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https://www.readbyqxmd.com/read/28737994/impact-of-a-patient-support-program-on-patient-adherence-to-adalimumab-and-direct-medical-costs-in-crohn-s-disease-ulcerative-colitis-rheumatoid-arthritis-psoriasis-psoriatic-arthritis-and-ankylosing-spondylitis
#1
David T Rubin, Manish Mittal, Matthew Davis, Scott Johnson, Jingdong Chao, Martha Skup
BACKGROUND: AbbVie provides a free-to-patient patient support program (PSP) to assist adalimumab-treated patients with medication costs, nurse support, injection training, pen disposal, and medication reminders. The impact of these services on patient adherence to adalimumab and direct medical costs associated with autoimmune disease has not been assessed. OBJECTIVE: To quantify the relationship between participation in a PSP and outcomes (adalimumab adherence, persistence, and direct medical costs) in patients initiating adalimumab treatment...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28725789/improving-american-healthcare-through-clinical-lab-2-0-a-project-santa-fe-report
#2
James M Crawford, Khosrow Shotorbani, Gaurav Sharma, Michael Crossey, Tarush Kothari, Thomas S Lorey, Jeffrey W Prichard, Myra Wilkerson, Nancy Fisher
Project Santa Fe was established both to provide thought leadership and to help develop the evidence base for the valuation of clinical laboratory services in the next era of American healthcare. The participants in Project Santa Fe represent major regional health systems that can operationalize laboratory-driven innovations and test their valuation in diverse regional marketplaces in the United States. We provide recommendations from the inaugural March 2016 meeting of Project Santa Fe. Specifically, in the transition from volume-based to value-based health care, clinical laboratories are called upon to provide programmatic leadership in reducing total cost of care through optimization of time-to-diagnosis and time-to-effective therapeutics, optimization of care coordination, and programmatic support of wellness care, screening, and monitoring...
January 2017: Acad Pathol
https://www.readbyqxmd.com/read/28694275/the-chief-primary-care-medical-officer-restoring-continuity
#3
Noemi Doohan, Jennifer DeVoe
The year 2016 marked the 20th anniversary of the hospitalist profession, with more than 50,000 physicians identifying as hospitalists. The Achilles heel of hospitalist medicine, however, is discontinuity. Despite many current payment and delivery systems rewarding this discontinuity and severing long-term relationships between patient and primary care teams at the hospital door, primary care does not stop being important when a person is admitted to the hospital. The notion of a broken primary care continuum is not an academic construct, it causes real harm to patients...
July 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28693465/involvement-of-mitanins-female-health-volunteers-in-active-malaria-surveillance-determinants-and-challenges-in-tribal-populated-malaria-endemic-villages-of-chhattisgarh-india
#4
Mehul Kumar Chourasia, Kamaraju Raghavendra, Rajendra Mohan Bhatt, Dipak Kumar Swain, G D P Dutta, Immo Kleinschmidt
BACKGROUND: Accredited Social Health Activists (ASHA), female health volunteers working at village level have become an integral component of National Health Mission (NHM) in India in the past two decades. Mitanin (meaning female friend in local dialect), a precursor of ASHA, play an indispensable role in early detection of health related problems and are helping in improving overall community health status in Chhattisgarh state. The current study was carried out to evaluate the feasibility of involving Mitanin in active malaria surveillance work in 80 tribal villages of Chhattisgarh and to explore the challenges and determinants to perform malaria surveillance activities by the Mitanins...
July 11, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28686512/tracking-patients-in-community-based-palliative-care-through-the-centers-for-medicare-and-medicaid-services-healthcare-innovation-project
#5
Janet Bull, Arif H Kamal, Matthew Harker, Lindsay Bonsignore, John Morris, Lisa Massie, Parampal Singh Bhullar, Mark Hendrix, Deeana Bennett, Don Taylor
BACKGROUND: Although limited, the evidence base for Community Based Palliative Care (CBPC) has shown that it improves patient health outcomes, increases satisfaction, and decreases cost. Minimal data exist comparing points of entry into palliative care and patient transition outcomes. OBJECTIVES: In 2014, Four Seasons Compassion for Life was awarded a Centers for Medicare & Medicaid Services Healthcare Innovation Award to expand an existing CBPC model into additional counties and to propose a new payment approach...
July 7, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28666443/the-effect-of-health-literacy-and-self-management-efficacy-on-the-health-related-quality-of-life-of-hypertensive-patients-in-a-western-rural-area-of-china-a-cross-sectional-study
#6
Chenli Wang, Juntao Lang, Lixia Xuan, Xuemei Li, Liang Zhang
BACKGROUND: Hypertension is a common and frequently occurring chronic disease of the cardiovascular system. Besides the pathological factors, the occurrence and exacerbation of hypertension are also associated with many factors of lifestyle and behaviors. Thus hypertensive patients' Health-related quality of life (HRQL) is not only influenced by the disease itself but also by many subjective factors such as health literacy and self-management efficacy, especially in the deeper part of southwestern China and thus is less developed compared to the other places...
