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https://www.readbyqxmd.com/read/29302988/social-health-insurance-difference-in-inpatient-expenditure-and-service-category-in-china
#1
Qing Wang, Jay Shen, Jennifer Rice, Kaitlyn Frakes
China successfully achieved universal health insurance coverage in 2011. Previous work on the effects of social health insurance in China has overlooked the association between health insurance and inpatient service category as well as the mechanisms of institutional characteristics. This study seeks to estimate the social health insurance difference in inpatient expenditure and service category. The role of institutional characteristics was also studied. The logistic model was applied to estimate the association of social health insurance and service category...
January 1, 2018: Asia-Pacific Journal of Public Health
https://www.readbyqxmd.com/read/29274520/managing-imperfect-competition-by-pay-for-performance-and-reference-pricing
#2
Henry Y Mak
I study a managed health service market where differentiated providers compete for consumers by choosing multiple service qualities, and where copayments that consumers pay and payments that providers receive for services are set by a payer. The optimal regulation scheme is two-sided. On the demand side, it justifies and clarifies value-based reference pricing. On the supply side, it prescribes pay for performance when consumers misperceive service benefits or providers have intrinsic quality incentives. The optimal bonuses are expressed in terms of demand elasticities, service technology, and provider characteristics...
November 5, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/29246427/diverging-patterns-of-cardiovascular-diseases-across-immigrant-groups-in-northern-italy
#3
Ugo Fedeli, Francesco Avossa, Eliana Ferroni, Elena Schievano, Claudio Bilato, Pietro Amedeo Modesti, Maria Chiara Corti
BACKGROUND: Only fragmentary data are available on the burden of non-communicable diseases among immigrants in Europe, mostly limited to mortality by cause. Aim of the study is to investigate the prevalence of cardiovascular diseases across different immigrant groups in the Veneto Region (North-Eastern Italy). METHODS: The resident population aged 20-59 was classified according to country of citizenship. The Adjusted Clinical Groups System was adopted to identify selected cardiovascular conditions by linkage of Hospital Discharge Records, Emergency Room visits, Chronic disease registry for copayment exemptions, the Home care database, and drugs reimbursed by the Regional Health Service...
December 8, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29231748/relationship-between-patient-copayments-in-medicare-part-d-and-vaccination-claim-status-for-herpes-zoster-and-tetanus-diphtheria-acellular-pertussis
#4
Songkai Yan, Maral DerSarkissian, Rachel H Bhak, Patrick Lefebvre, Mei Sheng Duh, Girishanthy Krishnarajah
OBJECTIVE: To assess the relationship between copay amount and vaccination claim submission status for tetanus-diphtheria-acellular pertussis (Tdap) and herpes zoster (GSK study identifier: HO-14-14319). METHODS: Retrospective analyses were performed using vaccination administrative claims data in patients aged ≥65 years with ≥1 claim for Tdap or zoster vaccines between 2012-2014. To avoid confounding by other financial responsibility, analyses were conducted among patients in the copayment phase of insurance...
December 12, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29207446/has-the-copayment-ceiling-improved-financial-protection-in-the-korean-national-health-insurance-system-evidence-from-the-2009-policy-change
#5
Tae-Jin Lee, Chelim Cheong
Objectives: To relieve the financial burden faced by households, the Korean National Health Insurance (NHI) system introduced a "copayment ceiling," which evolved into a differential ceiling in 2009, with the copayment ceiling depending on patients' income. This study aimed to examine the effect of the differential copayment ceiling on financial protection and healthcare utilization, particularly focusing on whether its effects varied across different income groups. Methods: This study obtained data from the Korea Health Panel...
November 2017: Journal of Preventive Medicine and Public Health, Yebang Ŭihakhoe Chi
https://www.readbyqxmd.com/read/29201531/stigma-partners-providers-and-costs-potential-barriers-to-prep-uptake-among-us-women
#6
Lakshmi Goparaju, Nathan C Praschan, Lari Warren-Jeanpiere, Laure S Experton, Mary A Young, Seble Kassaye
Background: Pre-Exposure Prophylaxis (PrEP) use has remained low among US women while significantly increasing among men who have sex with men. Besides lack of awareness, women face several social and structural barriers in gaining access to and using PrEP. Methods: Four focus group discussions with 20 HIV-negative women who live in the Washington DC metropolitan area. Results: The women expressed concerns about social and structural barriers to PrEP use...
September 2017: Journal of AIDS & Clinical Research
https://www.readbyqxmd.com/read/29175374/social-capital-and-preventive-care-use-among-the-elderly-under-taiwan-s-national-health-insurance
#7
Yu-I Peng, Tsui-Fang Lin
OBJECTIVE: The National Health Insurance (NHI) system in Taiwan provides free annual preventive care services and other disease-specific preventive care services under low copayments to people aged 65 and older, yet their utilization rates remain low ever since implementation. This study investigates whether social capital is associated with preventive care use among people aged 65 and older. METHOD: Using the 2009 National Health Interview Study, this study measures social capital by the elderly's social network and social participation, and employs the logistic regressions to estimate the association between social capital and the odds of using a variety of preventive care services...
