keyword
MENU ▼
Read by QxMD icon Read
search

Payer

keyword
https://www.readbyqxmd.com/read/27913067/the-financial-impact-of-clinic-no-show-rates-in-an-academic-pediatric-otolaryngology-practice
#1
Zhen Huang, Mariam Ashraf, Heather Gordish-Dressman, Pamela Mudd
PURPOSE: To investigate determinants of no-show rates in an academic pediatric otolaryngology practice including appointment time, age, sex, new patient status, payer mix, and median household income by zip code. MATERIALS AND METHODS: Retrospective chart review of clinic no-show rates and patient demographics in a free standing children's hospital and affiliated outpatient clinics across eight providers in a one-year period. RESULTS: Analysis shows that the overall no-show rate across all providers was 15% with the highest rate of 19% in the zip code with the lowest median income...
November 23, 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27912920/the-relationship-between-therapist-rated-function-and-patient-reported-outcome-measures
#2
Yvonne Braun, Jos J Mellema, Rinne M Peters, Suzanne Curley, Gae Burchill, David Ring
STUDY DESIGN: Prospective cohort study. INTRODUCTION: Some third-party payers require hand therapists to rate patient's functional disability based on patient self-rating using patient-reported outcome measures (PROMs), objective measurements of impairment, and observation of functional tasks-hand therapist-rated function (HTRF). PURPOSE OF THE STUDY: To test the correlation between HTRF and PROMs (upper limb functional index [ULFI] and Patient-Reported Outcomes Measurement Information System upper extremity [PROMIS UE]) and its association with psychological factors...
November 29, 2016: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/27909653/magnetic-resonance-imaging-of-the-cervical-spine-under-represents-sagittal-plane-deformity-in-degenerative-myelopathy-patients
#3
Douglas S Weinberg, Arunit J Chugh, Jeremy J Gebhart, Jason D Eubanks
BACKGROUND: In treating patients with cervical myelopathy, surgical approach may be dictated by sagittal balance, highlighting the need for accurate pre-operative assessment. Magnetic Resonance Imaging (MRI) is widely-recognized for its utility in the diagnosis and surgical planning of cervical myelopathy. Plain radiographs (X-rays) are a reliable tool to assess bony alignment. However, they may not always be included in standard pre-operative evaluation, especially in an era of restricted payer-environments...
2016: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/27908281/health-technology-assessment-of-drugs-for-rare-diseases-insights-trends-and-reasons-for-negative-recommendations-from-the-cadth-common-drug-review
#4
REVIEW
Ghayath Janoudi, William Amegatse, Brendan McIntosh, Chander Sehgal, Trevor Richter
BACKGROUND: A shift in biochemical research towards drugs for rare diseases has created new challenges for the pharmaceutical industry, government regulators, health technology assessment agencies, and public and private payers. In this article, we aim to comprehensively review, characterize, identify possible trends, and explore reasons for negative reimbursement recommendations in submissions made to the Common Drug Review (CDR) for drugs for rare diseases (DRD) at the Canadian Agency for Drugs and Technologies in Health (CADTH), a publicly funded pan-Canadian health technology assessment agency...
December 1, 2016: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/27900870/-hemosuccus-pancreaticus-rare-complication-of-chronic-pancreatitis
#5
Igor Šturdík, Martin Kužma, Zuzana Kužmová, Tomáš Koller, Vladimír Javorka, Tibor Hlavatý, Juraj Payer
Hemosuccus pancreaticus is a rare cause of upper digestive tract bleeding, it is hemorrhage to the pancreatic duct. A case report is about 56-years old man who was repeatedly hospitalized and suffered from melena and enterorrhagia during 3 years. Imaging studies did not clearly identified etiology of bleeding or source of hemorrhage was wrong identified. Finally, hemosuccus pancreaticus from collaterals of pseudoaneurysm after embolization was suspected because of repeating hemorrhage and embolization of a gastroduodenal artery in history...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27900641/cardiovascular-pet-mr-we-need-evidence-not-hype
#6
EDITORIAL
Afshin Farzaneh-Far, Raymond Y Kwong
Recent introduction of hybrid positron emission tomography/magnetic resonance (PET/MR) scanners has created excitement regarding potential applications in cardiovascular medicine. This has led to a number of optimistic assessments of its potential value in the nuclear cardiology literature, although most published data are still at the feasibility or pre-clinical level. Such excitement is understandable and provides "fuel" for generation of the necessary clinical validation studies, which will be required. Given the current scrutiny from payers and government agencies to reduce the costs of cardiac imaging, the responsibility for showing additive benefit lies on the shoulders of those advocating for new, more expensive technologies...
