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https://www.readbyqxmd.com/read/28878668/analysis-of-regional-variation-in-the-scope-of-eligibility-defined-by-ages-in-children-s-medical-expense-subsidy-program-in-japan
#1
Takuma Sugahara
Children's medical expense subsidy programs are programs run by local governments that use public monies to reduce or eliminate the copayments for children's medical treatment including pharmaceutical cost (typically 20% for preschoolers and 30% thereafter). Currently, all prefectures and municipalities in Japan provide subsidies for infants' and children's medical expenses, but scope on ages of eligibility, income limits, and copayment requirements vary. The fact that these programs are run by local governments has given rise to differences in the costs borne by households with children, depending on the jurisdiction in which they live...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28851435/first-dollar-cost-sharing-for-skilled-nursing-facility-care-in-medicare-advantage-plans
#2
Laura M Keohane, Regina C Grebla, Momotazur Rahman, Dana B Mukamel, Yoojin Lee, Vincent Mor, Amal Trivedi
BACKGROUND: The initial days of a Medicare-covered skilled nursing facility (SNF) stay may have no cost-sharing or daily copayments depending on beneficiaries' enrollment in traditional Medicare or Medicare Advantage. Some policymakers have advocated imposing first-dollar cost-sharing to reduce post-acute expenditures. We examined the relationship between first-dollar cost-sharing for a SNF stay and use of inpatient and SNF services. METHODS: We identified seven Medicare Advantage plans that introduced daily SNF copayments of $25-$150 in 2009 or 2010...
August 29, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28837516/inflammatory-bowel-diseases-in-children-and-young-adults-with-celiac-disease-a-multigroup-matched-comparison
#3
Cristina Canova, Gisella Pitter, Loris Zanier, Renzo Zanotti, Lorenzo Simonato, Jonas F Ludvigsson
BACKGROUND: Celiac disease (CD) has been linked to inflammatory bowel disease (IBD) but previous reports have been inconsistent and may have been affected by surveillance bias. METHODS: Matched birth cohort study in Friuli-Venezia Giulia Region, Italy. We identified 1294 individuals with CD aged 0 to 23 years at diagnosis using pathology reports, hospital discharge records, or copayment exemptions. Each CD individual was matched with up to 5 general population reference individuals from the regional Medical Birth Register in Friuli-Venezia Giulia (n = 5681)...
August 22, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28834684/discussing-health-care-expenses-in-the-oncology-clinic-analysis-of-cost-conversations-in-outpatient-encounters
#4
Wynn G Hunter, S Yousuf Zafar, Ashley Hesson, J Kelly Davis, Christine Kirby, Jamison A Barnett, Peter A Ubel
PURPOSE: ASCO identified oncologist-patient conversations about cancer costs as an important component of high-quality care. However, limited data exist characterizing the content of these conversations. We sought to provide novel insight into oncologist-patient cost conversations by determining the content of cost conversations in breast cancer clinic visits. METHODS: We performed content analysis of transcribed dialogue from 677 outpatient appointments for breast cancer management...
August 23, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28813219/association-of-reference-pricing-with-drug-selection-and-spending
#5
James C Robinson, Christopher M Whaley, Timothy T Brown
Background In the United States, prices for therapeutically similar drugs vary widely, which has prompted efforts by public and private insurers to steer patients toward the lower-priced options. Under reference pricing, the insurer or employer establishes a maximum contribution it will make toward the price of a drug or procedure, and the patient pays the remainder. Methods We used difference-in-differences multivariable regression methods to analyze changes in prescriptions and pricing for 1302 drugs in 78 therapeutic classes in the United States, before and after implementation of reference pricing by an alliance of private employers...
August 17, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28793067/farm%C3%A3-cia-popular-program-pharmaceutical-market-analysis-of-antihypertensive-acting-on-the-renin-angiotensin-system-medicines
#6
Rondineli Mendes da Silva, Gabriela Costa Chaves, Luisa Arueira Chaves, Mônica Rodrigues Campos, Vera Lucia Luiza, Andréa Dâmaso Bertoldi, Dennis Ross-Degnan, Isabel Cristina Martins Emmerick
This paper aims to analyse changes in the retail pharmaceutical market following policy changes in the Farmácia Popular Program (FP), a medicines subsidy program in Brazil. The retrospective longitudinal analyses focus on therapeutic class of agents acting on the renin-angiotensin system. Data obtained from QuintilesIMS (formerly IMS Health) included private retail pharmacy sales volume (pharmaceutical units) and sales values from 2002 to 2013. Analyses evaluated changes in market share following key FP policy changes...
August 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28792299/impact-of-medicaid-prescription-copayments-on-use-of-antipsychotics-and-other-medications-in-patients-with-schizophrenia
#7
Jalpa A Doshi, Pengxiang Li, Sunita Desai, Steven C Marcus
OBJECTIVE: To assess the impact of Medicaid prescription copayment policies on antipsychotic and other medication use among patients with schizophrenia. METHOD: The study sample included fee-for-service adult Medicaid patients with schizophrenia. Medicaid claims records from 2003-2005 from 42 states and D.C. were linked with county-level data from the Area Resource File and findings from a state Medicaid policy survey. Patient-level fixed-effects regression models examined the impact of increases in generic copayments and generic/brand copayment differentials on monthly use of antipsychotic (overall and by generic/brand status) and other non-antipsychotic medications...
