keyword
MENU ▼
Read by QxMD icon Read
search

Payer

keyword
https://www.readbyqxmd.com/read/28920037/the-management-of-chronic-pain-caught-between-a-rock-and-a-hard-place-the-case-for-a-renewed-focus-on-provider-patient-and-payer-education
#1
Talal W Khan, Farnad Imani
No abstract text is available yet for this article.
February 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28919292/treatment-patterns-health-care-resource-utilization-and-spending-in-medicaid-beneficiaries-initiating-second-generation-long-acting-injectable-agents-versus-oral-atypical-antipsychotics
#2
Dominic Pilon, Neeta Tandon, Marie-Hélène Lafeuille, Rhiannon Kamstra, Bruno Emond, Patrick Lefebvre, Kruti Joshi
PURPOSE: Second-generation long-acting injectable therapies (SGA-LAIs) may reduce health care resource utilization (HRU) and health care costs compared with daily oral atypical antipsychotics (OAAs) in patients with schizophrenia due to reduced dosing frequency, delivery/monitoring by a health care provider, and improved adherence. The aim of the present study was to compare treatment patterns, HRU, and Medicaid spending in patients with schizophrenia initiated on SGA-LAIs (overall and according to agent) versus OAAs...
September 14, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28916895/the-cost-of-conversion-in-robotic-and-laparoscopic-colorectal-surgery
#3
Robert K Cleary, Andrew J Mullard, Jane Ferraro, Scott E Regenbogen
BACKGROUND: Conversion from minimally invasive to open colorectal surgery remains common and costly. Robotic colorectal surgery is associated with lower rates of conversion than laparoscopy, but institutions and payers remain concerned about equipment and implementation costs. Recognizing that reimbursement reform and bundled payments expand perspectives on cost to include the entire surgical episode, we evaluated the role of minimally invasive conversion in total payments. METHODS: This is an observational study from a linked data registry including clinical data from the Michigan Surgical Quality Collaborative and payment data from the Michigan Value Collaborative between July 2012 and April 2015...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28916284/stereotactic-body-radiotherapy-versus-low-dose-rate-brachytherapy-for-localised-prostate-cancer-a-cost-utility-analysis
#4
J Helou, S Torres, H B Musunuru, J Raphael, P Cheung, D Vesprini, H T Chung, L D'Alimonte, M Krahn, G Morton, A Loblaw
AIMS: To conduct a cost-utility analysis comparing stereotactic body radiotherapy (SBRT) with low dose rate brachytherapy (LDR-BT) for localised prostate cancer (PCa). MATERIALS AND METHODS: A decision-analytic Markov model was developed from the healthcare payer perspective to simulate the history of a 66-year-old man with low-risk PCa. The model followed patients yearly over their remaining lifetimes. Health states included 'recurrence-free', 'biochemical recurrence' (BR), 'metastatic' and 'death'...
September 12, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28915973/compassionomics-hypothesis-and-experimental-approach
#5
Stephen Trzeciak, Brian W Roberts, Anthony J Mazzarelli
Recent reports indicate that healthcare is experiencing a compassion crisis - an absence of (or inconsistency in) compassionate patient care. It is currently unclear if, or to what extent, this exerts significant effects on health and healthcare. Experimental data are few, and this represents a critical knowledge gap for all health sciences. We hypothesize that compassionate care is beneficial for patients (better outcomes), healthcare systems and payers (lower costs), and healthcare providers (lower burnout)...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28915099/examining-readmissions-through-the-zone-of-tolerance-theory
#6
Gary Hackbarth, Kirk Fiedler
The relationship between readmissions and customer service expectations is examined through the lens of the Zone of Tolerance (ZoT) theory. ZoT theory is expanded to consider the potential conflicting expectations and nature of the payer and patent customer dichotomy of the healthcare industry. The paper will suggest opportunities to influence patient expectations and understanding. It will also present empirical methods for understanding and responding to payer service expectations.
September 15, 2017: Hospital Topics
https://www.readbyqxmd.com/read/28913849/ethnic-disparities-in-renal-cell-carcinoma-an-analysis-of-hispanic-patients-in-a-single-payer-healthcare-system
#7
Alfredo Suarez-Sarmiento, Xiaopan Yao, Jonathan N Hofmann, Jamil S Syed, Wei K Zhao, Mark P Purdue, Wong-Ho Chow, Douglas Corley, Brian Shuch
OBJECTIVE: To investigate differences between Hispanics and non-Hispanic whites diagnosed with and treated for renal cell carcinoma in an equal access healthcare system. METHODS: We carried out a retrospective cohort study within the Kaiser Permanente healthcare system using records from renal cell carcinoma cases. Ethnicity was identified as Hispanic or non-Hispanic whites. Patient characteristics, comorbidities, tumor characteristics and treatment were compared...