November 29, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/27899219/the-arduous-quest-for-translating-health-care-productivity-gains-into-cost-savings-lessons-from-their-evolution-at-economic-scoring-agencies-in-the-netherlands-and-the-us
#7
Ab Klink, H Christiaan Schakel, Sander Visser, Patrick Jeurissen
We analyze the assessments of recent health reforms by the Congressional Budget Office (CBO) in the United States and the Bureau for Economic Policy Analysis (CPB) in the Netherlands. Both reforms aim to capitalize on productivity gains, which is appealing for policymakers because of the potential for cost savings while maintaining - or enhancing - quality and access. These measures however generally translate into more health care, rather than care that is affordable and appropriate. Scoring agencies therefore have rightfully been reluctant to assign significant savings to these measures...
November 15, 2016: Health Policy
https://www.readbyqxmd.com/read/27894838/direct-and-indirect-costs-for-adverse-drug-events-identified-in-medical-records-across-care-levels-and-their-distribution-among-payers
#8
Jennie Natanaelsson, Katja M Hakkarainen, Staffan Hägg, Karolina Andersson Sundell, Max Petzold, Clas Rehnberg, Anna K Jönsson, Hanna Gyllensten
BACKGROUND: Adverse drug events (ADEs) cause considerable costs in hospitals. However, little is known about costs caused by ADEs outside hospitals, effects on productivity, and how the costs are distributed among payers. OBJECTIVE: To describe the direct and indirect costs caused by ADEs, and their distribution among payers. Furthermore, to describe the distribution of patient out-of-pocket costs and lost productivity caused by ADEs according to socio-economic characteristics...
November 19, 2016: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/27894497/trauma-quality-improvement
#9
REVIEW
Mark R Hemmila, Jill L Jakubus
Trauma centers and a third-party payer within Michigan built a regional collaborative quality initiative. Hallmarks of the collaborative are standardized data collection, annual data validation visits, face-to-face collaborative meetings, and dedication to performance improvement. The Michigan Trauma Quality Improvement Program has shown measurable improvement in patient outcomes, resource use, and compliance with processes of care.
January 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/27893348/cost-utility-and-budget-impact-of-methylene-blue-treated-plasma-compared-to-quarantine-plasma
#10
Joseph B Babigumira, Solomon J Lubinga, Emma Castro, Brian Custer
BACKGROUND: Methylene blue and visible light treatment and quarantine are two methods used to reduce adverse events, mostly infections, associated with the transfusion of fresh-frozen plasma. The objective of this study was to estimate and compare the budget impact and cost-utility of these two methods from a payer's perspective. MATERIALS AND METHODS: A budget impact and cost-utility model simulating the risks of hepatitis B virus, hepatitis C virus, cytomegalovirus, a West Nile virus-like infection, allergic reactions and febrile non-haemolytic transfusion reactions achieved using plasma treated with methylene blue and visible light (MBP) and quarantine plasma (QP) was constructed for Spain...
November 16, 2016: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/27891527/the-multimorbidity-index-a-tool-for-assessing-the-prognosis-of-patients-from-their-history-of-illness
#11
Farrokh Alemi, Cari R Levy, Raya E Kheirbek
BACKGROUND: The Multimorbidity (MM) Index predicts the prognosis of patients from their diagnostic history. In contrast to existing approaches with broad diagnostic categories, it treats each diagnosis as a separate independent variable using individual International Classification of Disease, Revision 9 (ICD-9) codes. OBJECTIVE: This paper describes the MM Index, reviews the published data on its accuracy, and provides procedures for implementing the Index within electronic health record (EHR) systems...
2016: EGEMS
https://www.readbyqxmd.com/read/27888907/classification-of-chronic-rhinosinusitis-working-toward-personalized-diagnosis
#12
REVIEW
Adam S DeConde, Timothy L Smith
An estimated 4.5% of total US health care dollars have been devoted to mitigating chronic rhinosinusitis. The most recalcitrant of these patients undergo surgery, which fails to improve symptoms in approximately 25% of patients. Recent advances in informational, microbiomic, and genomic analysis have introduced the first set of tools that patients, physicians, politicians, and payers can apply to better forecast which patients will respond favorably to endoscopic sinus surgery. This article summarizes the forces driving the application of personalized medicine to CRS and how new advances can be applied to clinical practice...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27888437/estimated-budget-impact-of-adopting-the-affordable-care-act-s-required-smoking-cessation-coverage-on-united-states-healthcare-payers
#13
Christine L Baker, Cheryl P Ferrufino, Marianna Bruno, Stacey Kowal
INTRODUCTION: Despite abundant information on the negative impacts of smoking, more than 40 million adult Americans continue to smoke. The Affordable Care Act (ACA) requires tobacco cessation as a preventive service with no patient cost share for all FDA-approved cessation medications. Health plans have a vital role in supporting smoking cessation by managing medication access, but uncertainty remains on the gaps between smoking cessation requirements and what is actually occurring in practice...