July 1, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28664439/sages-quality-initiative-an-introduction
#7
Anne Lidor, Dana Telem, Curtis Bower, Prashant Sinha, Rocco Orlando, John Romanelli
The Medicare program has transitioned to paying healthcare providers based on the quality of care delivered, not on the quantity. In May 2015, SAGES held its first ever Quality Summit. The goal of this meeting was to provide us with the information necessary to put together a strategic plan for our Society over the next 3-5 years, and to participate actively on a national level to help develop valid measures of quality of surgery. The transition to value-based medicine requires that providers are now measured and reimbursed based on the quality of services they provide rather than the quantity of patients in their care...
August 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28661798/getting-the-incentives-right-improving-oral-health-equity-with-universal-school-based-caries-prevention
#8
Richard Niederman, Shulamite S Huang, Anna-Lena Trescher, Stefan Listl
Despite significant financial, training, and program investments, US children's caries experience and inequities continued to increase over the last 20 years. We posit that (1) dental insurance payment systems are not aligned with the current best evidence, exacerbating inequities, and (2) system redesign could meet health care's triple aim and reduce children's caries by 80%. On the basis of 2013 to 2016 Medicaid and private payment rates and the caries prevention literature, we find that effective preventive interventions are either (1) consistently compensated less than ineffective interventions or (2) not compensated at all...
May 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28654675/estimating-the-disease-burden-of-methicillin-resistant-staphylococcus-aureus-in-japan-retrospective-database-study-of-japanese-hospitals
#9
Hironori Uematsu, Kazuto Yamashita, Susumu Kunisawa, Kiyohide Fushimi, Yuichi Imanaka
OBJECTIVES: The nationwide impact of antimicrobial-resistant infections on healthcare facilities throughout Japan has yet to be examined. This study aimed to estimate the disease burden of methicillin-resistant Staphylococcus aureus (MRSA) infections in Japanese hospitals. DESIGN: Retrospective analysis of inpatients comparing outcomes between subjects with and without MRSA infection. DATA SOURCE: A nationwide administrative claims database...
2017: PloS One
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
#10
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/28642642/access-to-and-payment-for-office-based-buprenorphine-treatment-in-ohio
#11
Theodore V Parran, Joseph Z Muller, Elina Chernyak, Chris Adelman, Christina M Delos Reyes, Douglas Rowland, Mykola Kolganov
IMPORTANCE: Office-based opiate agonist therapy has dramatically expanded access to medication-assisted treatment over the past decade but has also led to increased buprenorphine diversion. OBJECTIVE: Our study sought to characterize physicians who participate in office-based therapy (OBT) to assess patient access to OBT in Ohio 10 years after its introduction. DESIGN/SETTING/PARTICIPANTS: Cross-sectional telephone survey of Drug Addiction Treatment Act-waivered physicians in Ohio listed by the Center for Substance Abuse Treatment (CSAT)...
2017: Substance Abuse: Research and Treatment
https://www.readbyqxmd.com/read/28633411/surgeon-level-variability-in-outcomes-cost-and-comorbidity-adjusted-cost-for-elective-lumbar-decompression-and-fusion
#12
Silky Chotai, Ahilan Sivaganesan, John A Sielatycki, Kristin R Archer, Richard Call, Matthew J McGirt, Clinton J Devin
BACKGROUND: The costs and outcomes following degenerative spine surgery may vary from surgeon to surgeon. Patient factors such as comorbidities may increase the health care cost. These variations are not well studied. OBJECTIVE: To understand the variation in outcomes, costs, and comorbidity-adjusted cost for surgeons performing lumbar laminectomy and fusions surgery. METHODS: A total of 752 patients undergoing laminectomy and fusion, performed by 7 surgeons, were analyzed...
June 14, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28604355/costs-and-performance-of-english-mental-health-providers
#13
Valerie Moran, Rowena Jacobs
BACKGROUND: Despite limited resources in mental health care, there is little research exploring variations in cost performance across mental health care providers. In England, a prospective payment system for mental health care based on patient needs has been introduced with the potential to incentivise providers to control costs. The units of payment under the new system are 21 care clusters. Patients are allocated to a cluster by clinicians, and each cluster has a maximum review period...
