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https://www.readbyqxmd.com/read/28109347/how-is-physician-work-valued
#1
Jeffrey P Jacobs, Stephen J Lahey, Francis C Nichols, James M Levett, George Gilbert Johnston, Richard K Freeman, James D St Louis, Julie Painter, Courtney Yohe, Cameron D Wright, Kirk R Kanter, John E Mayer, Keith S Naunheim, Jeffrey B Rich, Joseph E Bavaria
Strategies to value physician work continue to evolve. The Society of Thoracic Surgeons and The Society of Thoracic Surgeons National Database have an increasingly important role in this evolution. An understanding of the Current Procedural Terminology (CPT) system (American Medical Association [AMA], Chicago, IL) and the Relative Value Scale Update Committee (RUC) is necessary to comprehend how physician work is valued. In 1965, with the dawn of increasingly complex medical care, immense innovation, and the rollout of Medicare, the need for a common language describing medical services and procedures was recognized as being of critical importance...
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28106631/top-10-medicare-reimbursement-regulations-currently-impacting-wound-care-practices
#2
Kathleen D Schaum
No abstract text is available yet for this article.
February 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28105902/cost-effectiveness-of-using-adjunctive-porcine-small-intestine-submucosa-tri-layer-matrix-compared-with-standard-care-in-managing-diabetic-foot-ulcers-in-the-us
#3
J F Guest, D Weidlich, H Singh, J La Fontaine, A Garrett, C J Abularrage, C R Waycaster
OBJECTIVE: To estimate the cost-effectiveness of using tri-layer porcine small intestine submucosa (SIS; Oasis Ultra) as an adjunct to standard care compared with standard care alone in managing diabetic foot ulcers (DFUs) in the US, from the perspective of Medicare. METHOD: A Markov model was constructed to simulate the management of diabetic neuropathic lower extremity ulcers over a period of one year in the US. The model was used to estimate the cost-effectiveness of initially using adjunctive SIS compared with standard care alone to treat a DFU in the US at 2016 prices...
January 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28104069/outcomes-among-older-patients-receiving-implantable-cardioverter-defibrillators-for-secondary-prevention-from-the-ncdr-icd-registry
#4
Jarrod K Betz, David F Katz, Pamela N Peterson, Ryan T Borne, Sana M Al-Khatib, Yongfei Wang, Carolina Malta Hansen, David D McManus, Jehu S Mathew, Frederick A Masoudi
BACKGROUND: Clinical trials of implantable cardioverter-defibrillators (ICDs) for secondary prevention of sudden cardiac death were conducted nearly 2 decades ago and enrolled few older patients. OBJECTIVES: This study assessed morbidity and mortality of older patients receiving ICDs for secondary prevention in contemporary clinical practice. METHODS: We identified 12,420 Medicare beneficiaries from the National Cardiovascular Data Registry ICD Registry undergoing first-time secondary prevention ICD implantation between 2006 and 2009 in 956 U...
January 24, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28101955/prescription-drug-monitoring-programs-produce-a-limited-impact-on-painkiller-prescribing-in-medicare-part-d
#5
Courtney R Yarbrough
OBJECTIVE: To measure the impact of prescription drug monitoring programs (PDMPs) on prescribing of opioid and nonopioid painkillers. DATA SOURCE: 2010-2013 physician-level Medicare Part D prescribing data released by the Centers for Medicare and Medicaid Services and Propublica. STUDY DESIGN: Using difference-in-differences models with physician-level fixed effects, the study compares prescribing in states with and without PDMPs for opioid and nonopioid analgesics, oxycodone, hydrocodone, and opioids by controlled substances Schedules II-IV...
January 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/28099688/discerning-the-survival-advantage-among-patients-with-prostate-cancer-who-undergo-radical-prostatectomy-or-radiotherapy-the-limitations-of-cancer-registry-data
#6
Stephen B Williams, Jinhai Huo, Karim Chamie, Marc C Smaldone, Christopher D Kosarek, Justin E Fang, Leslie M Ynalvez, Simon P Kim, Karen E Hoffman, Sharon H Giordano, Brian F Chapin
BACKGROUND: The objective of this study was to compare the overall survival of patients who undergo radical prostatectomy or radiotherapy versus noncancer controls to discern whether there is a survival advantage according to prostate cancer treatment and the impact of selection bias on these results. METHODS: A matched cohort study was performed using the Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked database. In total, 34,473 patients ages 66 to 75 years were identified who were without significant comorbidity, were diagnosed with localized prostate cancer, and received treatment treated with surgery or radiotherapy between 2004 and 2011...
