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Luzmercy Perez, Knashawn H Morales, Heather Klusaritz, Xiaoyan Han, Jingru Huang, Marisa Rogers, Ian M Bennett, Cynthia S Rand, Grace Ndicu, Andrea J Apter
BACKGROUND: Self-management of moderate/severe asthma depends upon patients' ability to: 1) navigate (access health care to obtain diagnoses and treatment), 2) use inhaled corticosteroids (ICS) properly, and 3) understand ICS function. OBJECTIVE: To test whether navigation skills (medication recall, knowledge of copay requirements ability to provide information needed for a medical visit about a persistent cough unresponsive to medication), are related to other self-management skills and to health literacy...
October 12, 2016: Journal of Allergy and Clinical Immunology
Amitava Banerjee, Shweta Khandelwal, Lavanya Nambiar, Malvika Saxena, Victoria Peck, Mohammed Moniruzzaman, Jose Rocha Faria Neto, Katherine Curi Quinto, Andrew Smyth, Darryl Leong, José Pablo Werba
BACKGROUND: Secondary prevention is cost-effective for cardiovascular disease (CVD), but uptake is suboptimal. Understanding barriers and facilitators to adherence to secondary prevention for CVD at multiple health system levels may inform policy. OBJECTIVES: To conduct a systematic review of barriers and facilitators to adherence/persistence to secondary CVD prevention medications at health system level. METHODS: Included studies reported effects of health system level factors on adherence/persistence to secondary prevention medications for CVD (coronary artery or cerebrovascular disease)...
2016: Open Heart
Peter A Ubel, Peter B Bach
No abstract text is available yet for this article.
October 11, 2016: Annals of Internal Medicine
Osamah Saeedi, Hasan Ashraf, Eric P Slade, Deborah R Medoff, Lan Li, David S Friedman, Julie Kreyenbuhl
PURPOSE: To assess trends in prevalence of diagnosed ocular disease and utilization of eye care services in the VA healthcare system. DESIGN: Prevalence study METHODS: We performed a retrospective study of all eligible Veterans in the VA Capitol Health Care Network from 2007 to 2011. The VA database was used to abstract demographic and socioeconomic variables including age, race, gender, marital status, service connection, prescription copay, homelessness, VA facility...
October 1, 2016: American Journal of Ophthalmology
David J T Campbell, Marcello Tonelli, Brenda Hemmelgarn, Chad Mitchell, Ross Tsuyuki, Noah Ivers, Tavis Campbell, Raj Pannu, Eric Verkerke, Scott Klarenbach, Kathryn King-Shier, Peter Faris, Derek Exner, Vikas Chaubey, Braden Manns
BACKGROUND: Chronic diseases result in significant morbidity and costs. Although medications and lifestyle changes are effective for improving outcomes in chronic diseases, many patients do not receive these treatments, in part because of financial barriers, patient and provider-level knowledge gaps, and low patient motivation. The Assessing outcomes of enhanced chronic disease care through patient education and a value-based formulary study (ACCESS) will determine the impact of two interventions: (1) a value-based formulary which eliminates copayment for high-value preventive medications; and (2) a comprehensive self-management support program aimed at promoting health behavior change and medication adherence, combined with relay of information on medication use to healthcare providers, on cardiovascular events and/or mortality in low-income seniors with elevated cardiovascular risk...
September 26, 2016: Implementation Science: IS
(no author information available yet)
The Department of Veterans Affairs (VA) adopts as final, without change, an interim final rule amending its medical regulations. Specifically, this rule allows veterans to complete applications for health care enrollment by providing application information, agreeing to VA's provisions regarding copayment liability and assignment of third-party insurance benefits, and attesting to the accuracy and authenticity of the information provided to a VA employee over the phone. This action makes it easier for veterans to apply to enroll and speeds VA processing of applications...
