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https://www.readbyqxmd.com/read/27920312/dental-care-and-medicare-beneficiaries-access-gaps-cost-burdens-and-policy-options
#1
Amber Willink, Cathy Schoen, Karen Davis
Despite the wealth of evidence that oral health is related to physical health, Medicare explicitly excludes dental care from coverage, leaving beneficiaries at risk for tooth decay and periodontal disease and exposed to high out-of-pocket spending. To profile these risks, we examined access to dental care across income groups and types of insurance coverage in 2012. High-income beneficiaries were almost three times as likely to have received dental care in the previous twelve months, compared to low-income beneficiaries-74 percent of whom received no dental care...
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27920305/projections-of-dental-care-use-through-2026-preventive-care-to-increase-while-treatment-will-decline
#2
Chad D Meyerhoefer, Irina Panovska, Richard J Manski
This study provides a forward-thinking assessment of the factors likely to affect future trends in dental care in the United States. We developed a forecasting model based on historical data from the Medical Expenditure Panel Survey to determine how demographic trends and recent health care policies will affect dental care use in the future. Our forecasts suggest that the medical and dental insurance reforms instituted under the Affordable Care Act will increase rates of dental care use and the number of dental visits, with utilization rates reaching 47 percent in 2026 and the number of visits reaching 334 million, under optimistic assumptions about take-up of pediatric dental coverage...
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27919580/variation-in-diagnoses-for-hip-arthroplasty-among-new-york-state-hospitals-implications-for-the-comprehensive-care-for-joint-replacement-model
#3
John A Buza, Jeffrey M Jancuska, James D Slover, Richard Iorio, Joseph A Bosco
BACKGROUND: The Comprehensive Care for Joint Replacement model is designed to minimize costs and improve quality for Medicare patients undergoing joint arthroplasty. The cost of hip arthroplasty (HA) episode varies depending on the preoperative diagnosis and is greater for fracture than for osteoarthritis. Hospitals that perform a higher percentage of HA for OA may therefore have an advantage in the Comprehensive Care for Joint Replacement model. The purposes of this study are to (1) determine the variability in underlying diagnosis for HA in New York State hospitals, and (2) determine hospital characteristics, such as volume, associated with this...
November 15, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27919104/dual-health-care-system-use-and-high-risk-prescribing-in-patients-with-dementia-a-national-cohort-study
#4
Joshua M Thorpe, Carolyn T Thorpe, Walid F Gellad, Chester B Good, Joseph T Hanlon, Maria K Mor, John R Pleis, Loren J Schleiden, Courtney Harold Van Houtven
Background: Recent federal policy changes attempt to expand veterans' access to providers outside the Department of Veterans Affairs (VA). Receipt of prescription medications across unconnected systems of care may increase the risk for unsafe prescribing, particularly in persons with dementia. Objective: To investigate the association between dual health care system use and potentially unsafe medication (PUM) prescribing. Design: Retrospective cohort study...
December 6, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27914968/segmenting-high-cost-medicare-patients-into-potentially-actionable-cohorts
#5
Karen E Joynt, Jose F Figueroa, Nancy Beaulieu, Robert C Wild, E John Orav, Ashish K Jha
BACKGROUND: Providers are assuming growing responsibility for healthcare spending, and prior studies have shown that spending is concentrated in a small proportion of patients. Using simple methods to segment these patients into clinically meaningful subgroups may be a useful and accessible strategy for targeting interventions to control costs. METHODS: Using Medicare fee-for-service claims from 2011 (baseline year, used to determine comorbidities and subgroups) and 2012 (spending year), we used basic demographics and comorbidities to group beneficiaries into 6 cohorts, defined by expert opinion and consultation: under-65 disabled/ESRD, frail elderly, major complex chronic, minor complex chronic, simple chronic, and relatively healthy...
