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https://www.readbyqxmd.com/read/28448777/effect-of-an-advanced-pharmacy-practice-experience-on-medication-therapy-management-services-in-a-centralized-retail-pharmacy-program
#1
Joseph P Vande Griend, Melissa Rodgers, Wesley Nuffer
BACKGROUND: Medication therapy management (MTM) delivery is increasingly important in managed care. Successful delivery positively affects patient health and improves Centers for Medicare & Medicaid Services star ratings, a measure of health plan quality. As MTM services continue to grow, there is an increased need for efficient and effective care models. The primary objectives of this project were to describe the delivery of MTM services by fourth-year Advanced Pharmacy Practice Experience (APPE) students in a centralized retail pharmacy system and to evaluate and quantify the clinical and financial contributions of the students...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448109/how-medicaid-enrollees-fare-compared-with-privately-insured-and-uninsured-adults-findings-from-the-commonwealth-fund-biennial-health-insurance-survey-2016
#2
Munira Z Gunja, Sara R Collins, David Blumenthal, Michelle M Doty, Sophie Beutel
ISSUE: The number of Americans insured by Medicaid has climbed to more than 70 million, with an estimated 12 million gaining coverage under the Affordable Care Act’s Medicaid expansion. Still, some policymakers have questioned whether Medicaid coverage actually improves access to care, quality of care, or financial protection. GOALS: To compare the experiences of working-age adults who were either: covered all year by private employer or individual insurance; covered by Medicaid for the full year; or uninsured for some time during the year...
April 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28446176/health-care-providers-perspectives-regarding-the-use-of-chlorhexidine-gel-for-cord-care-in-neonates-in-rural-kenya-implications-for-scale-up
#3
Angela Muriuki, Francis Obare, Bill Ayieko, Dennis Matanda, Kenneth Sisimwo, Brian Mdawida
BACKGROUND: This paper explores the perspectives of health care providers regarding the use of 7.1% Chlorhexidine Digluconate (CHX) gel that releases 4% chlorhexidine for newborn umbilical cord care under a managed access program (MAP) implemented in Bungoma County of Kenya. Understanding the perspectives of providers regarding CHX is important since they play a key role in the health system and the fact that their views could be influenced by prior beliefs and inconsistent practices regarding umbilical cord care...
April 26, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28434466/cost-effectiveness-of-acupuncture-in-an-employee-population-a-retrospective-analysis
#4
Bijan J Borah, James M Naessens, Amy E Glasgow, Brent A Bauer, Tony Y Chon
OBJECTIVES: To determine whether acupuncture is a cost-effective adjunct to usual care for Mayo Clinic employees and their dependents experiencing pain symptoms. DESIGN: Retrospective review of the medical and billing records of 466 employee-patients and their dependents who had received acupuncture as part of their care and 466 propensity score-matched control patients. INTERVENTIONS: Usual care in combination with acupuncture compared with usual care alone...
April 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28433453/attending-documentation-contribution-to-billing-at-an-academic-emergency-department-with-an-electronic-health-record
#5
Brian J Yun, Stephen C Dorner, Brian M Baccari, John Brennan, Karen Smith, Ali S Raja, Benjamin A White
INTRODUCTION: In emergency medicine (EM), patient care documentation serves many functions, including supporting reimbursement. In addition, many electronic health record systems facilitate automatically populating certain data fields. As a result, in the academic model, the attending's note may now more often recapitulate many of the same elements found in the resident's or physician assistant's (PA) note. We sought to determine the value of additional attending documentation, and how often the attending documentation prevented a downcoding event...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28430692/lack-of-association-between-the-use-of-nerve-blockade-and-the-risk-of-postoperative-chronic-opioid-use-among-patients-undergoing-total-knee-arthroplasty-evidence-from-the-marketscan-database
#6
Eric C Sun, Brian T Bateman, Stavros G Memtsoudis, Mark D Neuman, Edward R Mariano, Laurence C Baker
BACKGROUND: Total knee arthroplasty (TKA) is associated with high rates of prolonged opioid use after surgery (10%-34%). By decreasing opioid use in the immediate postoperative period, perioperative nerve blockade has been hypothesized to decrease the risk of persistent opioid use. METHODS: Using health care utilization data, we constructed a sample of 120,080 patients undergoing TKA between 2002 and 2012 and used billing data to identify the utilization of peripheral or neuraxial blockade...