August 9, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28791752/is-higher-population-level-use-of-ics-laba-combination-associated-with-better-asthma-outcomes-cross-sectional-surveys-of-nationally-representative-populations-in-new-zealand-and-australia
#8
Helen K Reddel, Lutz Beckert, Angela Moran, Tristram Ingham, Rosario D Ampon, Matthew J Peters, Susan M Sawyer
BACKGROUND AND OBJECTIVE: New Zealand (NZ) and Australia (AU) have similarly high asthma prevalence; both have universal public health systems, but different criteria for subsidized medicines. We explored differences in asthma management and asthma-related outcomes between these countries. METHODS: A web-based survey was administered in AU (2012) and NZ (2013) to individuals aged ≥16 years with current asthma, drawn randomly from web-based panels, stratified by national population proportions...
August 9, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28777235/cost-effectiveness-of-health-coaching-an-integrative-review
#9
Rachel Hale, Jeannie Giese
PURPOSE/OBJECTIVES: The purpose of this review was to evaluate published literature to distinguish how health coaching influences the cost of chronic disease management in insured adults with chronic conditions. PRIMARY PRACTICE SETTING: An integrated literature review was conducted. MEDLINE, Business Source Complete, and OneSearch were searched for the years 2001-2016 utilizing the following key words: health coaching, health coaching AND insurance companies, health coaching AND cost, health coaching AND health insurance, and health coaching AND insurance cost...
September 2017: Professional Case Management
https://www.readbyqxmd.com/read/28776113/the-impact-of-copayments-on-mental-healthcare-utilization-a-natural-experiment
#10
Timo R Lambregts, René C J A van Vliet
Empirical evidence suggests that people are fairly sensitive to cost sharing arrangements in ambulatory mental healthcare. However, pure cost sharing effects are typically hard to measure due to the presence of adverse selection effects. In this paper, we examine the impact of cost sharing on mental healthcare utilization in the context of mandatory health insurance where adverse selection is absent. Using a large proprietary dataset of a Dutch private health insurer, we examine to what extent a new copayment scheme for adult mental healthcare changed healthcare utilization...
August 3, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28755097/provider-experiences-with-chronic-care-management-ccm-services-and-fees-a-qualitative-research-study
#11
Ann S O'Malley, Rumin Sarwar, Rosalind Keith, Patrick Balke, Sai Ma, Nancy McCall
BACKGROUND: Support for ongoing care management and coordination between office visits for patients with multiple chronic conditions has been inadequate. In January 2015, Medicare introduced the Chronic Care Management (CCM) payment policy, which reimburses providers for CCM activities for Medicare beneficiaries occurring outside of office visits. OBJECTIVE: To explore the experiences, facilitators, and challenges of practices providing CCM services, and their implications going forward...
July 28, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28745476/extending-marketplace-tax-credits-would-make-coverage-more-affordable-for-middle-income-adults
#12
Jodi Liu, Christine Eiber
ISSUE: Affordability of health coverage is a growing challenge for Americans facing rising premiums, deductibles, and copayments. The Affordable Care Act's tax credits make marketplace insurance more affordable for eligible lower-income individuals. However, individuals lose tax credits when their income exceeds 400 percent of the federal poverty level, creating a steep cliff. GOALS: To analyze the effects of extending eligibility for tax credits to individuals with incomes above 400 percent of the federal poverty level...
July 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28736929/impact-of-cost-sharing-increases-on-continuity-of-specialty-drug-use-a-quasi-experimental-study
#13
Pengxiang Li, Tianyan Hu, Xinyan Yu, Salim Chahin, Nabila Dahodwala, Marissa Blum, Amy R Pettit, Jalpa A Doshi
OBJECTIVE: To examine the impact of cost-sharing increases on continuity of specialty drug use in Medicare beneficiaries with multiple sclerosis (MS) or rheumatoid arthritis (RA). DATA SOURCES/STUDY SETTING: Five percent Medicare claims data (2007-2010). STUDY DESIGN: Quasi-experimental study examining changes in specialty drug use among a group of Medicare Part D beneficiaries without low-income subsidies (non-LIS) as they transitioned from a 5 percent cost-sharing preperiod to a ≥25 percent cost-sharing postperiod, as compared to changes among a disease-matched contemporaneous control group of patients eligible for full low-income subsidies (LIS), who faced minor cost sharing (≤$6...
