keyword
MENU ▼
Read by QxMD icon Read
search

Insurance reimbursement

keyword
https://www.readbyqxmd.com/read/28431415/potential-impact-of-affordable-care-act-related-insurance-expansion-on-trauma-care-reimbursement
#1
John W Scott, Pooja U Neiman, Peter A Najjar, Thomas C Tsai, Kirstin W Scott, Mark G Shrime, David M Cutler, Ali Salim, Adil H Haider
BACKGROUND: Nearly one quarter of trauma patients are uninsured and hospitals recoup less than 20% of inpatient costs for their care. This study examines changes to hospital reimbursement for inpatient trauma care if the full coverage expansion provisions of the Affordable Care Act (ACA) were in effect. METHODS: We abstracted nonelderly adults (ages 18-64 years) admitted for trauma from the Nationwide Inpatient Sample during 2010-the last year before most major ACA coverage expansion policies...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28429976/reimbursement-changes-and-drug-switching-are-severe-patients-more-affected
#2
Shou-Hsia Cheng, Chi-Chen Chen, Hung-Chih Kuo, Chi-Chuan Wang
Objectives To examine the long-term effects of drug reimbursement adjustments on drug-switching decisions and to investigate whether patients with complicated or severe conditions are more affected. Methods A population-based, longitudinal study with a before-and-after design. Analysis of 141,703 patients with type 2 diabetes covered by the universal health insurance program in Taiwan. Observation of five 6-month phases before and after a drug reimbursement adjustment implemented in October 2009. Drug switching was defined as a brand change within the same anatomical therapeutic chemical group between two consecutive physician visits...
April 2017: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/28426677/information-ranks-highest-expectations-of-female-adolescents-with-a-rare-genital-malformation-towards-health-care-services
#3
Elisabeth Simoes, Alexander N Sokolov, Andrea Kronenthaler, Hanna Hiltner, Norbert Schaeffeler, Katharina Rall, Esther Ueding, Monika A Rieger, Anke Wagner, Leonie S Poesch, Marie-Christin Baur, Judith Kittel, Sara Y Brucker
BACKGROUND: Access to highly specialized health care services and support to meet the patient's specific needs is critical for health outcome, especially during age-related transitions within the health care system such as with adolescents entering adult medicine. Being affected by an orphan disease complicates the situation in several important respects. Long distances to dedicated institutions and scarcity of knowledge, even among medical doctors, may present major obstacles for proper access to health care services and health chances...
2017: PloS One
https://www.readbyqxmd.com/read/28419487/the-effect-of-medicaid-physician-fee-increases-on-health-care-access-utilization-and-expenditures
#4
Kevin Callison, Binh T Nguyen
OBJECTIVE: To evaluate the effect of Medicaid fee changes on health care access, utilization, and spending for Medicaid beneficiaries. DATA SOURCE: We use the 2008 and 2012 waves of the Medical Expenditure Panel Survey linked to state-level Medicaid-to-Medicare primary care reimbursement ratios obtained through surveys conducted by the Urban Institute. We also incorporate data from the Current Population Survey and the Area Resource Files. STUDY DESIGN: Using a control group made up of the low-income privately insured, we conduct a difference-in-differences analysis to assess the relationship between Medicaid fee changes and access to care, utilization of health care services, and out-of-pocket medical expenditures for Medicaid enrollees...
April 16, 2017: Health Services Research
https://www.readbyqxmd.com/read/28418834/reduction-in-costs-after-treating-comorbid-panic-disorder-with-agoraphobia-and-generalized-anxiety-disorder
#5
Vedrana Ikic, Claude Belanger, Stephane Bouchard, Patrick Gosselin, Frederic Langlois, Joane Labrecque, Michel J Dugas, Andre Marchand
BACKGROUND: Panic disorder with agoraphobia (PDA) and generalized anxiety disorder (GAD) are impairing and costly disorders that are often misdiagnosed and left untreated despite multiple consultations. These disorders frequently co-occur, but little is known about the costs associated with their comorbidity and the impact of cognitive-behavioral therapy (CBT) on cost reduction. AIMS OF THE STUDY: The first objective of this study was to assess the mental health-related costs associated with the specific concomitance of PDA and GAD...