November 15, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29154019/local-specialty-pharmacy-and-specialty-clinic-collaboration-assists-access-to-hepatitis-c-direct-acting-antivirals
#8
Julia Zhu, Ronald J Hazen, Cara Joyce, Ambrose Delpino, Heather S Kirkham, Carson Dietrich Strickland, Shauna Markes-Wilson, Tomeka Kim, Meen Kang, Raymond A Rubin, Lance L Stein
OBJECTIVES: To measure prescribed time to therapy (TtT) and sustained virologic response (SVR). Secondary objectives were to assess insurance appeals and copay assistance amount facilitated by a local specialty pharmacy (LSP). METHODS: This descriptive, retrospective study used a joint clinical and pharmacy database of patients who were prescribed direct-acting antivirals (DAAs) at a single-center liver specialty clinic and received LSP services from December 2013 to December 2015...
November 16, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29151900/examining-factors-associated-with-nonadherence-and-identifying-providers-caring-for-nonadherent-subgroups
#9
Deborah A Taira, Brendan K Seto, James W Davis, Todd B Seto, Doug Landsittel, Wesley K Sumida
Objectives: To examine racial/ethnic and regional differences in medication adherence in patients with diabetes taking oral anti-diabetic, anti-hypertensive, and cholesterol lowering medications and to identify the pharmacies and prescribers who serve these communities. Methods: Administrative claims data was analyzed for members enrolled in a large health plan in Hawaii (2008-2010) with diabetes mellitus who were taking three types of medications: 1) oral anti-diabetic medications; 2) anti-hypertensive medications; 3) cholesterol lowering medications (n=5136)...
December 2017: Journal of Pharmaceutical Health Services Research
https://www.readbyqxmd.com/read/29148258/influence-of-medical-insurance-schemes-and-charity-assistance-projects-on-regular-prophylaxis-treatment-of-the-boys-with-severe-haemophilia-a-in-china
#10
Z Li, J Wu, Y Zhao, R Liu, K Li, Y Zhou, R Wu, R Yang, X Zhang, S Lian, Q Hu, X Li, J Gu, R Zhou, J Sun, C Li, W Xu, M-C Poon, J Xiao
OBJECTIVE: To explore the influence of medical insurance policy and charity assistance projects on the uptake and discontinuation of regular prophylaxis treatment in Chinese severe haemophilia A children. METHODOLOGY: This retrospective study was conducted on children with severe haemophilia A, who received FVIII prophylaxis treatment at 12 haemophilia centres in China from 1 November 2007 to 31 May 2013. RESULTS: The average duration of prophylaxis treatment received by haemophilia children significantly increased from 16...
November 17, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29137559/factors-influencing-receipt-of-mental-health-services-among-medicaid-beneficiaries-with-breast-cancer
#11
Michael T Halpern, Mallorie H Fiero
OBJECTIVE: This study examined associations of state-level Medicaid reimbursement and other policies and patient characteristics with receipt of mental health diagnostic and treatment services for beneficiaries with cancer. METHODS: Data (2006-2008) from Medicaid beneficiaries with breast cancer were analyzed to examine predictors of receiving mental health diagnostic services and mental health treatment services. Independent variables included state-level Medicaid policies for reimbursements for mental health services and consultations (requests from one health care provider to another for advice regarding evaluation or management of a specific problem), required patient copayments, and requirements governing the timing of Medicaid eligibility recertification (eligibility recertification period)...
November 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29121177/out-of-pocket-and-health-care-spending-changes-for-patients-using-orally-administered-anticancer-therapy-after-adoption-of-state-parity-laws
#12
Stacie B Dusetzina, Haiden A Huskamp, Aaron N Winn, Ethan Basch, Nancy L Keating
Importance: Oral anticancer medications are increasingly important but costly treatment options for patients with cancer. By early 2017, 43 states and Washington, DC, had passed laws to ensure patients with private insurance enrolled in fully insured health plans pay no more for anticancer medications administered by mouth than anticancer medications administered by infusion. Federal legislation regarding this issue is currently pending. Despite their rapid acceptance, the changes associated with state adoption of oral chemotherapy parity laws have not been described...
November 9, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/29089247/factors-associated-with-non-adherence-among-type-2-diabetic-patients-in-primary-care-setting-in-eastern-bosnia-and-herzegovina
#13
Olga Horvat, Jelena Popržen, Ana Tomas, Milica Paut Kusturica, Zdenko Tomić, Ana Sabo
AIMS: The aims of this study were to assess patients' non-adherence and associated factors to antidiabetic medication in the primary care setting in the eastern part of Bosnia and Herzegovina (BiH). METHODS: We conducted a retrospective chart review of 323 patients with type 2 diabetes mellitus (T2DM) attending the primary health care center of the Foča municipality in eastern part of BiH and measured adherence to antidiabetic medication. Adherence was measured using a pill count method...