July 24, 2017: Health Services Research
https://www.readbyqxmd.com/read/28732518/impact-of-the-change-of-copay-policy-in-medicare-part-d-on-zoster-vaccine-uptake-among-medicare-beneficiaries-in-a-managed-care-organization
#14
Rulin C Hechter, Lei Qian, Songkai Yan, Yi Luo, Girishanthy Krishnarajah, Hung-Fu Tseng
BACKGROUND: Kaiser Permanente Southern California (KPSC) adopted the Medicare Part D Tier-6 with zero patient copay for zoster vaccination in 2012. We assessed the impact of the implementation on zoster vaccination rate (GSK study identifier: HO-13-14,182). METHODS: Zoster vaccination rate was examined among an open cohort of ≥65-year-old Medicare Part D beneficiaries during 01/01/2008-06/30/2014, compared to ≥65-year-old commercial health plan members and 60-64-year-old members...
July 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28675119/what-do-patients-want-from-otolaryngologists-a-discrete-choice-experiment
#15
Matthew R Naunheim, Vinay K Rathi, Margaret L Naunheim, Blake C Alkire, Allen C Lam, Phillip C Song, Mark G Shrime
Objectives Patient preferences are crucial for the delivery of patient-centered care. Discrete choice experiments (DCEs) are an emerging quantitative methodology used for understanding these preferences. In this study, we employed DCE techniques to understand the preferences of patients presenting for an ear, nose, and throat clinic visit. Study Design DCE. Setting Decision science laboratory. Methods A DCE survey of 5 attributes-wait time, physician experience, physician personality, utilization of visit time, and cost/copayment-was constructed with structured qualitative interviews with patients...
June 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28664240/understanding-patients-preferences-for-surgical-management-of-urethral-stricture-disease
#16
Lindsay A Hampson, Tracy K Lin, Leslie Wilson, Isabel E Allen, Thomas W Gaither, Benjamin N Breyer
OBJECTIVES: To understand how prioritization of treatment attributes and treatment choice varies by patient characteristics, we sought to specifically determine how demographic variables affect patient treatment preference. PATIENTS AND METHODS: Male patients with urethral stricture disease participated in a choice-based conjoint (CBC) analysis exercise evaluating six treatment attributes associated with internal urethrotomy and urethroplasty. Demographic and past symptom data were collected...
June 29, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28663023/epidemiological-trends-and-direct-costs-of-diabetes-in-a-northern-italy-area-2012-health-administrative-records-analysis-lht-n-20-verona
#17
J Demurtas, N Alba, G Rigon, M V Nesoti, C Bovo, A Vaona
OBJECTIVE: This analysis estimates type 1 and type 2 diabetes direct costs in 2012, in terms of hospital care, outpatient visits, diagnostics and medications, in a local healthcare trust in Northern Italy (ULSS n.20 Verona). METHODS: The Johns Hopkins Adjusted Clinical Group (ACG(®)) System was used to analyze data, including hospital discharges, emergency room admissions, medical encounter records, disease registries, copayment exemptions, home care services, psychiatric services, rehabilitation services, and medications...
June 26, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28660657/pay-less-consume-more-the-price-elasticity-of-home-care-for-the-disabled-elderly-in-france
#18
Quitterie Roquebert, Marianne Tenand
Little is known about the price sensitivity of demand for home care of the disabled elderly. We partially fill this knowledge gap by using administrative data on the beneficiaries of the main French home care subsidy program in a department and exploiting interindividual variation in provider prices. We address the potential endogeneity of prices by taking advantage of the unequal spatial coverage of providers and instrumenting price by the number of municipalities served by a provider. We estimate a price elasticity of around -0...
June 29, 2017: Health Economics
https://www.readbyqxmd.com/read/28640674/racial-ethnic-minority-older-adults-perspectives-on-proposed-medicaid-reforms-effects-on-dental-care-access
#19
Mary E Northridge, Ivette Estrada, Eric W Schrimshaw, Ariel P Greenblatt, Sara S Metcalf, Carol Kunzel
To examine how proposed Medicaid reform plans are experienced by racial/ethnic minority older adults and what the implications are for their ability to access dental care through Medicaid, from 2013 to 2015 we conducted focus groups in northern Manhattan, New York, New York, among African American, Dominican, and Puerto Rican adults aged 50 years and older. Participants reported problems with affording copayments for care, complicated health and social issues, the need for vision and dental care close to home, and confusion about and stigmatization with Medicaid coverage...
May 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28637723/impact-of-consumer-copayments-for-subsidised-medicines-on-health-services-use-and-outcomes-a-protocol-using-linked-administrative-data-from-western-australia
#20
Karla L Seaman, Frank M Sanfilippo, Elizabeth E Roughead, Max K Bulsara, Anna Kemp-Casey, Caroline Bulsara, Gerald F Watts, David Preen
INTRODUCTION: Across the world, health systems are adopting approaches to manage rising healthcare costs. One common strategy is a medication copayments scheme where consumers make a contribution (copayment) towards the cost of their dispensed medicines, with remaining costs subsidised by the health insurance service, which in Australia is the Federal Government.In Australia, copayments have tended to increase in proportion to inflation, but in January 2005, the copayment increased substantially more than inflation...
June 21, 2017: BMJ Open
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