March 1, 2017: Journal of Mental Health Policy and Economics
https://www.readbyqxmd.com/read/28409741/impact-of-comorbidities-among-medicaid-enrollees-with-chronic-obstructive-pulmonary-disease-united-states-2009
#6
Gloria Westney, Marilyn G Foreman, Junjun Xu, Marshaleen Henriques King, Eric Flenaugh, George Rust
INTRODUCTION: Multimorbidity, the presence of 2 or more chronic conditions, frequently affects people with chronic obstructive pulmonary disease (COPD). Many have high-cost, highly complex conditions that have a substantial impact on state Medicaid programs. We quantified the cost of Medicaid-insured patients with COPD co-diagnosed with other chronic disorders. METHODS: We used nationally representative Medicaid claims data to analyze the impact of comorbidities (other chronic conditions) on the disease burden, emergency department (ED) use, hospitalizations, and total health care costs among 291,978 adult COPD patients...
April 13, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28408618/national-policies-fostering-hospice-care-increased-hospice-utilization-and-reduced-the-invasiveness-of-end-of-life-care-for-cancer-patients
#7
Yu-Yun Shao, Emily Han-Chung Hsiue, Chih-Hung Hsu, Chien-An Yao, Ho-Min Chen, Mei-Shu Lai, Ann-Lii Cheng
BACKGROUND: In 2011, two national policies aiming to foster hospice services for terminal cancer patients took effect in Taiwan. The single-payer National Health Insurance of Taiwan started to reimburse full hospice services. The national hospital accreditation program, which graded all hospitals, incorporated hospice utilization in its evaluation. We assessed the impact of these national policies. METHODS: A cohort of 249,394 patients aged ≥18 years who died of cancer between 2008 and 2013 were identified from the National Death Registry...
April 13, 2017: Oncologist
https://www.readbyqxmd.com/read/28403462/medicaid-coverage-of-smoking-cessation-counseling-and-medication-is-underutilized-for-pregnant-women
#8
Taneisha S Scheuermann, Kimber P Richter, Lisette T Jacobson, Theresa I Shireman
Introduction: Policies to promote smoking cessation among Medicaid-insured pregnant women have the potential to assist a significant proportion of pregnant smokers. In 2010, Kansas Medicaid began covering smoking cessation counseling for pregnant smokers. Our aim was to evaluate the use of smoking cessation benefits provided to pregnant women as a result of the Kansas Medicaid policy change that provided reimbursement for physician-provided smoking cessation counseling. Methods: We examined Kansas Medicaid claims data to estimate rates of delivery of smoking cessation treatment to Medicaid-insured pregnant women in Kansas from fiscal year 2010 through 2013...
May 1, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28400312/assigning-clinical-codes-with-data-driven-concept-representation-on-dutch-clinical-free-text
#9
Elyne Scheurwegs, Kim Luyckx, Léon Luyten, Bart Goethals, Walter Daelemans
Clinical codes are used for public reporting purposes, are fundamental to determining public financing for hospitals, and form the basis for reimbursement claims to insurance providers. They are assigned to a patient stay to reflect the diagnosis and performed procedures during that stay. This paper aims to enrich algorithms for automated clinical coding by taking a data-driven approach and by using unsupervised and semi-supervised techniques for the extraction of multi-word expressions that convey a generalisable medical meaning (referred to as concepts)...
April 8, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28392596/will-catholic-hospitals-survive-without-government-reimbursements
#10
David L Archer
This brief essay will begin to address the feasibility of operating a Catholic healthcare system without reimbursement from government healthcare programs such as Medicare and Medicaid. This question stems from the recent ACA/HHS "Nondiscrimination in Health Programs and Activities" final rule. Summary : The average hospital in the United States receives 40-50 percent of its net revenues from governmental sources. Participation in Medicare is contingent upon the hospital having a Medicare provider agreement...