November 30, 2016: Healthcare
https://www.readbyqxmd.com/read/27909200/anticoagulation-use-and-clinical-outcomes-after-major-bleeding-on-dabigatran-or-warfarin-in-atrial-fibrillation
#6
Inmaculada Hernandez, Yuting Zhang, Maria M Brooks, Paul K L Chin, Samir Saba
BACKGROUND AND PURPOSE: Little is known about the clinical outcomes associated with posthemorrhage anticoagulation resumption for atrial fibrillation. This study had 2 objectives: first, to evaluate anticoagulation use after a first major bleed on warfarin or dabigatran and, second, to compare effectiveness and safety outcomes between patients discontinuing anticoagulation after a major bleed and patients restarting warfarin or dabigatran. METHODS: Using 2010 to 2012 Medicare Part D data, we identified atrial fibrillation patients who experienced a major bleeding event while using warfarin (n=1135) or dabigatran (n=404) and categorized them by their posthemorrhage use of anticoagulation...
December 1, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27908393/association-of-30-day-readmission-metric%C3%A2-for-heart-failure-under-the-hospital%C3%A2-readmissions-reduction-program%C3%A2-with-quality-of-care-and%C3%A2-outcomes
#7
Ambarish Pandey, Harsh Golwala, Haolin Xu, Adam D DeVore, Roland Matsouaka, Michael Pencina, Dharam J Kumbhani, Adrian F Hernandez, Deepak L Bhatt, Paul A Heidenreich, Clyde W Yancy, James A de Lemos, Gregg C Fonarow
OBJECTIVES: This study sought to determine whether processes of care and long-term clinical outcomes for heart failure (HF) admissions across Get With The Guidelines-Heart Failure (GWTG-HF) program participating centers differ according to HF-specific risk-adjusted 30-day readmission rates (excess readmission ratio [ERR]) as determined by the Hospital Readmission Reduction Program (HRRP). BACKGROUND: HRRP penalizes hospitals with higher than expected risk-adjusted 30-day readmission rates (ERR >1) for common conditions including HF...
December 2016: JACC. Heart Failure
https://www.readbyqxmd.com/read/27908335/the-past-present-and-future-of-the-centers-for-medicare-and-medicaid-services-quality-measure-sep-1-the-early-management-bundle-for-severe-sepsis-septic-shock
#8
REVIEW
Jeremy S Faust, Scott D Weingart
SEP-1, the new national quality measure on sepsis, resulted from an undertaking to standardize care for severe sepsis and septic shock regardless of the size of the emergency department where the patient is being treated. SEP-1 does not necessarily follow the best current evidence available. Nevertheless, a thorough understanding of SEP-1 is crucial because all hospitals and emergency providers will be accountable for meeting the requirements of this measure. SEP-1 is the first national quality measure on early management of sepsis care...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27906531/medicare-program-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other-revisions-to-part-b-for-cy-2017-medicare-advantage-bid-pricing-data-release-medicare-advantage-and-part-d-medical-loss-ratio-data-release-medicare-advantage-provider-network
#9
(no author information available yet)
This major final rule addresses changes to the physician fee schedule and other Medicare Part B payment policies, such as changes to the Value Modifier, to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. This final rule also includes changes related to the Medicare Shared Savings Program, requirements for Medicare Advantage Provider Networks, and provides for the release of certain pricing data from Medicare Advantage bids and of data from medical loss ratio reports submitted by Medicare health and drug plans...
November 15, 2016: Federal Register
https://www.readbyqxmd.com/read/27904935/incidence-of-reoperation-and-wound-dehiscence-in-patients-treated-for-peroneal-tendon-dislocations-comparison-between-osteotomy-versus-soft-tissue-procedures
#10
Youichi Yasui, Khushdeep S Vig, Ichiro Tonogai, Chun Wai Hung, Christopher D Murawski, Masato Takao, Hirotaka Kawano, John G Kennedy
PURPOSES: There is a lack of substantial clinical evidence endorsing the clinical outcomes of osteotomy for peroneal tendon dislocations. The aim of this study was to compare the post-operative reoperation rates following osteotomy techniques and soft tissues procedures using large database in order to investigate the efficacy of bony techniques. METHODS: Patients who underwent osteotomy and soft tissue procedures for peroneal tendon dislocations were identified and subsequently analysed using the United Healthcare Orthopedic and the Medicare datasets (PearlDiver Patient Record Database, PearlDiver Technologies Inc...