September 12, 2016: Federal Register
Lydia E Pace, Stacie B Dusetzina, Nancy L Keating
The oral contraceptive pill is the contraceptive method most commonly used by US women, but inconsistent use of the pill is a contributor to high rates of unintended pregnancy. The relationship between consumer cost sharing and consistent use of the pill is not well understood, and the impact of the elimination of cost sharing for oral contraceptive pills in a mandate in the Affordable Care Act (ACA) is not yet known. We analyzed insurance claims for 635,075 women with employer-sponsored insurance who were initiating use of the pill, to examine rates of discontinuation and nonadherence, their relationship with cost sharing, and trends before and during the first year after implementation of the ACA mandate...
September 1, 2016: Health Affairs
Kai Yeung, Anirban Basu, Ryan N Hansen, John B Watkins, Sean D Sullivan
BACKGROUND: Value-based benefit design has been suggested as an effective approach to managing the high cost of pharmaceuticals in health insurance markets. Premera Blue Cross, a large regional health plan, implemented a value-based formulary (VBF) for pharmaceuticals in 2010 that explicitly used cost-effectiveness analysis (CEA) to inform medication copayments. OBJECTIVE OF THE STUDY: The objective of the study was to determine the impact of the VBF. DESIGN: Interrupted time series of employer-sponsored plans from 2006 to 2013...
August 30, 2016: Medical Care
Ye Jin Kang, Danny McCormick, Leah Zallman
Immigrants' perceptions of affordability of insurance and knowledge of insurance after health reform are unknown. We conducted face-to-face surveys with a convenience sample of 1124 patients in three Massachusetts safety net Emergency Departments after the Massachusetts health reform (August 2013-January 2014), comparing immigrants and non-immigrants. Immigrants, as compared to non-immigrants, reported more concern about paying premiums (30 vs. 11 %, p = 0.0003) and about affording the current ED visit (38 vs...
August 26, 2016: Journal of Immigrant and Minority Health
Julián Librero, Gabriel Sanfélix-Gimeno, Salvador Peiró
OBJECTIVE: To identify adherence patterns over time and their predictors for evidence-based medications used after hospitalization for coronary heart disease (CHD). PATIENTS AND METHODS: We built a population-based retrospective cohort of all patients discharged after hospitalization for CHD from public hospitals in the Valencia region (Spain) during 2008 (n = 7462). From this initial cohort, we created 4 subcohorts with at least one prescription (filled or not) from each therapeutic group (antiplatelet, beta-blockers, ACEI/ARB, statins) within the first 3 months after discharge...
2016: PloS One
Nika Marđetko, Mitja Kos
Background The therapeutic reference pricing (TRP) in Slovenia was implemented for proton pump inhibitors in 2013 and for angiotensin-converting enzyme inhibitors and lipid-lowering medicines in 2014. Objective The study aimed to assess patients' knowledge and attitude towards the TRP system. Moreover, the patients' willingness to pay was evaluated for patients who rejected the substitution of a current medicine within a therapeutic class by the reference medicine for which no co-payment is needed. Setting Invitation of patients to participate in a survey and filling in the first part of the questionnaire was run in the community pharmacies in Slovenia...
October 2016: International Journal of Clinical Pharmacy
Kaori Koyanagi, Toshio Kubota, Daisuke Kobayashi, Taro Kihara, Takeo Yoshida, Takamasa Miisho, Tomoko Miura, Yoshiko Sakamoto, Junichi Takaki, Takashi Seo, Takao Shimazoe
BACKGROUND: Medication adherence has an important influence on health outcomes in patients with chronic diseases. However, few studies have been performed in Japan to determine factors related to medication non-adherence. OBJECTIVE: The aim of this study was to identify prescription factors related to medication non-adherence by investigating patient characteristics, all prescriptions, and prescriptions for oral antidiabetic drugs (OADs). METHODS: A retrospective cross-sectional survey of prescription data about implementation of dosing regimen was performed at community pharmacies engaged in appropriate use of leftover drugs...