February 2017: Linacre Quarterly
https://www.readbyqxmd.com/read/28390774/surgeon-leadership-in-the-coding-billing-and-contractual-negotiations-for-fenestrated-endovascular-aortic-aneurysm-repair-increases-medical-center-contribution-margin-and-physician-reimbursement
#11
Francesco Aiello, Jonathan Durgin, Vijaya Daniel, Louis Messina, Danielle Doucet, Jessica Simons, James Jenkins, Andres Schanzer
BACKGROUND: Fenestrated endovascular aneurysm repair (FEVAR) allows endovascular treatment of thoracoabdominal and juxtarenal aneurysms previously outside the indications of use for standard devices. However, because of considerable device costs and increased procedure time, FEVAR is thought to result in financial losses for medical centers and physicians. We hypothesized that surgeon leadership in the coding, billing, and contractual negotiations for FEVAR procedures will increase medical center contribution margin (CM) and physician reimbursement...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28390298/androgen-deprivation-therapy-and-cardiovascular-risk-no-meaningful-difference-between-gnrh-antagonist-and-agonists-a-nationwide-population-based-cohort-study-based-on-2010-2013-french-health-insurance-data
#12
Lucie-Marie Scailteux, Sébastien Vincendeau, Frédéric Balusson, Christophe Leclercq, André Happe, Béranger Le Nautout, Elisabeth Polard, Emmanuel Nowak, Emmanuel Oger
BACKGROUND: Observational studies suggested that androgen deprivation therapy (ADT) is associated with an increased cardiovascular (CV) risk. They all compared ADT-treated cancer patients to non-treated patients or non-cancer subjects. Our aim was to evaluate whether CV risk differs by type of ADT. METHODS: Through nationwide population-based claims reimbursement database linked to hospital discharge database, we identified adult men with prostate cancer who initiated ADT (gonadotrophin releasing hormone [GnRH] agonist or antagonist, antiandrogen [AA], combined androgen blockade [CAB]) or had orchiectomy (OT) between 1st July, 2010, and the 31st December, 2011, and followed them up to 31st December, 2013...
April 5, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28389487/what-is-the-care-pathway-of-patients-who-undergo-thyroid-surgery-in-france-and-its-potential-pitfalls-a-national-cohort
#13
Muriel Mathonnet, Anne Cuerq, Christophe Tresallet, Jean-Christophe Thalabard, Elisabeth Fery-Lemonnier, Gilles Russ, Laurence Leenhardt, Claude Bigorgne, Philippe Tuppin, Bertrand Millat, Anne Fagot-Campagna
CONTEXT: The rate of thyroid cancer is increasing in France, as well as concerns about overdiagnosis and treatment. OBJECTIVES: To examine the care pathway of patients who undergo thyroid surgery in France and detect potential pitfalls. DESIGN: A large observational study based on medical reimbursements, 2009-2011. SETTING: Data from the Sniiram (National Health Insurance Information System). PATIENTS: Patients with thyroid surgery in 2010, classified into 4 groups: thyroid cancer, benign nodule, goitre or multiple nodules, other (hyperthyroidism, head-neck cancer)...
April 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28382687/stakeholders-views-on-maternity-care-shortcomings-in-rural-ghana-an-ethnographic-study-among-women-providers-public-and-quasiprivate-policy-sector-actors
#14
Martin Amogre Ayanore, Milena Pavlova, Regien Biesma, Wim Groot
Access to skilled provider and emergency obstetric care is not universal across all districts in Ghana. The lived experiences of 3 stakeholder groups on maternity care shortcomings in 3 rural Ghanaian districts are examined in this study. We applied an ethnographic study approach where field data were collected between March to May 2015 in 3 rural districts of northern Ghana. Data were collected among women with recent births experiences (n = 90), health care providers (n = 16), and policy actors (n = 6)...
April 6, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28378543/towards-actualizing-the-value-potential-of-korea-health-insurance-review-and-assessment-hira-data-as-a-resource-for-health-research-strengths-limitations-applications-and-strategies-for-optimal-use-of-hira-data
#15
REVIEW
Jee Ae Kim, Seokjun Yoon, Log Young Kim, Dong Sook Kim
Health Insurance and Review Assessment (HIRA) in South Korea, also called National Health Insurance (NHI) data, is a repository of claims data collected in the process of reimbursing healthcare providers. Under the universal coverage system, having fee-for-services covering all citizens in South Korea, HIRA contains comprehensive and rich information pertaining to healthcare services such as treatments, pharmaceuticals, procedures, and diagnoses for almost 50 million beneficiaries. This corpus of HIRA data, which constitutes a large repository of data in the healthcare sector, has enormous potential to create value in several ways: enhancing the efficiency of the healthcare delivery system without compromising quality of care; adding supporting evidence for a given intervention; and providing the information needed to prevent (or monitor) adverse events...