January 18, 2017: Cancer
https://www.readbyqxmd.com/read/28095170/financial-burden-for-patients-with-chronic-myeloid-leukemia-enrolled-in-medicare-part-d-taking-targeted-oral-anticancer-medications
#7
Chan Shen, Bo Zhao, Lei Liu, Ya-Chen Tina Shih
PURPOSE: The number of targeted oral anticancer medications (TOAMs) has grown rapidly in the past decade. The high cost of TOAMs raises concerns about the financial aspect of treatment, especially for patients enrolled in Medicare Part D plans because of the coverage gap. METHODS: We identified patients with chronic myeloid leukemia (CML) who were new TOAM users from the SEER registry data linked with Medicare Part D data, from years 2007 to 2012. We followed these patients throughout the calendar year when they started taking the TOAMs and examined their out-of-pocket (OOP) payments and gross drug costs, taking into account their benefit phase, plan type, and cost share group...
January 17, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28089387/treatment-of-men-with-high-risk-prostate-cancer-based-on-race-insurance-coverage-and-access-to-advanced-technology
#8
Robert Steven Gerhard, Dattatraya Patil, Yuan Liu, Kenneth Ogan, Mehrdad Alemozaffar, Ashesh B Jani, Omer N Kucuk, Viraj A Master, Theresa W Gillespie, Christopher P Filson
PURPOSE: We characterized factors related to nondefinitive management (NDM) of patients with high-risk prostate cancer and assessed impact from race, insurance status, and facility-level volume of technologically advanced prostate cancer treatments (i.e., intensity-modulated radiation therapy, robotic-assisted laparoscopic radical prostatectomy) on this outcome. METHODS: We identified men with high-risk localized prostate cancer (based on D׳Amico criteria) in the National Cancer Database (2010-2012)...
January 12, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28079917/did-you-know-medicare-does-not-usually-include-a-dental-benefit-findings-from-a-multisite-investigation-of-oral-health-literacy
#9
Mark D Macek, Kathryn A Atchison, William Wells, Don Haynes, Ruth M Parker, Haiyan Chen
OBJECTIVES: Medicare does not usually include a dental benefit. Adults who are unaware of this fact risk unanticipated expenses after retirement. This report will explore the sociodemographic and oral health literacy determinants of this knowledge. METHODS: Data came from the Multi-Site Oral Health Literacy Research Study, a survey of patients presenting to two university dental clinics. Sociodemographic descriptors included age, sex, race/ethnicity, education level, and dental insurance status...
January 12, 2017: Journal of Public Health Dentistry
https://www.readbyqxmd.com/read/28079594/impact-of-concurrent-medication-use-on-pancreatic-cancer-survival-seer-medicare-analysis
#10
Muhammad S Beg, Arjun Gupta, David Sher, Sadia Ali, Saad Khan, Ang Gao, Tyler Stewart, Chul Ahn, Jarett Berry, Eric M Mortensen
OBJECTIVES: Preclinical studies have suggested that non-antineoplastic medication use may impact pancreatic cancer biology. We examined the association of several medication classes on pancreatic cancer survival in a large medical claims database. MATERIALS AND METHODS: Histologically confirmed pancreatic adenocarcinoma diagnosed between 2006 and 2009 were analyzed from the Surveillance, Epidemiology, and End Results-Medicare database with available part D data...
January 10, 2017: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28075695/lessons-from-launching-the-diabetes-prevention-program-in-a-large-integrated-health-care-delivery-system-a-case-study
#11
Colin D Rehm, Melinda E Marquez, Elizabeth Spurrell-Huss, Nicole Hollingsworth, Amanda S Parsons
There is urgent need for health systems to prevent diabetes. To date, few health systems have implemented the evidence-based Diabetes Prevention Program (DPP), and the few that have mostly partnered with community-based organizations to implement the program. Given the recent decision by the Centers for Medicare & Medicaid Services to reimburse for diabetes prevention, there is likely much interest in how such programs can be implemented within large health systems or how community partnerships can be expanded to support DPP implementation...
January 11, 2017: Population Health Management
https://www.readbyqxmd.com/read/28073850/characterization-of-mineralocorticoid-receptor-antagonist-therapy-initiation-in-high-risk-patients-with-heart-failure
#12
Lauren B Cooper, Bradley G Hammill, Eric D Peterson, Bertram Pitt, Matthew L Maciejewski, Lesley H Curtis, Adrian F Hernandez
BACKGROUND: Heart failure guidelines recommend routine monitoring of serum potassium, and renal function in patients treated with a mineralocorticoid receptor antagonist (MRA). How these recommendations are implemented in high-risk patients or according to setting of drug initiation is poorly characterized. METHODS AND RESULTS: We conducted a retrospective cohort study of Medicare beneficiaries linked to laboratory data in 10 states with prevalent heart failure as of July 1, 2011, and incident MRA use between May 1 and September 30, 2011...
