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https://www.readbyqxmd.com/read/28730518/the-case-for-enrolling-high-cost-patients-in-an-aco
#1
Abraham Graber, Shane Carter, Asha Bhandary, Matthew Rizzo
Though accountable care organizations (ACOs) are increasingly important to American healthcare, ethical inquiry into ACOs remains in its nascent stages. Several articles have raised the concern that ACOs have an incentive to avoid enrolling high-cost patients and, thereby, have an incentive to deny care to those who need it the most. This concern is borne out by the reports of consultants working with newly formed ACOs. This paper argues that, contra initial appearances, there is no financial incentive for ACOs to avoid enrolling high-cost patients...
July 20, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28712357/medicare-accountable-care-organizations-and-antidepressant-use-by-patients-with-depression
#2
Alisa B Busch, Haiden A Huskamp, Amanda R Kreider, J Michael McWilliams
OBJECTIVE: This study examined whether Medicare accountable care organization (ACO) programs were associated with early changes in antidepressant use or adherence among beneficiaries with depression. METHODS: A difference-in-difference design was used to compare claims from Medicare fee-for-service beneficiaries (2009-2013) and ACO patients with those from local control groups. Outcome measures were total antidepressant days supplied, filling one or more antidepressant prescriptions, and proportion of days covered (PDC) by supply among antidepressant users (adherence)...
July 17, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28710004/development-of-pegylated-carboxylic-acid-modified-polyamidoamine-dendrimers-as-bone-targeting-carriers-for-the-treatment-of-bone-diseases
#3
Shugo Yamashita, Hidemasa Katsumi, Nozomi Hibino, Yugo Isobe, Yumiko Yagi, Kosuke Kusamori, Toshiyasu Sakane, Akira Yamamoto
In this study, we aimed to develop a polyethylene glycol (PEG)-conjugated third generation polyamidoamine (PAMAM) dendrimer with multiple carboxylic acids as a bone-targeting carrier for the treatment of bone diseases. We conjugated PAMAM backbones to various carboxylic acids [aspartic acid (Asp), glutamic acid (Glu), succinic acid (Suc), or aconitic acid (Aco)] to obtain four different types of carboxylic acid-modified PAMAMs. PEG was covalently bound to carboxylic acid-modified PAMAMs to obtain PEGylated carboxylic acid-modified PAMAMs...
July 11, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/28703800/killing-two-birds-with-one-stone-dual-blockade-of-integrin-and-fgf-signaling-through-targeting-syndecan-4-in-postoperative-capsular-opacification
#4
Yingyan Qin, Yi Zhu, Furong Luo, Chuan Chen, Xiaoyun Chen, Mingxing Wu
The most common complication after cataract surgery is postoperative capsular opacification, which includes anterior capsular opacification (ACO) and posterior capsular opacification (PCO). Increased adhesion of lens epithelial cells (LECs) to the intraocular lens material surface promotes ACO formation, whereas proliferation and migration of LECs to the posterior capsule lead to the development of PCO. Cell adhesion is mainly mediated by the binding of integrin to extracellular matrix proteins, while cell proliferation and migration are regulated by fibroblast growth factor (FGF)...
July 13, 2017: Cell Death & Disease
https://www.readbyqxmd.com/read/28701317/redefining-the-overlap-of-asthma-and%C3%A2-copd
#5
(no author information available yet)
The term asthma-COPD overlap (ACO) has been suggested for people with chronic airflow obstruction that has features characteristic of both asthma and chronic obstructive pulmonary disease (COPD).(1) People with clinical features of asthma and COPD tend to have worse outcomes than those with either asthma or COPD alone, yet their clinical management has remained unclear. UK guidelines currently do not specifically address this issue,(2,3) but the Global Initiative for Asthma (GINA) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) have published a consensus-based report on the diagnosis and treatment of people with asthma, COPD and ACO...
July 2017: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/28700790/association-of-changes-in-medication-use-and-adherence-with-accountable-care-organization-exposure-in-patients-with-cardiovascular-disease-or-diabetes
#6
J Michael McWilliams, Mehdi Najafzadeh, William H Shrank, Jennifer M Polinski
Importance: Many of the quality measures used to assess accountable care organization (ACO) performance in the Medicare Shared Savings Program (MSSP) focus on disease control and medication use among patients with cardiovascular disease and diabetes. To date, the association between participation in the MSSP by provider organizations and medication use or adherence among their patients with cardiovascular disease or diabetes has not been described. Objective: To assess the association between exposure to the MSSP and changes in the use of and adherence to common antihypertensive, lipid-lowering, and hypoglycemic medications...
July 12, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28699635/anion-capped-metallohost-allows-extremely-slow-guest-uptake-and-on-demand-acceleration-of-guest-exchange
#7
Yoko Sakata, Chiho Murata, Shigehisa Akine
The switching of molecular recognition selectivity is important for tuning molecular functions based on host-guest binding. While the switching processes in artificial functional molecules are usually driven by changes of the thermodynamic stabilities, non-equilibrium phenomena also play an important role in biological systems. Thus, here we designed a host-guest system utilizing a non-equilibrium kinetically trapped state for on-demand and time-programmable control of molecular functions. We synthesized a bis(saloph) macrocyclic cobalt(III) metallohost 1(OTf)2, which has anion caps at both sides of the cation-binding site...
