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https://www.readbyqxmd.com/read/28774725/endogenous-information-adverse-selection-and-prevention-implications-for-genetic-testing-policy
#1
Richard Peter, Andreas Richter, Paul Thistle
We examine public policy toward the use of genetic information by insurers. Individuals engage in unobservable primary prevention and have access to different prevention technologies. Thus, insurance markets are affected by moral hazard and adverse selection. Individuals can choose to take a genetic test to acquire information about their prevention technology. Information has positive decision-making value, that is, individuals may adjust their behavior based on the result of the test. However, testing also exposes individuals to uncertainty over the available insurance contract, so-called classification risk, which lowers the value of information...
July 13, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28765463/dental-group-practice-and-the-need-for-dentists
#2
David S Gesko, Howard L Bailit
This study compared the number of patients treated per year by general dentists and dental hygienists in solo practice and by those employed by a large group practice. Information on the annual number of patient visits to solo general dental practitioners comes from the 2013 American Dental Association (ADA) Survey of Dental Practice. Patient visits were divided by 2.5 to estimate the number of patients treated annually. The data on group practices come from HealthPartners (HP) of Minnesota, a large not-for-profit medical and dental Health Maintenance Organization that accepts insurance contracts based on global budgets and is financially at risk...
August 2017: Journal of Dental Education
https://www.readbyqxmd.com/read/28718496/-introduction-of-rapid-syphilis-and-hiv-testing-in-prenatal-care-in-colombia-qualitative-analysis
#3
María Teresa Ochoa-Manjarrés, Hernando Guillermo Gaitán-Duarte, Sidia Caicedo, Berta Gómez, Freddy Pérez
Objective: Interpret perceptions of Colombian health professionals concerning factors that obstruct and facilitate the introduction of rapid syphilis and HIV testing in prenatal care services. Methods: A qualitative study based on semi-structured interviews was carried out. A convenience sample was selected with 37 participants, who included health professionals involved in prenatal care services, programs for pregnant women, clinical laboratories, and directors of health care units or centers, as well as representatives from regional departments and the Ministry of Health...
December 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28655014/association-between-health-plan-exit-from-medicaid-managed-care-and-quality-of-care-2006-2014
#4
Chima D Ndumele, William L Schpero, Mark J Schlesinger, Amal N Trivedi
Importance: State Medicaid programs have increasingly contracted with insurers to provide medical care services for enrollees (Medicaid managed care plans). Insurers that provide these plans can exit Medicaid programs each year, with unclear effects on quality of care and health care experiences. Objective: To determine the frequency and interstate variation of health plan exit from Medicaid managed care and evaluate the relationship between health plan exit and market-level quality...
June 27, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28649732/impact-of-medicaid-disenrollment-in-tennessee-on-breast-cancer-stage-at-diagnosis-and-treatment
#5
Wafa W Tarazi, Cathy J Bradley, Harry D Bear, David W Harless, Lindsay M Sabik
BACKGROUND: States routinely may consider rollbacks of Medicaid expansions to address statewide economic conditions. To the authors' knowledge, little is known regarding the effects of public insurance contractions on health outcomes. The current study examined the effects of the 2005 Medicaid disenrollment in Tennessee on breast cancer stage at the time of diagnosis and delays in treatment among nonelderly women. METHODS: The authors used Tennessee Cancer Registry data from 2002 through 2008 and estimated a difference-in-difference model comparing women diagnosed with breast cancer who lived in low-income zip codes (and therefore were more likely to be subject to disenrollment) with a similar group of women who lived in high-income zip codes before and after the 2005 Medicaid disenrollment...
June 26, 2017: Cancer
https://www.readbyqxmd.com/read/28621208/stem-cells-in-court-historical-trends-in-us-legal-cases-related-to-stem-cells
#6
Andreia Martins Martinho, Leigh Turner
Using two legal research platforms, we identified 193 stem-cell-related legal cases that were decided in US courts. Classifying the cases by category, we examined historical trends in the types of legal cases related to stem cells. Major types of cases involved plaintiffs seeking to overturn denial of health insurance coverage decisions, disputes related to intellectual property, false advertising, breaches of contract, exposure to hazardous agents, regulatory decisions, stem cell procedures and professional standard of care, use of stems cells in research, and public funding of embryonic stem cell research...
June 16, 2017: Regenerative Medicine
https://www.readbyqxmd.com/read/28599329/-healthcare-research-of-cataract-surgery-analysis-of-patient-s-satisfaction-following-cataract-surgery-in-mecklenburg-vorpommern-germany
#7
Maria Seifried, Helmut Höh
Background The collection of pre-, peri- and postoperative data took place between 2005 and 2008, based on a contract between the social insurance company, AOK Mecklenburg-Vorpommern, and the outpatient cataract surgeons/centers in Mecklenburg-Vorpommern, Germany. The purpose of the contract was the monitoring of quality of cataract surgery in the outpatient healthcare system. Materials and Methods We analysed 2952 datasets of 2952 eyes, remaining after exclusion of 109 datasets because of lack of plausibility and missing data (initially 3058 eyes with surgery in our centre)...