November 25, 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27888091/patient-and-clinical-characteristics-that-heighten-risk-for-heart-failure-readmission
#14
Chad Bradford, Bijal M Shah, Patricia Shane, Nicole Wachi, Kamalpreet Sahota
BACKGROUND: Within 30 days of hospital discharge, heart failure (HF) readmission rates nationally accumulate to more than 20%. Due to this high rate of unplanned re-hospitalization, predictive models are needed to identify patients who pose the highest readmission risk. OBJECTIVE: To evaluate the diagnosis and timing and to identify patient and clinical characteristics associated with 30 day readmissions among HF patients. METHODS: A retrospective analysis of electronic health records was conducted to study HF admissions during the period October 2008 to November 2014...
November 10, 2016: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/27885814/trends-microbiology-and-outcomes-of-infective-endocarditis-in-children-during-2000-2010-in-the-united-states
#15
Shipra Gupta, Ankit Sakhuja, Eric McGrath, Basim Asmar
BACKGROUND: We studied the incidence, trend, underlying conditions, microbiology, and outcomes of infective endocarditis (IE) in children during 11 years using Nationwide Inpatient Sample (NIS) database. This is the largest all-payer inpatient care database in the United States containing data for more than 8 million hospital stays from over 1000 hospitals. METHODS: NIS data from 2000 to 2010 of primary discharge diagnosis of IE in children aged ≤19 years old were studied...
November 25, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27884544/pancreas-fistula-risk-prediction-implications-for-hospital-costs-and-payments
#16
Daniel E Abbott, Ching Wei D Tzeng, Matthew T McMillan, Mark P Callery, Tara S Kent, John D Christein, Stephen W Behrman, Daniel P Schauer, Dennis J Hanseman, Mark H Eckman, Charles M Vollmer
BACKGROUND: As payment models evolve, disease-specific risk stratification may impact patient selection and financial outcomes. This study sought to determine whether a validated clinical risk score for post-operative pancreatic fistula (POPF) could predict hospital costs, payments, and profit margins. METHODS: A multi-institutional cohort of 1193 patients undergoing pancreaticoduodenectomy (PD) were matched to an independent hospital where cost, in US$, and payment data existed...
November 21, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27882839/real-world-drug-costs-of-treating-hepatitis-c-genotypes-1-4-with-direct-acting-antivirals-initiating-treatment-at-fibrosis-0-2-and-3-4
#17
Timothy A Bach, Kathy Zaiken
BACKGROUND: Direct-acting antivirals (DAA) for the treatment of hepatitis C virus (HCV) have drastically improved outcomes but are also very costly. For this reason, priority for treatment is often given to patients with a higher fibrosis score at baseline by payers and providers rather than treating all eligible patients. Simulation studies have suggested that waiting to treat patients until fibrosis 3-4 may be more costly and result in worse outcomes; however, real-world implications are unknown...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27882834/amcp-partnership-forum-navigating-innovations-in-diabetes-care
#18
(no author information available yet)
: New developments that provide opportunities to enhance cost-effective diabetes care include advances in the pharmacologic treatment of diabetes, new drug delivery devices, innovations in patient management strategies, contracting strategies that incentivize effective interventions, and mobile health technologies. Payers must carefully consider the utility of these advances when making coverage decisions and designing benefits. To engage national stakeholders in a discussion about how to utilize innovations in diabetes care to optimize patient outcomes, the Academy of Managed Care Pharmacy organized the Partnership Forum on Navigating Innovations in Diabetes Care in Arlington, Virginia, on July 19-20, 2016...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27882831/quantifying-differences-in-health-care-consumption-for-the-management-of-multiple-sclerosis-within-privately-and-publicly-insured-health-care-programs
#19
Terrie Livingston, Monica Fay, Ravi Iyer, Wendy Wells, Michael W Pill
BACKGROUND: Multiple sclerosis (MS) is a chronic and debilitating disease of the central nervous system that affects more than 570,000 persons in the United States and 2.3 million worldwide. Since most individuals experience initial symptoms between the ages of 20 and 40 years, MS can have a significant effect on health care consumption, quality of life, productivity, and employment over the long-term disease course. Opportunities exist to better understand how benefit design and other nonclinical factors can affect health care delivery and associated costs...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27882552/trends-and-the-utilization-of-transoral-robotic-surgery-with-neck-dissection-in-new-york-state
#20
Catherine H Frenkel, Jie Yang, Mengru Zhang, Elliot Regenbogen, Dana A Telem, Ghassan J Samara
OBJECTIVES: The timing of neck dissection (ND) in relation to transoral robotic surgery (TORS) is controversial. This study identifies local practice patterns and economic and social access disparities during adoption of TORS. STUDY DESIGN: We analyzed utilization patterns of TORS and ND using the New York Statewide Planning and Research Cooperative System all-payer administrative database. Statewide head and neck cancer incidence from the Centers for Disease Control and Prevention (Bethesda, MD) was used to control for overall cancer incidence...
November 24, 2016: Laryngoscope
keyword
keyword
22260
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"