January 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28070913/does-identification-of-previously-undiagnosed-conditions-change-care-seeking-behavior
#13
Rebecca M Myerson, Lisandro D Colantonio, Monika M Safford, Elbert S Huang
OBJECTIVE: To determine whether identification of previously undiagnosed high cholesterol, hypertension, and/or diabetes during an in-home assessment impacts care seeking among Medicare beneficiaries. DATA SOURCES/STUDY SETTING: Data from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, which recruited African American and white participants across the continental United States from 2003-2007, were linked to Medicare claims. STUDY DESIGN: We used panel data models to analyze changes in doctor visits for evaluation and management of conditions after participants were assessed, utilizing the study's rolling recruitment to control for secular trends...
January 10, 2017: Health Services Research
https://www.readbyqxmd.com/read/28069850/spending-on-care-after-surgery-driven-by-choice-of-care-settings-instead-of-intensity-of-services
#14
Lena M Chen, Edward C Norton, Mousumi Banerjee, Scott E Regenbogen, Anne H Cain-Nielsen, John D Birkmeyer
The rising popularity of episode-based payment models for surgery underscores the need to better understand the drivers of variability in spending on postacute care. Examining postacute care spending for fee-for-service Medicare beneficiaries after three common surgical procedures in the period 2009-12, we found that it varied widely between hospitals in the lowest versus highest spending quintiles for postacute care, with differences of 129 percent for total hip replacement, 103 percent for coronary artery bypass grafting (CABG), and 82 percent for colectomy...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069160/implementing-lung-cancer-screening-the-us-experience
#15
REVIEW
D R Aberle
The reduced lung cancer mortality observed with low-dose computed tomography (LDCT) screening in the National Lung Screening Trial (NLST) has led to annual screening in the United States as a covered benefit by both private insurers and the federal health insurance programme, the Centers for Medicare and Medicaid Services. Reimbursement for screening requires data submission to a federal registry on all individuals, whether privately or federally insured. Data must document individual patient eligibility as well as shared decision-making regarding the benefits and risks of LDCT screening, smoking cessation counselling, and the importance of annual screening...
January 6, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28068298/validity-of-the-agency-for-healthcare-research-and-quality-patient-safety-indicators-and-the-centers-for-medicare-and-medicaid-hospital-acquired-conditions-a-systematic-review-and-meta-analysis-by-bradford-d-winters-phd-md-aamir-bharmal-bs-mph-renee-f-wilson
#16
https://www.readbyqxmd.com/read/28067955/cancer-preventive-services-socioeconomic-status-and-the-affordable-care-act
#17
Gregory S Cooper, Tzuyung Doug Kou, Avi Dor, Siran M Koroukian, Mark D Schluchter
BACKGROUND: Out-of-pocket expenditures are thought to be an important barrier to the receipt of cancer preventive services, especially for those of a lower socioeconomic status (SES). The Affordable Care Act (ACA) eliminated out-of-pocket expenditures for recommended services, including mammography and colonoscopy. The objective of this study was to determine changes in the uptake of mammography and colonoscopy among fee-for-service Medicare beneficiaries before and after ACA implementation...
January 9, 2017: Cancer
https://www.readbyqxmd.com/read/28062815/content-and-outcomes-of-social-work-consultation-for-patients-with-diabetes-in-primary-care
#18
Andrew J Rabovsky, Michael B Rothberg, Susannah L Rose, Andrei Brateanu, Lei Kou, Anita D Misra-Hebert
PURPOSE: Social workers are positioned to address social determinants of health (SDHs), but their specific roles in outpatient primary care practice have not been well described. We aimed to describe needs of patients with diabetes addressed during social work (SW) consultations and their impact on disease control. METHODS: This study was a retrospective review of electronic medical records of 977 patients with diabetes with a SW consultation at 3 primary care internal medicine sites in 2014...
January 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28060238/single-institution-early-experience-with-the-bundled-payments-for-care-improvement-initiative
#19
Richard Iorio, Joseph Bosco, James Slover, Yousuf Sayeed, Joseph D Zuckerman
The Centers for Medicare & Medicaid Services (CMS) implemented the Bundled Payments for Care Improvement (BPCI) initiative in 2011. Through BPCI, organizations enlisted into payment agreements that include both performance and financial accountability for episodes of care. To succeed, BPCI requires quality maintenance and care delivery at lower costs. This necessitates physicians and hospitals to merge interests. Orthopaedic surgeons must assume leadership roles in cost containment, surgical safety, and quality assurance to deliver cost-effective care...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28060052/evaluating-the-effects-of-pioneer-accountable-care-organizations-on-medicare-part-d-drug-spending-and-utilization
#20
Yuting Zhang, Kadin J Caines, Christopher A Powers
BACKGROUND: The improvement of medication use is a critical mechanism that accountable care organization (ACO) could use to save overall costs. Currently pharmaceutical spending is not part of the calculation for ACO-shared savings and risks. Thus, ACO providers may have strong incentives to prescribe more medications hoping to avoid expensive downstream medical costs. METHODS: We designed a quasinatural experiment study to evaluate the effects of Pioneer ACOs on Medicare Part D spending and utilization...
January 3, 2017: Medical Care
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