July 12, 2017: Nature Communications
https://www.readbyqxmd.com/read/28696811/prevalence-clinical-characteristics-and-morbidity-of-the-asthma-copd-overlap-in-a-general-population-sample
#8
Linda Ekerljung, Roxana Mincheva, Stig Hagstad, Anders Bjerg, Gunilla Telg, Georgios Stratelis, Jan Lötvall
Objective Although asthma and COPD have been regarded as distinct conditions, emerging literature suggests that overlapping phenotypes exists, asthma-COPD overlap (ACO). The aim of this study was to describe prevalence, patient characteristics and morbidity of ACO. Methods From a cross-sectional population sample, the West Sweden Asthma Study, subjects with suspected asthma, chronic bronchitis or COPD, and a random sample, were invited to clinical examinations. ACO was defined as doctors diagnosed asthma, or clear clinical signs of asthma at examination, with a FEV1/FVC<0...
July 11, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28694694/expression-profiling-of-mirna-145-and-mirna-338-in-serum-and-sputum-of-patients-with-copd-asthma-and-asthma-copd-overlap-syndrome-phenotype
#9
Donato Lacedonia, Grazia Pia Palladino, Maria Pia Foschino-Barbaro, Giulia Scioscia, Giovanna Elisiana Carpagnano
BACKGROUND AND OBJECTIVES: A new phenotype with overlapping characteristics between asthma and chronic obstructive pulmonary disease (COPD) called asthma-COPD overlap syndrome (ACOS) is emerging among inflammation diseases. To date, there is no agreement on specific criteria to define this syndrome, and the current guidelines are insufficient to classify the analogy and differences between overlap and COPD or asthma phenotypes. It would be necessary to identify new biomarkers able to identify these diseases clearly...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28694693/prevalence-and-characteristics-of-asthma-copd-overlap-syndrome-identified-by-a-stepwise-approach
#10
Hiromasa Inoue, Takahide Nagase, Satoshi Morita, Atsushi Yoshida, Tatsunori Jinnai, Masakazu Ichinose
BACKGROUND AND OBJECTIVE: There is increasing recognition of asthma-COPD overlap syndrome (ACOS), which shares some features of both asthma and COPD; however, the prevalence and characteristics of ACOS are not well understood. The aim of this study was to investigate the prevalence of ACOS among patients with COPD and its characteristics using a stepwise approach as stated in the recent report of the Global Initiative for Asthma (GINA) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28693337/systems-opportunities-to-reduce-ed-crowding-from-nonemergency-referrals
#11
Carolyn Joy Sachs, Charles K Yu, Peter C Nauka, David L Schriger
Emergency department (ED) crowding threatens patient safety and is associated with increased mortality. This study explored the role of nonurgent referrals to the ED in crowding and collaborated on a large quality initiative with the study institution's accountable care organization (ACO) to provide timely alternatives to such referrals. Fifty-two percent of nonemergent ED patients report contacting a medical provider prior to coming to the ED, with 70% of those providers directing the patient to go to the ED...
March 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28686787/barriers-and-facilitators-of-colorectal-cancer-screening-for-patients-of-rural-accountable-care-organization-clinics-a-multilevel-analysis
#12
Hongmei Wang, Fang Qiu, Abbey Gregg, Baojiang Chen, Jungyoon Kim, Lufei Young, Neng Wan, Li-Wu Chen
PURPOSE: This study examines multilevel factors related to colorectal cancer (CRC) screening in a rural Accountable Care Organization (ACO) setting. METHODS: The study used electronic medical record data from 8 rural ACO clinics in Nebraska. The final sample included 15,866 average-risk patients aged 50-75 years who visited participating clinics at least once from June 2014 to May 2015. Logistic regression was conducted to examine simultaneous effects of patient, provider, and county characteristics on CRC screening after accounting for provider-county-level correlation using a generalized estimating equations method...
July 7, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28685850/return-on-investment-roi-analyses-of-an-inpatient-lay-health-worker-model-on-30-day-readmission-rates-in-a-rural-community-hospital
#13
Roberto Cardarelli, Gregory Bausch, Joan Murdock, Michelle Renee Chyatte
PURPOSE: The purpose of the study was to assess the return-on-investment (ROI) of an inpatient lay health worker (LHW) model in a rural Appalachian community hospital impacting 30-day readmission rates. METHODS: The Bridges to Home (BTH) study completed an evaluation in 2015 of an inpatient LHW model in a rural Kentucky hospital that demonstrated a reduction in 30-day readmission rates by 47.7% compared to a baseline period. Using the hospital's utilization and financial data, a validated ROI calculator specific to care transition programs was used to assess the ROI of the BTH model comparing 3 types of payment models including Diagnosis Related Group (DRG)-only payments, pay-for-performance (P4P) contracts, and accountable care organizations (ACOs)...