August 2017: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/28586962/nature-of-medical-malpractice-claims-against-radiation-oncologists
#8
Deborah Marshall, Kathryn Tringale, Michael Connor, Rinaa Punglia, Abram Recht, Jona Hattangadi-Gluth
PURPOSE: To examine characteristics of medical malpractice claims involving radiation oncologists closed during a 10-year period. METHODS AND MATERIALS: Malpractice claims filed against radiation oncologists from 2003 to 2012 collected by a nationwide liability insurance trade association were analyzed. Outcomes included the nature of claims and indemnity payments, including associated presenting diagnoses, procedures, alleged medical errors, and injury severity...
May 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28567507/-a%C3%A2-standard-data-set-for-the-evaluation-of-venous-leg-ulcers-in-selective-contracts-national-consensus
#9
K Heyer, S Milde, J Schmitt, M May, J Helfrich, M Augustin
BACKGROUND: Selective agreements are becoming increasingly important in health care management. To date, no standard recommendations for the evaluation of selective contracts are available. OBJECTIVES: Against this background, a recommendation on the evaluation of selective contracts in patients with leg ulcers (LU) was developed and approved by the nationwide consensus conference. MATERIALS AND METHODS: Based on a systematic literature review and followed by a manual search through other possible evaluation indicators in the care of patients with LU, a Delphi-based consensus process was performed by various scientific societies, professional associations, insurances and supply networks...
May 31, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28554214/battling-the-chargemaster-a-simple-remedy-to-balance-billing-for-unavoidable-out-of-network-care
#10
Barak D Richman, Nick Kitzman, Arnold Milstein, Kevin A Schulman
OBJECTIVES: To develop an effective legal mechanism to combat chargemaster abuses and to facilitate price transparency. STUDY DESIGN: Applying legal doctrines to out-of-network (OON) billing disputes. METHODS: We reviewed rudimentary contract law and examined the law's handling of contracts where prices have not been specified in advance. These cases are the controlling authority to guide courts, handling of surprise and OON billing problems...
April 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28530521/the-direct-cost-of-managing-a-rare-disease-assessing-medical-and-pharmacy-costs-associated-with-duchenne-muscular-dystrophy-in-the-united-states
#11
Sarah Thayer, Christopher Bell, Craig M McDonald
BACKGROUND: A Duchenne muscular dystrophy (DMD) cohort was identified using a claims-based algorithm to estimate health care utilization and costs for commercially insured DMD patients in the United States. Previous analyses have used broad diagnosis codes that include a range of muscular dystrophy types as a proxy to estimate the burden of DMD. OBJECTIVE: To estimate DMD-associated resource utilization and costs in a sample of patients identified via a claims-based algorithm using diagnosis codes, pharmacy prescriptions, and procedure codes unique to DMD management based on DMD clinical milestones...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28505704/-compilation-of-second-opinion-programs-in-the-german-statutory-health-insurance
#12
Dawid Pieper, Simone Heß, Tim Mathes
Objective According to a new legislation passed in 2016, patients with an indication for elective procedures have the right to obtain a second opinion. The Federal Joint Committee has not yet provided a list of indications that this legislation will cover. Independently of this, the statutory health insurances can, nonetheless, pay for a second opinion. The aim of this article is to give an overview of current second opinion programs delivered by the statutory health insurance schemes. Methods Websites of all German statutory health insurance schemes (n=117) were searched for second opinion programs and their features in November 2016...
May 15, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28482714/risk-and-impact-of-tuberculosis-in-patients-with-multiple-myeloma
#13
Chun-Kuang Tsai, Leh-Kiong Huon, Shuo-Ming Ou, Ai-Seon Kuan, Chiu-Mei Yeh, Yu-Ting Lee, Yao-Chung Liu, Tzeng-Ji Chen, Jin-Hwang Liu, Chia-Jen Liu
We investigated the risk and impact of mycobacterium tuberculosis (TB) infection in patients with multiple myeloma (MM). We identified 3979 MM patients from Taiwan's National Health Insurance database between 2000 and 2011 and compared the incidence rates of TB infection in these patients with 15,916 randomly selected age-, sex-, and comorbidity-matched subjects without MM. The risk of TB was higher in the myeloma cohort (adjusted hazard ratio [HR] 3.11, 95% confidence interval [CI] 2.41-4.02). Risk factors for MM patients contracting TB were age ≥65 (adjusted HR 1...