May 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28376478/french-medical-administrative-database-for-epidemiology-and-safety-in-ophthalmology-episafe-the-episafe-collaboration-program-in-cataract-surgery
#16
Vincent Daien, Jean-Francois Korobelnik, Cécile Delcourt, Audrey Cougnard-Gregoire, Marie Noelle Delyfer, Alain M Bron, Isabelle Carrière, Max Villain, Jean Pierre Daures, Sandy Lacombe, Anne Sophie Mariet, Catherine Quantin, Catherine Creuzot-Garcher
Medical-administrative databases are an important source of big data to assess the epidemiology of diseases and interventions, compare drugs, and investigate rare adverse events. We describe the French national health insurance system databases and the Epidemiology and Safety (EPISAFE) collaboration program in ophthalmology and illustrate the paper with recent studies that used the databases to investigate cataract surgery. The Système national d'information inter-régime de l'assurance maladie (SNIIR-AM) is one of the largest databases of medical and administrative data for a general population, covering nearly 65 million people...
April 4, 2017: Ophthalmic Research
https://www.readbyqxmd.com/read/28376233/a-call-for-fertility-preservation-coverage-for-breast-cancer-patients-the-cost-of-consistency
#17
Jessica R Walter, Shuai Xu, Teresa K Woodruff
In 1998, the passage of the Women's Health and Cancer Rights Act required insurance health plans nationwide covering breast cancer treatments to also reimburse for subsequent breast reconstructive surgery and prostheses. In response to low utilization of breast reconstructive services, particularly among racial minorities, plastic surgery interest groups successfully advocated for the passage of the Breast Cancer Patient Education Act, which provides a timely opportunity to reconsider patient accessibility to other equally important quality of life issues for cancer survivors...
May 1, 2017: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/28374978/patterns-and-correlates-of-benzodiazepine-use-in-nurses-a-nationwide-population-based-study
#18
Elaine Sang, Yuan-Mei Liao, Nae-Fang Miao, Kuei-Ru Chou, Min-Huey Chung
In the present study, we examined patterns of benzodiazepine (BZD) use in nurses, and compared the characteristics of frequent users with those of infrequent users. Data on all nurses enrolled in the study were derived from the reimbursement claim records in Taiwan's National Health Insurance Research Database for the period 2004-2008. The case group comprised 33 588 nurses with BZD use, and the control group was exactly matched to each case according to age and sex. The patterns of occasional, frequent, and daily BZD use demonstrated an increasing trend from 2004 to 2008...
April 4, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28373247/practices-and-attitudes-of-doctors-and-patients-to-downward-referral-in-shanghai-china
#19
Wenya Yu, Meina Li, Xin Nong, Tao Ding, Feng Ye, Jiazhen Liu, Zhixing Dai, Lulu Zhang
OBJECTIVES: In China, the rate of downward referral is relatively low, as most people are unwilling to be referred from hospitals to community health systems (CHSs). The aim of this study was to explore the effect of doctors' and patients' practices and attitudes on their willingness for downward referral and the relationship between downward referral and sociodemographic characteristics. METHODS: Doctors and patients of 13 tertiary hospitals in Shanghai were stratified through random sampling...
April 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28370318/the-impact-of-change-from-copayment-to-coinsurance-on-medical-care-usage-and-expenditure-in-outpatient-setting-in-older-koreans
#20
Byoungjun Bae, Bo Ram Choi, Inmyung Song
Patient cost-sharing change was implemented on August 1, 2007, for outpatient care in the clinic setting in Korea from copayment to coinsurance. This study aims to estimate the effect of the policy change on medical care usage and expenditure in older Koreans. By using national health insurance claims data from the Health Insurance Reimbursement Assessment Service, this study analyzed the entire 137 million claims for a total of approximately 4.1 million patients aged 60 to 69 years who had been diagnosed and/or treated for outpatient care in clinics from January 1, 2007, to December 31, 2008...
April 3, 2017: International Journal of Health Planning and Management
keyword
keyword
119127
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"