Medicare Part D exceeded $1.5 billion in 2015. Previous data have shown that Part D costs for mineral and bone disorder medications increased faster than costs for all Part D medications for dialysis patients. Despite extensive use of phosphate binders and escalating costs, conclusive evidence is lacking that they improve important clinical end points in dialysis patients or non-dialysis-dependent patients with chronic kidney disease...
November 28, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29195016/association-of-high-cost-sharing-and-targeted-therapy-initiation-among-elderly-medicare-patients-with-metastatic-renal-cell-carcinoma
#8
Pengxiang Li, Yu-Ning Wong, Jordan Jahnke, Amy R Pettit, Jalpa A Doshi
High out-of-pocket costs may limit access to oral therapies covered by patients' prescription drug benefits. We explored financial barriers to treatment initiation in patients newly diagnosed with metastatic renal cell carcinoma (mRCC) by comparing Medicare Part D patients with low out-of-pocket costs due to receipt of full low-income subsidies (LIS beneficiaries) to their counterparts who were responsible for more than 25% cost sharing during Medicare's initial coverage phase (non-LIS beneficiaries). We used 2011-2013 100% Medicare claims for non-LIS and LIS beneficiaries newly diagnosed with metastases in the liver, lung, or bone to examine targeted therapy treatment initiation rates and time to initiation for (1) oral medications (sorafenib, sunitinib, everolimus, pazopanib, or axitinib) covered under Medicare's prescription drug benefit (Part D); (2) injected or infused medications (temsirolimus or bevacizumab) covered by Medicare's medical benefit (Part B); and (3) any (Part D or Part B) targeted therapy...
December 1, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/29180558/using-drug-prescribing-patterns-to-identify-stewards-of-cost-conscious-care
#9
Nicole Michele Gastala, Peter Wingrove, Winston Liaw, Stephen Petterson, Andrew Bazemore
PURPOSE: To characterize family physicians (FPs) who are stewards of care by consistently prescribing omeprazole over esomeprazole. METHODS: Cross-sectional analysis of physicians prescribing omeprazole or esomeprazole under Medicare Part D in 2014. RESULTS: There was a regional trend with 49% of Western FPs but only 6% of Southern FPs rarely prescribing esomeprazole. Physicians had increased odds of being a steward if they worked with a care coordinator (P < ...
November 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29174406/total-hip-arthroplasty-in-patients-with-previous-lumbar-fusion-surgery-are-there-more-dislocations-and-revisions
#10
Arthur L Malkani, Andrew T Garber, Kevin L Ong, John R Dimar, Doruk Baykal, Steven D Glassman, Adam R Cochran, Daniel J Berry
BACKGROUND: The purpose of this study was to determine whether the risk of dislocation and/or revision following THA is increased in patients with a history of prior lumbar fusion given the alterations in dynamic pelvic motion following LSF. METHODS: A total of 62,387 patients (5% Medicare part B claims database) were identified from 1997 to 2014 with primary THA. From this group, 1809 patients (2.9%) were stratified to identify those with prior lumbar fusion within 5 years of primary THA to compare risk of dislocation and revision with those without lumbar fusion...
October 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29170561/choice-inconsistencies-among-the-elderly-evidence-from-plan-choice-in-the-medicare-part-d-program-reply
#11
COMMENT
Jason Abaluck, Jonathan Gruber
We explore the in- and out- of sample robustness of tests for choice inconsistencies based on parameter restrictions in parametric models, focusing on tests proposed by Ketcham, Kuminoff and Powers (KKP). We argue that their non-parametric alternatives are inherently conservative with respect to detecting mistakes. We then show that our parametric model is robust to KKP's suggested specification checks, and that comprehensive goodness of fit measures perform better with our model than the expected utility model...
December 2017: American Economic Review
https://www.readbyqxmd.com/read/29159797/correlation-of-opioid-mortality-with-prescriptions-and-social-determinants-a-cross-sectional-study-of-medicare-enrollees
#12
Christos A Grigoras, Styliani Karanika, Elpida Velmahos, Michail Alevizakos, Myrto-Eleni Flokas, Christos Kaspiris-Rousellis, Ioannis-Nektarios Evaggelidis, Panagiotis Artelaris, Constantinos I Siettos, Eleftherios Mylonakis
BACKGROUND: The opioid epidemic is an escalating health crisis. We evaluated the impact of opioid prescription rates and socioeconomic determinants on opioid mortality rates, and identified potential differences in prescription patterns by categories of practitioners. METHODS: We combined the 2013 and 2014 Medicare Part D data and quantified the opioid prescription rate in a county level cross-sectional study with data from 2710 counties, 468,614 unique prescribers and 46,665,037 beneficiaries...
November 20, 2017: Drugs
https://www.readbyqxmd.com/read/29148351/opioid-prescribing-by-nurse-practitioners-in-medicare-part-d-impact-of-state-scope-of-practice-legislation
#13
Elissa Ladd, Casey Fryer Sweeney, Anthony Guarino, Alex Hoyt
Many state legislatures restrict nurse practitioner (NP) scope of practice as a way of addressing patient safety concerns. The purpose of this study was to investigate the influence of state NP scope of practice laws on the prescription of oxycodone and hydrocodone containing medications by NP and MD/DO/PA prescribers to Medicare Part D beneficiaries. Using the Medicare Part D public use file, we analyzed oxycodone and hydrocodone containing prescriptions per Medicare Part D beneficiary by prescriber type, NP state scope of practice, and geographic variables...