May 9, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28465821/dow-s-fire-and-explosion-index-a-case-study-in-the-process-unit-of-an-oil-extraction-factory
#14
Zeynab Sadat Nezamodini, Zahra Rezvani, Kumars Kian
INTRODUCTION: The incidence of fires and explosions have led to severe damage in many industries, primarily in industries' financial losses. This study was conducted to estimate losses due to fire and explosion and the impact of control measures on the number of losses applying Dow's Fire and Explosion Index. METHODS: This is a case study conducted in one of the process units of an oil extraction factory. Dow's Fire and Explosion Index Hazard classification guide, 7(th) edition, issued by the American Institute of Chemical Engineers was applied...
February 2017: Electronic Physician
https://www.readbyqxmd.com/read/28464814/was-federal-parity-associated-with-changes-in-out-of-network-mental-health-care-use-and-spending
#15
Susan H Busch, Emma E Mcginty, Elizabeth A Stuart, Haiden A Huskamp, Teresa B Gibson, Howard H Goldman, Colleen L Barry
BACKGROUND: The goal of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act is to eliminate differences in insurance coverage between behavioral health and general medical care. The law requires out-of-network mental health benefits be equivalent to out-of-network medical/surgical benefits. Insurers were concerned this provision would lead to unsustainable increases in out-of-network related expenditures. We examined whether federal parity implementation was associated with significant increases in out-of-network mental health care use and spending...
May 2, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28454870/temporary-jobs-and-the-severity-of-workplace-accidents
#16
Matteo Picchio, Jan C van Ours
INTRODUCTION: From the point of view of workplace safety, it is important to know whether having a temporary job has an effect on the severity of workplace accidents. We present an empirical analysis on the severity of workplace accidents by type of contract. METHOD: We used microdata collected by the Italian national institute managing the mandatory insurance against work related accidents. We estimated linear models for a measure of the severity of the workplace accident...
June 2017: Journal of Safety Research
https://www.readbyqxmd.com/read/28445624/the-role-of-publicly-funded-family-planning-sites-in-health-insurance-enrollment
#17
Jennifer Yarger, Sara Daniel, M Antonia Biggs, Jan Malvin, Claire D Brindis
CONTEXT: Publicly funded family planning providers are well positioned to help uninsured individuals learn about health insurance coverage options and effectively navigate the enrollment process. Understanding how these providers are engaged in enrollment assistance and the challenges they face in providing assistance is important for maximizing their role in health insurance outreach and enrollment. METHODS: In 2014, some 684 sites participating in California's family planning program were surveyed about their involvement in helping clients enroll in health insurance...
June 2017: Perspectives on Sexual and Reproductive Health
https://www.readbyqxmd.com/read/28381338/selective-contracting-and-channelling-patients-to-preferred-providers-a-scoping-review
#18
REVIEW
Romy E Bes, Emile C Curfs, Peter P Groenewegen, Judith D de Jong
Selective contracting by health insurers and channelling patients to contracted providers is crucial in a health care system based on managed competition, as this should lead to better value for money delivery of healthcare. However, an important consequence for enrolees is that health insurers interfere with their choice of care provider. This scoping review aims to find out what is known about selective contracting from the enrolee's perspective. Is it being done and how do enrolees feel about the role of their health insurer in their care provider choice? A literature search was conducted, and, in addition, experts were consulted for extra information and documents...
March 24, 2017: Health Policy
https://www.readbyqxmd.com/read/28375593/va-dental-insurance-program-final-rule
#19
(no author information available yet)
This document revises Department of Veterans Affairs (VA) medical regulations to reflect the codification of the authority for the VA Dental Insurance Program (VADIP), a program through which VA contracts with private dental insurers to offer premium-based dental insurance to enrolled veterans and certain survivors and dependents of veterans. The VA Dental Insurance Reauthorization Act of 2016 codified the authority of the VADIP, and this final rulemaking accordingly revises the authority citation in the VA medical regulations that implement VADIP...
April 4, 2017: Federal Register
https://www.readbyqxmd.com/read/28371945/-linkage-between-promotion-of-employment-and-promotion-of-health-in-the-community-setting-results-of-the-pilot-project-of-the-federal-employment-agency-and-the-statutory-health-insurance
#20
Michael Bellwinkel, Karin Schreiner-Kürten, Kathrin Melzer
The Federal Employment Agency and the Statutory Health Insurance (GKV) have put the link between the promotion of employment and of health to the test by making a joint approach aiming to reach unemployed persons with preventive health services and to maintain or improve their employability. Specialist case workers (Integrationsfachkräfte) of the job centres conducted health consultations, motivating unemployed persons and raising their awareness of their own health as well as enabling them to access health promotion services of health insurance funds on a voluntary basis...
April 3, 2017: Das Gesundheitswesen
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