September 15, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28910289/how-tavi-registries-report-clinical-outcomes-a-systematic-review-of-endpoints-based-on-varc-2-definitions
#8
Shixuan Zhang, Peter L Kolominsky-Rabas
INTRODUCTION: Transcatheter aortic valve implantation (TAVI) has been demonstrated to be an alternative treatment for severe aortic stenosis in patients considered as high surgical risk. Since its first human implantation by Cribier et al., TAVI has been shown to increase survival rate and quality of life for high surgical risks patients. The objective of this study is to provide an overview of TAVI registries and the reporting clinical outcomes based on the VARC-2 definitions. In addition, the comparability and adherence of VARC-2 reporting within the identified TAVI registries was reviewed...
2017: PloS One
https://www.readbyqxmd.com/read/28910222/restricted-access-state-medicaid-coverage-of-sofosbuvir-hepatitis-c-treatment
#9
Marea B Tumber
Chronic hepatitis C (HCV) infection can persist for decades without symptoms. Many Americans are unaware of their infection status and are not receiving necessary care and treatment. This places them at greater risk for severe, even fatal, complications from the disease and increases the likelihood that they will transmit the virus to others. In late 2013, the Food and Drug Administration approved a direct acting antiviral drug called sofosbuvir to treat chronic HCV infection. Sofosbuvir is a highly effective, but very expensive, curative treatment for HCV...
January 2017: Journal of Legal Medicine
https://www.readbyqxmd.com/read/28905412/long-term-treatment-costs-for-aggressive-periodontitis-in-a-german-population
#10
Falk Schwendicke, Anne Sophie Biffar, Christian Graetz
AIM: This study assessed the long-term annual costs for treating aggressive periodontitis (AgP) patients. METHODS: A cohort of compliant AgP patients was retrospectively evaluated. Costs for active periodontal therapy (APT, including scaling and root planning, open flap debridement, root resections, but not pocket-elimination or regenerative surgery) and supportive periodontal therapy (SPT, including also costs for restorative, endodontic, prosthetic and surgical treatments) were estimated from a mixed payer-perspective in Germany...
September 14, 2017: Journal of Clinical Periodontology
https://www.readbyqxmd.com/read/28902741/the-influence-of-geography-time-and-payer-type-on-the-utilization-of-bone-morphogenetic-protein-bmp-between-2005-and-2015
#11
Sohrab S Virk, Frank M Phillips, Safdar N Khan
Bone morphogenetic protein (BMP) is a critical compound for endochondral bone formation and is used as a bone graft substitute to promote spinal fusion and fracture healing. We sought to identify rate, type, and applications of use of BMP in spinal fusion surgery during 2005 to 2015. The Medicare 5% national sample (SAF5) database and the Humana Orthopaedics database (HORTHO) were searched for patients who underwent spinal fusion with BMP. Rate of use over time and influence of geographic region and payer type on utilization of BMP during 2005 to 2015 were analyzed...
September 11, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28900839/behavioral-health-integration-into-primary-care-a-microsimulation-of-financial-implications-for-practices
#12
Sanjay Basu, Bruce E Landon, John W Williams, Asaf Bitton, Zirui Song, Russell S Phillips
BACKGROUND: New payments from Medicare encourage behavioral health services to be integrated into primary care practice activities. OBJECTIVE: To evaluate the financial impact for primary care practices of integrating behavioral health services. DESIGN: Microsimulation model. PARTICIPANTS: We simulated patients and providers at federally qualified health centers (FQHCs), non-FQHCs in urban and rural high-poverty areas, and practices outside of high-poverty areas surveyed by the National Association of Community Health Centers, National Ambulatory Medical Care Survey, National Health and Nutrition Examination Survey, and National Health Interview Survey...