August 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148328/medicare-part-d-beneficiaries-plan-switching-decisions-and-information-processing
#14
Jayoung Han, Julie Urmie
Medicare Part D beneficiaries tend not to switch plans despite the government's efforts to engage beneficiaries in the plan switching process. Understanding current and alternative plan features is a necessary step to make informed plan switching decisions. This study explored beneficiaries' plan switching using a mixed-methods approach, with a focus on the concept of information processing. We found large variation in beneficiary comprehension of plan information among both switchers and nonswitchers. Knowledge about alternative plans was especially poor, with only about half of switchers and 2 in 10 nonswitchers being well informed about plans other than their current plan...
March 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148319/association-between-prescription-drug-insurance-and-health-care-utilization-among-medicare-beneficiaries
#15
G Caleb Alexander, Cuiping Schiman, Robert Kaestner
Medicare Part D was associated with reduced hospitalizations, yet little is known whether these effects varied across patients and how Part D was associated with length of stay and inpatient expenditures. We used Medicare claims and the Medicare Current Beneficiary Survey from 2002 to 2010 and an instrumental variables approach. Gaining drug insurance through Part D was associated with a statistically significant 8.0% reduction in likelihood of admission across conditions examined. Reductions were generally greater for younger, healthier, and male individuals...
December 1, 2016: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29131897/comparison-of-hospital-resource-use-and-outcomes-among-hospitalists-primary-care-physicians-and-other-generalists
#16
Jennifer P Stevens, David J Nyweide, Sha Maresh, Laura A Hatfield, Michael D Howell, Bruce E Landon
Importance: A physician's prior experience caring for a patient may be associated with patient outcomes and care patterns during and after hospitalization. Objective: To examine differences in the use of health care resources and outcomes among hospitalized patients cared for by hospitalists, their own primary care physicians (PCPs), or other generalists. Design, Setting, and participants: This retrospective study analyzed admissions for the 20 most common medical diagnoses among elderly fee-for-service Medicare patients from January 1 through December 31, 2013...
November 13, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29130269/medicare-advantage-and-fee-for-service-performance-on-clinical-quality-and-patient-experience-measures-comparisons-from-three-large-states
#17
Justin W Timbie, Andy Bogart, Cheryl L Damberg, Marc N Elliott, Ann Haas, Sarah J Gaillot, Elizabeth H Goldstein, Susan M Paddock
OBJECTIVE: To compare performance between Medicare Advantage (MA) and Fee-for-Service (FFS) Medicare during a time of policy changes affecting both programs. DATA SOURCES/STUDY SETTING: Performance data for 16 clinical quality measures and 6 patient experience measures for 9.9 million beneficiaries living in California, New York, and Florida. STUDY DESIGN: We compared MA and FFS performance overall, by plan type, and within service areas associated with contracts between CMS and MA organizations...
December 2017: Health Services Research
https://www.readbyqxmd.com/read/29128411/psychometric-properties-of-the-kidney-disease-quality-of%C3%A2-life-36-item-short-form-survey-kdqol-36-in-the%C3%A2-united%C3%A2-states
#18
John D Peipert, Peter M Bentler, Kristi Klicko, Ron D Hays
BACKGROUND: The Centers for Medicare & Medicaid Services require that dialysis patients' health-related quality of life be assessed annually. The primary instrument used for this purpose is the Kidney Disease Quality of Life 36-Item Short-Form Survey (KDQOL-36), which includes the SF-12 as its generic core and 3 kidney disease-targeted scales: Burden of Kidney Disease, Symptoms and Problems of Kidney Disease, and Effects of Kidney Disease. Despite its broad use, there has been limited evaluation of KDQOL-36's psychometric properties...
November 8, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29126268/duration-of-antibiotic-use-among-adults-with-uncomplicated-community-acquired-pneumonia-requiring-hospitalization-in-the-united-states
#19
Sarah H Yi, Kelly M Hatfield, James Baggs, Lauri A Hicks, Arjun Srinivasan, Sujan Reddy, John A Jernigan
Background: Previous studies suggest duration of antibiotic therapy for community-acquired pneumonia (CAP) often exceeds national recommendations and might represent an important opportunity to improve antibiotic stewardship nationally. The objective of this study was to determine average length of antibiotic therapy (LOT) for patients treated for uncomplicated CAP in US hospitals and proportion of patients with excessive durations. Methods: Records of retrospective cohorts of patients 18-64 years with private insurance and ≥65 years with Medicare hospitalized for CAP in 2012-13 were utilized...
November 6, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29124747/medicare-and-medication-access-basics-for-providers-and-patients
#20
EDITORIAL
Debra Saliba
Patients and families frequently turn to healthcare providers and health researchers for advice about insurance plans and healthcare related purchases. While these questions occur throughout the year, they are more frequent during the annual Medicare Open enrollment period which this year runs from October 15, 2017 to December 7, 2017. During this period, eligible individuals may enroll in or change their Medicare Part D plan and enroll in or change their Medicare Advantage plan (Medicare part C). This article is protected by copyright...
November 9, 2017: Journal of the American Geriatrics Society
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