November 30, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27898132/community-models-of-care-a-scoping-review
#11
Lindsay Mullins, Lisa E Skemp, Meridean L Maas
Nurse preparation and role in community models of care for older adults is not well documented. The purpose of the current structured scoping literature review was to identify nurse-led or nurse-involved community models of care for older adults, articulate the nurse's role and preparation in the model, and identify Triple Aim policy implications. Literature from 2008 through 2014 yielded 34 models identified in 51 articles. Twenty-one of 34 models were evaluated and none clearly articulated the full impact of a nurse role...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27890437/trends-of-anti-vascular-endothelial-growth-factor-use-in-ophthalmology-among-privately-insured-and-medicare-advantage-patients
#12
Ravi Parikh, Joseph S Ross, Lindsey R Sangaralingham, Ron A Adelman, Nilay D Shah, Andrew J Barkmeier
PURPOSE: To characterize the first 10 years of intravitreal anti-vascular endothelial growth factor (VEGF) medication use for ophthalmic disease, including bevacizumab, ranibizumab, and aflibercept. DESIGN: A retrospective cohort study using administrative claims data from January 1, 2006 to December 31, 2015. SUBJECTS: Total of 124 835 patients 18 years of age or over in the United States. METHODS: OptumLabs Data Warehouse, which includes administrative claims data for over 100 million commercially insured and Medicare Advantage individuals, was used to identify patients receiving intravitreal anti-VEGF injections based on Current Procedural Terminology codes...
November 24, 2016: Ophthalmology
https://www.readbyqxmd.com/read/27885590/payment-reform-needed-to-address-health-disparities-of-undiagnosed-diabetic-retinopathy-in-the-city-of-chicago
#13
Dustin D French, Jess J Behrens, Kathryn L Jackson, Abel N Kho, Theresa L Walunas, Charlesnika T Evans, Michael Mbagwu, Curtis E Margo, Paul J Bryar
INTRODUCTION: The Affordable Care Act (ACA) has expanded health coverage for thousands of Illinois residents. Expanded coverage, however, does not guarantee appropriate health care. Diabetes and its ocular complications serve as an example of how providers in underserved urban areas may not be able to keep up with new demand for labor- and technology-intensive health care unless changes in reimbursement policies are instituted. METHODS: A retrospective cohort study was conducted using medical encounter information from the Chicago HealthLNK Data Repository (HDR), an assembly of non-duplicated and de-identified patient medical records...
November 24, 2016: Ophthalmology and Therapy
https://www.readbyqxmd.com/read/27882835/health-care-costs-for-patients-with-heart-failure-escalate-nearly-3-fold-in-final-months-of-life
#14
Engels N Obi, Jason P Swindle, Stuart J Turner, Patricia A Russo, Aylin Altan
BACKGROUND: Heart failure (HF) is a severe chronic disease with growing prevalence and health care burden as well as high mortality. End-of-life cost data for patients with HF may inform disease and medication therapy management. OBJECTIVES: To (a) characterize a real-world sample of patients with HF who died; (b) estimate health care costs for 6 months and semiannually for 24 months, before death; and (c) examine associations between patient characteristics and predeath health care costs...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27881561/reassessment-of-cardiac-function-and-implantable-cardioverter-defibrillator-use-among-medicare-patients-with-low-ejection-fraction-after-myocardial-infarction
#15
Sean D Pokorney, Amy L Miller, Anita Y Chen, Laine Thomas, Gregg C Fonarow, James A de Lemos, Sana M Al-Khatib, Eric J Velazquez, Eric D Peterson, Tracy Y Wang
BACKGROUND: -Guidelines recommend that patients with low ejection fractions (EF) post-myocardial infarction (MI) have their EF reassessed 40 days after MI for implantable cardioverter-defibrillator (ICD) candidacy. This study examines rates of EF reassessment and their association with 1-year ICD implantation in post-MI patients with low EF. METHODS: -We examined rates of post-discharge EF reassessment and ICD implantation among 10,289 Medicare-insured patients ≥65 years with an EF≤35% during the index MI admission from 1/2007-9/2010 in ACTION Registry-GWTG...