April 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28422517/neuropathic-pain-a-narrative-review-of-etiology-assessment-diagnosis-and-treatment-for-primary-care-providers
#7
Bill McCarberg, Yvonne D'Arcy, Bruce Parsons, Alesia Sadosky, Andrew Thorpe, Regina Behar
Neuropathic pain (NeP) is a distinct type of chronic pain that is a direct result of damage to the nervous system itself. Studies have shown that training on the topic of chronic pain in medical schools is lacking and many practitioners are not confident in their ability to effectively manage patients with such pain. The purpose of this narrative review is to provide a brief high-level overview of NeP for primary healthcare providers that includes a discussion of mechanisms, prevalence, burden, assessment, and treatment...
April 19, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28420595/using-an-array-of-implementation-strategies-to-improve-success-rates-of-pharmacist-initiated-medication-therapy-management-services-in-community-pharmacies
#8
Rachel Stafford, Jeremy Thomas, Nalin Payakachat, Tiffany Diemer, Michele Lang, Brooke Kordsmeier, Geoffrey Curran
BACKGROUND: With the introduction of the Centers for Medicare and Medicaid Services Stars Measure program has come a greater expectation of Medication Therapy Management (MTM) services from community pharmacies. To meet the growing demand of these services, pharmacies have sought out various methods of engaging pharmacists to provide MTM. Barriers for completing MTM include inadequate time to complete the services, insufficient staffing, lack of sufficient compensation, billing difficulty, lack of interest among patients (including refusing MTM services when offered), inadequate training/experience, and lack of support from management...
April 8, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28418524/evaluating-testing-strategies-for-identifying-youths-with-hiv-infection-and-linking-youths-to-biomedical-and-other-prevention-services
#9
Robin Lin Miller, Cherrie B Boyer, Danielle Chiaramonte, Peter Lindeman, Kate Chutuape, Bendu Cooper-Walker, Bill G Kapogiannis, Craig M Wilson, J Dennis Fortenberry
Importance: Most human immunodeficiency virus (HIV)-infected youths are unaware of their serostatus (approximately 60%) and therefore not linked to HIV medical or prevention services. The need to identify promising and scalable approaches to promote uptake of HIV testing among youths at risk is critical. Objective: To evaluate a multisite HIV testing program designed to encourage localized HIV testing programs focused on self-identified sexual minority males and to link youths to appropriate prevention services after receipt of their test results...
April 17, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28418280/twenty-first-century-pathologists-advocacy
#10
Timothy Craig Allen
Pathologists' advocacy plays a central role in the establishment of continuously improving patient care quality and patient safety, and in the maintenance and progress of pathology as a profession. Pathology advocacy's primary goal is the betterment of patient safety and quality medical care; however, payment is a necessary and appropriate component to both, and has a central role in advocacy. Now is the time to become involved in pathology advocacy; the Medicare Access and Children's Health Insurance Program (CHIP) Reauthorization Act of 2015 (MACRA) and the Protecting Access to Medicare Act of 2014 (PAMA) are two of the most consequential pieces of legislation impacting the pathology and laboratory industry in the last 20 years...
April 18, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28414254/lifestyle-intervention-for-adults-with-spinal-cord-injury-results-of-the-usc-rlanrc-pressure-ulcer-prevention-study
#11
Mike Carlson, Cheryl Lp Vigen, Salah Rubayi, Erna Imperatore Blanche, Jeanine Blanchard, Michal Atkins, Barbara Bates-Jensen, Susan L Garber, Elizabeth A Pyatak, Jesus Diaz, Lucia I Florindez, Joel W Hay, Trudy Mallinson, Jennifer B Unger, Stanley Paul Azen, Michael Scott, Alison Cogan, Florence Clark
CONTEXT/OBJECTIVE: Medically serious pressure injuries (MSPrIs), a common complication of spinal cord injury (SCI), have devastating consequences on health and well-being and are extremely expensive to treat. We aimed to test the efficacy of a lifestyle-based intervention designed to reduce incidence of MSPrIs in adults with SCI. DESIGN: A randomized controlled trial (RCT), and a separate study wing involving a nonrandomized standard care control group. SETTING: Rancho Los Amigos National Rehabilitation Center, a large facility serving ethnically diverse, low income residents of Los Angeles County...
April 17, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28414115/cost-analysis-of-a-surgical-consensus-guideline-in-breast-conserving-surgery
#12
Jennifer Yu, Leisha C Elmore, Amy E Cyr, Rebecca L Aft, William E Gillanders, Julie A Margenthaler
BACKGROUND: The SSO/ASTRO consensus statement was the first professional guideline in breast oncology to declare "no ink on tumor" as a negative margin in patients with stages I/II breast cancer undergoing breast conservation therapy (BCT). We sought to analyze the financial impact of this guideline at our institution using a historic cohort. STUDY DESIGN: We identified women undergoing re-excision following breast-conserving surgery for invasive breast cancer from 2010-2013 using a prospectively-maintained institutional database...