June 1, 2017: Journal of Mental Health Policy and Economics
https://www.readbyqxmd.com/read/28598890/comparing-population-based-risk-stratification-model-performance-using-demographic-diagnosis-and-medication-data-extracted-from-outpatient-electronic-health-records-versus-administrative-claims
#14
Hadi Kharrazi, Winnie Chi, Hsien-Yen Chang, Thomas M Richards, Jason M Gallagher, Susan M Knudson, Jonathan P Weiner
BACKGROUND: There is an increasing demand for electronic health record (EHR)-based risk stratification and predictive modeling tools at the population level. This trend is partly due to increased value-based payment policies and the increasing availability of EHRs at the provider level. Risk stratification models, however, have been traditionally derived from claims or encounter systems. This study evaluates the challenges and opportunities of using EHR data instead of or in addition to administrative claims for risk stratification...
August 2017: Medical Care
https://www.readbyqxmd.com/read/28594696/quality-measures-in-gastrointestinal-endoscopy-the-current-state
#15
Megan A Adams, Sameer D Saini, John I Allen
PURPOSE OF REVIEW: The purpose of this review is to summarize the current state of endoscopic quality measurement and use of measures in enhancing the value of endoscopic services. RECENT FINDINGS: Initially, quality measurement of endoscopic procedures was claims based or included small unit or practice-specific efforts. Now we have a mature national registry and large electronic medical or procedural records that are designed to yield valuable data relevant to quality measurement...
June 7, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28591975/an-overview-of-home-based-primary-care-learning-from-the-field
#16
Sarah Klein, Martha Hostetter, Douglas McCarthy
ISSUE: Homebound and functionally limited individuals are often unable to access office-based primary care, leading to unmet needs and increased health care spending. GOAL: Show how home-based primary care affects outcomes and costs for Medicare and Medicaid beneficiaries with complex care needs. METHODS: Qualitative synthesis of expert perspectives and the experiences of six case-study sites. FINDINGS AND CONCLUSIONS: Successful home-based primary care practices optimize care by: fielding interdisciplinary teams, incorporating behavioral care and social supports into primary care, responding rapidly to urgent and acute care needs, offering palliative care, and supporting family members and caregivers...
June 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28591799/incentivizing-universal-safe-delivery-in-nepal-10%C3%A2-years-of-experience
#17
Tim Ensor, Hema Bhatt, Suresh Tiwari
Payments to users and providers of health services are an important ingredient in attempts to promote universal health coverage in low resource settings. The maternal health programme in Nepal explicitly recognizes that ensuring universal access to safe delivery care requires policies that both ensure effective services and overcome demand-side barriers. The programme has used three innovative financing initiatives to stimulate an increase in the use of facility-based delivery: the maternity incentive scheme (2005) reimbursing women for accessing a facility, activity payments in poor districts (2006) and universal free-delivery (2009)...
June 7, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28585094/a-retrospective-review-comparing-two-year-patient-reported-outcomes-costs-and-healthcare-resource-utilization-for-tlif-vs-plf-for-single-level-degenerative-spondylolisthesis
#18
Elliott Kim, Silky Chotai, David Stonko, Joseph Wick, Alex Sielatycki, Clinton J Devin
PURPOSE: The purpose of this study was to compare patient-reported outcomes (PROs), morbidity, and costs of TLIF vs PLF to determine whether one treatment was superior in the setting of single-level degenerative spondylolisthesis. METHODS: Patients undergoing TLIF or PLF for single-level spondylolisthesis were included for retrospective analysis. EQ-5D, ODI, SF-12 MCS/PCS, NRS-BP/LP scores were collected at baseline and 24 months after surgery. 90-day post-operative complications, revision surgery rates, and satisfaction scores were also collected...
June 5, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28577702/the-role-of-patient-reported-outcome-measures-in-value-based-payment-reform
#19
Lee Squitieri, Kevin J Bozic, Andrea L Pusic
The U.S. health care system is currently experiencing profound change. Pressure to improve the quality of patient care and control costs have caused a rapid shift from traditional volume-driven fee-for-service reimbursement to value-based payment models. Under the 2015 Medicare Access and Children's Health Insurance Program Reauthorization Act, providers will be evaluated on the basis of quality and cost efficiency and ultimately receive adjusted reimbursement as per their performance. Although current performance metrics do not incorporate patient-reported outcome measures (PROMs), many wonder whether and how PROMs will eventually fit into value-based payment reform...
June 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28570449/quality-measures-in-breast-reconstruction-a-systematic-review
#20
Rahim N Nazerali, Micaela A Finnegan, Vasu Divi, Gordon K Lee, Robin N Kamal
BACKGROUND: The importance of providing quality care over quantity of care, and its positive effects on health care expenditure and health, has motivated a transition toward value-based payments. The Centers for Medicare and Medicaid Services and private payers are establishing programs linking financial incentives and penalties to adherence to quality measures. As payment models based on quality measures are transitioned into practice, it is beneficial to identify current quality measures that address breast reconstruction surgery as well as understand gaps to inform future quality measure development...
May 31, 2017: Annals of Plastic Surgery
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