November 16, 2016: Circulation
https://www.readbyqxmd.com/read/27881100/high-prevalence-of-non-steroidal-anti-inflammatory-drug-use-among-acute-kidney-injury-survivors-in-the-southern-community-cohort-study
#16
Loren Lipworth, Khaled Abdel-Kader, Jennifer Morse, Thomas G Stewart, Edmond K Kabagambe, Sharidan K Parr, Kelly A Birdwell, Michael E Matheny, Adriana M Hung, William J Blot, T Alp Ikizler, Edward D Siew
BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used and have been linked to acute kidney injury (AKI), chronic kidney disease (CKD) and cardiovascular disease (CVD). Patients who survive an AKI episode are at risk for future adverse kidney and cardiovascular outcomes. The objective of our study was to examine the prevalence and predictors of NSAID use among AKI survivors. METHODS: The Southern Community Cohort Study is a prospective study of low-income adults aged 40-79 in the southeastern US...
November 24, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27880087/ethnic-disparities-in-medicare-part-d-satisfaction-and-intention-to-switch-plans
#17
Kai You, Robert L Strawderman, Yue Li
Medicare Part D has been successful in providing affordable prescription drug coverage with relatively high levels of beneficiary reported satisfaction. We use nationally representative survey data to examine whether racial/ethnic disparities exist in reported Part D satisfaction and plan evaluations. Compared to non-Hispanic white Medicare beneficiaries, Hispanic beneficiaries are considerably more likely to report to switch to a new plan in the next year and, among beneficiaries auto-enrolled in a Part D plan, are less likely to be very satisfied with the currently enrolled plan...
November 23, 2016: Journal of Aging & Social Policy
https://www.readbyqxmd.com/read/27878715/prescription-drug-coverage-and-chronic-pain
#18
Padmaja Ayyagari
Chronic pain is one of the most common chronic conditions affecting more than 50 % of older adults. While pain management can be quite complex, prescription drugs are the most commonly used treatment modality. In this study, I examine whether increased access to prescription drugs due to the introduction of the Medicare Part D program in 2006 led to better management of pain among the elderly. While prior work has identified increases in the utilization of analgesics due to the introduction of Medicare Part D, the extent to which this increase in drug use actually improved the well-being of older adults is not known...
June 2016: Int J Health Econ Manag
https://www.readbyqxmd.com/read/27871075/comparative-effectiveness-of-renin-angiotensin-system-antagonists-in-maintenance-dialysis-patients
#19
Theresa I Shireman, Jonathan D Mahnken, Milind A Phadnis, Edward F Ellerbeck, James B Wetmore
BACKGROUND/AIMS: Whether angiotensin converting enzyme inhibitors (ACE) and angiotensin receptor blockers (ARB) are differentially associated with reductions in cardiovascular events and mortality in patients receiving maintenance dialysis is uncertain. We compared outcomes between ACE and ARB users among hypertensive, maintenance dialysis patients. METHODS: National retrospective cohort study of hypertensive, Medicare-Medicaid eligible patients initiating chronic dialysis between 1/1/2000 to 12/31/2005...
November 21, 2016: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/27868212/myelodysplastic-syndromes-and-acute-myeloid-leukemia-after-radiotherapy-for-prostate-cancer-a-population-based-study
#20
Rong Wang, Amer M Zeidan, James B Yu, Pamela R Soulos, Amy J Davidoff, Steven D Gore, Scott F Huntington, Cary P Gross, Xiaomei Ma
BACKGROUND: To understand the impact of radiotherapy on the development of myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) among elderly prostate cancer patients. METHODS: We performed a retrospective cohort study of elderly prostate cancer patients diagnosed during 1999-2011 by using the National Cancer Institute's Surveillance, Epidemiology and End Results-Medicare linked database. Competing risk analyses adjusting for patient characteristics were conducted to assess the impact of radiotherapy on the development of subsequent MDS/AML, compared with surgery...
November 21, 2016: Prostate
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