April 14, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28411297/hospitalizations-with-observation-services-and-the-medicare-part-a-complex-appeals-process-at-three-academic-medical-centers
#13
Ann M Sheehy, Jeannine Z Engel, Charles F S Locke, Daniel J Weissburg, Kevin Eldridge, Bartho Caponi, Amy Deutschendorf
Hospitalists and other providers must classify hospitalized patients as inpatient or outpatient, the latter of which includes all observation stays. These orders direct hospital billing and payment, as well as patient out-of-pocket expenses. The Centers for Medicare & Medicaid Services (CMS) audits hospital billing for Medicare beneficiaries, historically through the Recovery Audit program. A recent U.S. Government Accountability Office (GAO) report identified problems in the hospital appeals process of Recovery Audit program audits to which CMS proposed reforms...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28403936/the-short-term-and-long-term-effects-of-bariatric-metabolic-surgery-on-subcutaneous-adipose-tissue-inflammation-in-humans
#14
Derek K Hagman, Ilona Larson, Jessica N Kuzma, Gail Cromer, Karen Makar, Katya B Rubinow, Karen E Foster-Schubert, Brian van Yserloo, Peter S Billing, Robert W Landerholm, Matthew Crouthamel, David R Flum, David E Cummings, Mario Kratz
CONTEXT: The mechanisms mediating the short- and long-term improvements in glucose homeostasis following bariatric/metabolic surgery remain incompletely understood. OBJECTIVE: To investigate whether a reduction in adipose tissue inflammation plays a role in the metabolic improvements seen after bariatric/metabolic surgery, both in the short-term and longer-term. DESIGN: Fasting blood and subcutaneous abdominal adipose tissue were obtained before (n=14), at one month (n=9), and 6-12months (n=14) after bariatric/metabolic surgery from individuals with obesity who were not on insulin or anti-diabetes medication...
May 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28403462/medicaid-coverage-of-smoking-cessation-counseling-and-medication-is-underutilized-for-pregnant-women
#15
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/28401115/team-based-innovations-in-primary-care-delivery-in-quebec-and-timely-physician-follow-up-after-hospital-discharge-a-population-based-cohort-study
#16
Bruno D Riverin, Patricia Li, Ashley I Naimi, Mamadou Diop, Sylvie Provost, Erin Strumpf
BACKGROUND: Outpatient follow-up has been a key intervention point in addressing gaps in care after hospital discharge. We sought to estimate the association between enrolment in new team-based primary care practices and 30-day postdischarge physician follow-up among older patients and patients with chronic illnesses who were admitted to hospital in Quebec, Canada. METHODS: Patients were selected into this cohort if a primary care physician enrolled them as a "vulnerable patient" between November 2002 and January 2005...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28396027/risk-factors-for-community-associated-clostridium-difficile-infection-in-children
#17
Daniel J Adams, Matthew D Eberly, Michael Rajnik, Cade M Nylund
OBJECTIVE: To characterize the medication and other exposures associated with pediatric community-associated Clostridium difficile infections (CA-CDIs). STUDY DESIGN: We performed a case-control study using billing records from the US military health system database. CA-CDI cases included children 1-18 years of age with an outpatient International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic code for Clostridium difficile infection (CDI) from 2001 to 2013...
April 7, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28393587/addressing-discriminatory-benefit-design-for-people-living-with-hiv-a-california-case-study
#18
Sara B McMenamin, Riti Shimkhada, Sarah P Hiller, Garen Corbett, Ninez Ponce
Concern is growing in the United States regarding the potential for health insurance benefit designs to discriminate against persons living with HIV as research demonstrates that such practices are occurring. A recent complaint filed against health insurers in seven states alleges that some health insurance companies have been using benefit designs that discourage enrollment of people living with HIV either by not covering essential HIV medications or by requiring cost-sharing for these prohibitively expensive medications...
April 9, 2017: AIDS Care
https://www.readbyqxmd.com/read/28391419/do-consultants-follow-up-on-tests-they-recommend-insights-from-an-academic-inpatient-gastrointestinal-consult-service
#19
Benjamin E Cassell, Ted Walker, Saad Alghamdi, Jason Bill, Pierre Blais, Harold Boutté, Jeffrey W Brown, Gregory S Sayuk, C Prakash Gyawali
BACKGROUND: Inpatient care is a fundamental part of gastroenterology training and involves the recommendation, performance, and interpretation of diagnostic tests. However, test results are not always communicated to patients or treating providers. We determined the process of communication of test results and recommendations in our inpatient gastroenterology (GI) consult service. METHODS: Test recommendations on 304 consecutive new GI consults (age 60.2 ± 1...
April 8, 2017: Digestive Diseases and Sciences
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
#20
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
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