September 12, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28900481/routine-pre-treatment-mri-for-breast-cancer-in-a-single-payer-medical-center-effects-on-surgical-choices-timing-and-outcomes
#13
Timothy J Vreeland, John S Berry Iv, Erika Schneble, Doreen O Jackson, Garth S Herbert, Diane F Hale, Jonathon M Martin, Madeline Flores, Adam R Pattyn, Kai Hata, Guy T Clifton, Aaron D Kirkpatrick, George E Peoples
Introduction: Pre-operative MRI is being used with increasing frequency to evaluate breast cancer patients, but the debate surrounding risks and benefits of this use continues. At our institution, we instituted a standardized protocol for pre-operative MRI. Here, we compare patients seen prior to routine use of MRI to those seen after and examine effects on surgical choices, timing and outcomes. Methods: This is a retrospective review of a prospectively collected database of all new invasive breast cancers seen from January 2007 to December 2012...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28899480/variability-in-hemoglobin-levels-in-hemodialysis-patients-in-the-current-era-a-retrospective-cohort-study
#14
David T Gilbertson, Yan Hu, Yi Peng, Bradley J Maroni, James B Wetmore
BACKGROUND: Given regulatory and reimbursement changes in anemia management, we examined hemoglobin variability in a contemporary cohort of maintenance hemodialysis patients. MATERIALS AND METHODS: The study population included > 200,000 hemodialysis patients with Medicare parts A and B as primary payer on October 1, 2012. Based on 25th and 75th percentiles, monthly hemoglobin values were categorized as low, intermediate, or high. Six variability categories were created by patterns during the 6-month observation period...
September 7, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28895838/why-a-strong-consumer-centered-strategy-will-never-go-out-of-style
#15
Zachary Hafner
The awakening of the health care consumer is powerfully good news for the mission of providers and payers. In other industries, the same forces have led to innovation, cost reduction, and heightened value. We should expect health care to be no different.
July 2017: Managed Care
https://www.readbyqxmd.com/read/28895830/california-dreamin-but-will-it-stay-that-way
#16
Jan Greene
Medicaid expansion and Covered California's $100 million marketing plan makes the individual insurance market viable. This, even though premiums have gone up in the past few years (4.2% in 2015, 4% in 2016, 13.3% in 2017), and a movement to install a single-payer system would blow up the private insurance market.
July 2017: Managed Care
https://www.readbyqxmd.com/read/28895769/the-cost-effectiveness-of-levodopa-carbidopa-intestinal-gel-compared-to-standard-care-in-advanced-parkinson-s-disease
#17
Julia Lowin, Kavita Sail, Rakhi Baj, Yash J Jalundhwala, Thomas S Marshall, Henrietta Konwea, K R Chaudhuri
BACKGROUND: Parkinson's disease (PD) is an incurable, progressive neurological condition, with symptoms impacting movement, walking and posture that eventually become severely disabling. Advanced PD (aPD) has a significant impact on quality of life (QoL) for patients, their caregivers/families. Levodopa/carbidopa intestinal gel (LCIG) is indicated for the treatment of advanced levodopa-responsive PD with severe motor fluctuations and hyper-/dyskinesia when available combinations of therapy have not given satisfactory results...
September 12, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28895227/comparing-generic-drug-markets-in-europe-and-the-united-states-prices-volumes-and-spending
#18
COMPARATIVE STUDY
Olivier J Wouters, Panos G Kanavos, Martin McKEE
Policy Points: Our study indicates that there are opportunities for cost savings in generic drug markets in Europe and the United States. Regulators should make it easier for generic drugs to reach the market. Regulators and payers should apply measures to stimulate price competition among generic drugmakers and to increase generic drug use. To meaningfully evaluate policy options, it is important to analyze historical context and understand why similar initiatives failed previously. CONTEXT: Rising drug prices are putting pressure on health care budgets...
September 2017: Milbank Quarterly
https://www.readbyqxmd.com/read/28895218/strengthening-multipayer-collaboration-lessons-from-the-comprehensive-primary-care-initiative
#19
Grace Anglin, H A Tu, Kristie Liao, Laura Sessums, Erin Fries Taylor
Policy Points: Collaboration across payers to align financial incentives, quality measurement, and data feedback to support practice transformation is critical, but challenging due to competitive market dynamics and competing institutional priorities. The Centers for Medicare & Medicaid Services or other entities convening multipayer initiatives can build trust with other participants by clearly outlining each participant's role and the parameters of collaboration at the outset of the initiative. Multipayer collaboration can be improved if participating payers employ neutral, proactive meeting facilitators; develop formal decision-making processes; seek input on decisions from practice representatives; and champion the initiative within their organizations...
September 2017: Milbank Quarterly
https://www.readbyqxmd.com/read/28894314/home-care-pharmacy-practice-in-canada-a-cross-sectional-survey-of-services-provided-remuneration-barriers-and-facilitators
#20
Sherilyn Houle, Linda MacKeigan
BACKGROUND: As the population ages, and individuals desire to remain in their homes as long as possible, the need for in-home care is expected to increase. However, pharmacists have rarely been included in studies of in-home care, and little is known about the prevalence or effectiveness of pharmacists' home-based services in Canada. OBJECTIVE: To identify pharmacy practices in Canada that regularly provide in-home patient care and to identify specific services provided, remuneration obtained, and barriers and facilitators influencing the provision of home-based care...
July 2017: Canadian Journal of Hospital Pharmacy
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"