October 28, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/29083970/evaluating-patient-preferences-for-different-incentive-programs-to-optimize-pharmacist-provided-patient-care-program-enrollment
#14
Daniel Tomaszewski, Tim Cernohous, Rajiv Vaidyanathan
BACKGROUND: Employers have increased efforts to engage employees in health and wellness programs. Providing employees with incentives to participate in these programs has been shown to improve overall enrollment and engagement. One program that has had challenges with enrollment and engagement is medication therapy management (MTM). OBJECTIVES: To (a) determine how individuals evaluate different financial incentives to improve participation in an MTM program and (b) measure the effect of participant characteristics on incentive preference...
November 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29075552/patient-copayments-provider-incentives-and-income-effects-theory-and-evidence-from-the-essential-medications-list-under-china-s-2009-healthcare-reform
#15
Brian K Chen, Y Tony Yang, Karen Eggleston
Expanding access through insurance expansion can increase healthcare utilization through moral hazard. Reforming provider incentives to introduce more supply-side cost sharing is increasingly viewed as crucial for affordable, sustainable access. Using both difference-in-differences and segmented regression analyses on a panel of 1,466 hypertensive and diabetic patients, we empirically examine Shandong province's initial implementation of China's 2009 Essential Medications List policy. The policy reduced drug sale markups to providers but also increased drug coverage benefits for patients...
March 2017: World Medical & Health Policy
https://www.readbyqxmd.com/read/29074147/cost-savings-impact-of-a-pharmacist-initiated-teleservice-program-for-medicare-part-d-reviews
#16
Colleen Massey, Timothy Dy Aungst, Paula Evans, Donna Bartlett, Matthew A Silva
OBJECTIVES: To (a) determine potential cost savings of a pharmacy outreach teleservice program conducting Medicare Part D plan reviews for a large population of beneficiaries allowing for comparison of multiple preferences; and (b) explore client demographic comparisons, plan features, and stratification by cost and number of medications. METHODS: Retrospective cohort evaluation of a Medicare D review service during open enrollment period (October 15 to December 7, 2012)...
October 23, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28992824/a-nationwide-study-of-pharmacists-perception-of-the-impact-of-medicare-part-d-on-the-pharmacist-patient-relationship
#17
Joshua J Spooner, Harlan Spotts, Shamima Khan
BACKGROUND: Medicare Part D was implemented in 2006, introducing change to the community pharmacy marketplace, with profound disruption to independent pharmacy operations across the United States. AIMS: To understand pharmacist perceptions about Part D and their perceived obligation to address Part D issues on behalf of their beneficiaries. METHODS: A nationwide, cross-sectional survey of pharmacists was conducted between April and July 2013...
October 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28990452/do-medicare-beneficiaries-living-with-hiv-aids-choose-prescription-drug-plans-that-minimize-their-total-spending
#18
Katherine A Desmond, Thomas H Rice, Arleen A Leibowitz
This article examines whether California Medicare beneficiaries with HIV/AIDS choose Part D prescription drug plans that minimize their expenses. Among beneficiaries without low-income supplementation, we estimate the excess cost, and the insurance policy and beneficiary characteristics responsible, when the lowest cost plan is not chosen. We use a cost calculator developed for this study, and 2010 drug use data on 1453 California Medicare beneficiaries with HIV who were taking antiretroviral medications. Excess spending is defined as the difference between projected total spending (premium and cost sharing) for the beneficiary's current drug regimen in own plan vs spending for the lowest cost alternative plan...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28973219/patients-attitudes-toward-copayments-as-a-steering-tool-results-from-a-qualitative-study-in-norway-and-germany
#19
Wolfram J Herrmann, Alexander Haarmann, Anders Bærheim
Background: Copayments are implemented in many health care systems. The effect of copayments differs between countries. Up to now, patients' attitudes regarding copayments are mainly unknown. Objectives: Thus, the goal of our analysis was to explore adult patients' attitudes in Germany and Norway towards copayments as a steering tool. Methods: We conducted a qualitative comparative study. Episodic interviews were conducted with 40 patients in Germany and Norway...
September 16, 2017: Family Practice
https://www.readbyqxmd.com/read/28973087/association-of-prior-authorization-and-out-of-pocket-costs-with-patient-access-to-pcsk9-inhibitor-therapy
#20
Ann Marie Navar, Benjamin Taylor, Hillary Mulder, Eugene Fievitz, Keri L Monda, Anna Fievitz, Juan F Maya, J Antonio G López, Eric D Peterson
Importance: Although PCSK9 inhibitors (PCSK9i) were approved in 2015, their high cost has led to strict prior authorization practices and high copays, and use of PSCK9i in clinical practice has been low. Objective: To evaluate patient access to PCSK9i among those prescribed therapy. Design, Setting, and Participants: Using pharmacy transaction data, we evaluated 45 029 patients who were newly prescribed PCSK9i in the United States between August 1, 2015, and July 31, 2016...
November 1, 2017: JAMA Cardiology
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