2016: Frontiers in Pharmacology
James B Kirby, Amy J Davidoff, Jayasree Basu
BACKGROUND: Starting in September of 2010, the Patient Protection and Affordable Care Act required most health insurance policies to cover evidence-based preventive care with no cost-sharing (no copays, coinsurance, or deductibles). It is unknown, however, whether declines in out-of-pocket costs for preventive services are large enough to prompt increases in utilization, the ultimate goal of the policy. METHODS: In this study, we use a nationally representative sample of ambulatory care visits to estimate the impact of the zero cost-sharing mandate on out-of-pocket expenditures on well-child and screening mammography visits...
July 29, 2016: Medical Care
Niklas Jakobsson, Mikael Svensson
OBJECTIVE: This paper analyzes how primary care physician visits are affected by the level of copayment in Sweden. DATA SOURCE: We use data between the years 2003-2012 from 21 Swedish health care regions that have the mandate to set their own level of copayment. The copayment per visit varies between €10 and €20 for these years and regions. STUDY DESIGN: Our strategy to identify the causal effect and deal with unobserved endogeneity of price changes on physician visits is based on a panel data model using fixed effects to control for region and time and regional-variation in time trends...
September 2016: Health Policy
Elina Pradhan, Victoria Y Fan
OBJECTIVE: To assess the differential impact of a copayment exemption compared to a cash incentive on increasing skilled birth attendance (i.e., birth attended by a skilled health worker) in Nepal. DATA SOURCES/STUDY SETTING: This study used data on 8,785 children born between July 2005 and December 2008, obtained from the nationally representative Demographic and Health Surveys, 2006 and 2011. STUDY DESIGN: Twenty-five districts received both the policy interventions, and the remaining 50 control districts received only the cash incentive...
August 1, 2016: Health Services Research
Mohammad Alyahya, Heba H Hijazi, Farid T Nusairat
Appointment nonadherence is a health behavior that represents a burden to health care systems. On March 1, 2015, a new negative reinforcement intervention involving "service fees" for a visit without appointment was implemented at King Abdullah University Hospital in Jordan. To evaluate the effect of this intervention in improving patient adherence to medical appointment, a retrospective preintervention and postintervention analysis was used, including all patients (n = 65 535) who had scheduled appointments at 39 outpatient clinics...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
Michael T Halpern, Deborah Schrag
Medicaid beneficiaries with cancer are less likely to receive timely and high-quality care. This study examined whether differences in state-level Medicaid policies affect delays in time to surgery (TTS) among women diagnosed with breast cancer. Using 2006-2008 Medicaid data, we identified women aged 18-64 enrolled in Medicaid diagnosed with breast cancer. Analyses examined associations of state-specific Medicaid surgery reimbursements, Medicaid eligibility recertification period (annually vs. shorter) and required patient copayment on time from breast cancer diagnosis to receipt of breast surgery...
August 2016: Breast Cancer Research and Treatment
Annette Fulcher, Marty Lambeth, Lauren Miller, Amber Sullivan
No abstract text is available yet for this article.
May 2016: MGMA Connexion
Nicole M Gastala, Peter Wingrove, Anne Gaglioti, Stephen Petterson, Andrew Bazemore
Prescription drugs are a major source of US health care expenditure. "Me too" brand-name medications contribute to the cost of drugs, which is substantial for consumers. In 2013 patient copayments averaged 10.5 times more for two commonly prescribed brand-name medications versus generic therapeutic alternatives.
July 1, 2016: Health Affairs
Samuel L Dickman, Steffie Woolhandler, Jacob Bor, Danny McCormick, David H Bor, David U Himmelstein
US medical spending growth slowed between 2004 and 2013. At the same time, many Americans faced rising copayments and deductibles, which may have particularly affected lower-income people. To explore whether the health spending slowdown affected all income groups equally, we divided the population into income quintiles. We then assessed trends in health expenditures by and on behalf of people in each quintile using twenty-two national surveys carried out between 1963 and 2012. Before the 1965 passage of legislation creating Medicare and Medicaid, the lowest income quintile had the lowest expenditures, despite their worse health compared to other income groups...
July 1, 2016: Health Affairs
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