July 7, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28677357/asthma-copd-overlap-shows-favorable-clinical-outcomes-compared-to-pure-copd-in-a-korean-copd-cohort
#14
Hye Jung Park, Min Kwang Byun, Hyung Jung Kim, Chul Min Ahn, Jin Hwa Lee, Kyeong Cheol Shin, Soo Taek Uh, Seung Won Ra, Kwang Ha Yoo, Ki Suck Jung
PURPOSE: Comparisons of the characteristics of chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap syndrome (ACOS) have been the focus of several studies since the diseases were defined by the Global Initiative for Asthma and Global Initiative for Chronic Obstructive Lung Disease guidelines. However, no consensus is available yet. In this study, we aimed to compare the characteristics of asthma-COPD overlap (ACO) and COPD. METHODS: We retrospectively reviewed 1,504 patients with COPD in a Korean COPD Subtype Study cohort...
September 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/28670116/treatment-trends-in-patients-with-asthma-copd-overlap-syndrome-in-a-copd-cohort-findings-from-a-real-world-survey
#15
Bo Ding, Mark Small
BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) is an increasingly recognized phenotype. Few randomized clinical trials have been conducted in patients with ACOS; therefore, scientific evidence concerning ACOS is scarce and a therapeutic approach remains unclear. The aim of this study was to evaluate current treatment trends for patients with ACOS, identified as those with a dual definition of asthma and COPD, in a real-world COPD cohort. METHODS: Data were analyzed from patients with asthma and COPD in the USA, France, Germany, Italy, Spain, and the UK who participated in the 2012 and 2013 Adelphi Respiratory Disease Specific Programmes (DSPs)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28651925/engaging-small-independent-practices-in-value-based-payment-building-aledade-s-medicare-acos
#16
Brian W Powers, Farzad Mostashari, Emily Maxson, Kimberly Lynch, Amol S Navathe
No abstract text is available yet for this article.
June 23, 2017: Healthcare
https://www.readbyqxmd.com/read/28647442/the-impact-of-the-transition-from-volume-to-value-on-heart-failure-care-implications-of-novel-payment-models-and-quality-improvement-initiatives
#17
REVIEW
Dushyanth Srinivasan, Nihar R Desai
In response to wide variation in quality and outcomes as well as escalating health care costs, the U.S. health care system is transitioning away from a volume based payment system to a quality- and value-based system. Medicare, the largest insurer and payer of healthcare, has accelerated the movement towards value-based care with the development and implementation of myriad alternative payment models and pay for performance programs as part of the Affordable Care Act. Given that heart failure affects a significant number of Medicare patients and these patients account for a disproportionate amount of healthcare utilization and spending, heart failure has become a focal point for these initiatives...
June 21, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28641166/care-coordination-at-a-pediatric-accountable-care-organization-aco-a-qualitative-analysis
#18
Baria Hafeez, Sophia Miller, Anup D Patel, Zachary M Grinspan
OBJECTIVE: Care coordinators may help manage care for children with chronic illness. Their role in pediatric epilepsy care is understudied. We aimed to qualitatively describe the content of a care coordination intervention for children with epilepsy. METHODS: We conducted nine semi-structured interviews and one focus group with care coordinators at a pediatric accountable care organization (ACO) in Ohio. The care coordinators used a modified version of a published care coordination checklist for children with epilepsy (Patel AD, 2014)...
June 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28637558/travel-time-influences-readmission-risk-geospatial-mapping-of-surgical-readmissions
#19
Florence E Turrentine, Patrick J Buckley, Min-Woong Sohn, Michael D Williams
The University of Virginia (UVA) has recently become an Accountable Care Organization (ACO), intensifying efforts to provide better care for individuals. UVA's ACO population resides across the entire Commonwealth, with a large percentage of patients living in rural areas. To provide better health for this population, the central tenet of the ACO mission, we identified geographic risk factors influencing hospital readmission. We analyzed the relationship between the distance of patients' residence to the nearest hospital and 30-day readmission in general surgery patients...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28636425/ats-nhlbi-asthma-copd-overlap-aco-workshop-report
#20
Prescott G Woodruff, Maarten van den Berge, Richard C Boucher, Christopher Brightling, Esteban G Burchard, Stephanie A Christenson, MeiLan K Han, Michael J Holtzman, Monica Kraft, David A Lynch, Fernando D Martinez, Helen K Reddel, Don D Sin, George R Washko, Sally E Wenzel, Antonello Punturieri, Michelle M Freemer, Robert A Wise
Asthma and COPD are highly prevalent chronic obstructive lung diseases with an associated high burden of disease. Asthma, which is often allergic in origin, frequently begins in infancy or childhood with variable airflow obstruction and intermittent wheezing, cough, and dyspnea. Patients with COPD, in contrast, are usually current or former smokers who present after the age of 40 years with symptoms (often persistent), including dyspnea and a productive cough. Based on age and smoking history, it is often easy to distinguish between asthma and COPD...
June 21, 2017: American Journal of Respiratory and Critical Care Medicine
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