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Medicare risk adjustment

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https://www.readbyqxmd.com/read/29166251/risk-of-diabetes-mellitus-among-medicaid-beneficiaries-in-hawaii
#1
Dongmei Li, Chuan C Chinn, Ritabelle Fernandes, Christina M B Wang, Myra D Smith, Rebecca Rude Ozaki
INTRODUCTION: Medicaid is the largest primary health insurance for low-income populations in the United States, and it provides comprehensive benefits to cover treatment and services costs for chronic diseases, including diabetes. The standardized per capita spending on diabetes by Medicare beneficiaries enrolled in the fee-for-service program in Hawaii increased from 2012 to 2015. We examined the difference in odds of diabetes between Medicaid and non-Medicaid populations in major racial/ethnic groups in Hawaii...
November 22, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/29153624/the-effect-of-socioeconomic-status-race-and-insurance-type-on-newly-diagnosed-metastatic-prostate-cancer-in-the-united-states-2004-2013
#2
Adam B Weiner, Richard S Matulewicz, Jeffrey J Tosoian, Joseph M Feinglass, Edward M Schaeffer
BACKGROUND: Understanding the characteristics of men who initially present with metastatic prostate cancer (mPCa) can better enable directed improvement initiatives. The objective of this study was to assess the relationship between socioeconomic status (SES) and newly diagnosed mPCa. MATERIALS METHODS: All men diagnosed with PCa in the National Cancer Data Base from 2004 to 2013 were identified. Characteristics of men presenting with and without metastatic disease were compared...
November 15, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/29153119/annual-total-medical-expenditures-associated-with-hypertension-by-diabetes-status-in-u-s-adults
#3
Guijing Wang, Xilin Zhou, Xiaohui Zhuo, Ping Zhang
INTRODUCTION: Hypertension and diabetes, both independent risk factors for cardiovascular disease, often coexist. The hypertension-increased medical expenditures by diabetes status is unclear, however. This study estimated annual total medical expenditures in U.S. adults by hypertension and diabetes status. METHODS: The study population consisted of 40,746 civilian, non-institutionalized adults aged ≥18 years who participated in the 2013 or 2014 Medical Expenditure Panel Survey...
December 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29149478/hospital-quality-patient-risk-and-medicare-expenditures-for-cancer-surgery
#4
Sarah P Shubeck, Jyothi R Thumma, Justin B Dimick, Hari Nathan
BACKGROUND: Surgical resection is a cornerstone of curative-intent therapy for patients with solid organ malignancies. With increasing attention paid to the costs of surgical care, there is a new focus on variations in the costs of cancer surgery. This study evaluated the potential interactive effect of hospital quality and patient risk on expenditures for cancer resections. METHODS: With 100% Medicare claim data for 2010-2013, patients aged 65 to 99 years who had undergone cancer resection were identified...
November 17, 2017: Cancer
https://www.readbyqxmd.com/read/29141781/heart-failure-with-preserved-borderline-and-reduced-ejection-fraction-5-year-outcomes
#5
Kevin S Shah, Haolin Xu, Roland A Matsouaka, Deepak L Bhatt, Paul A Heidenreich, Adrian F Hernandez, Adam D Devore, Clyde W Yancy, Gregg C Fonarow
BACKGROUND: Patients with heart failure (HF) have a poor prognosis and are categorized by ejection fraction (EF). OBJECTIVES: This study sought to characterize differences in outcomes in patients hospitalized with heart failure with preserved ejection fraction (HFpEF) (EF ≥50%), heart failure with borderline ejection fraction (HFbEF) (EF 41% to 49%), and heart failure with reduced ejection fraction (HFrEF) (EF ≤40%). METHODS: Data from GWTG-HF (Get With The Guidelines-Heart Failure) were linked to Medicare data for longitudinal follow-up...
October 31, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29135661/reconsidering-the-affordable-care-act-s-restrictions-on-physician-owned-hospitals-analysis-of-cms-data-on-total-hip-and-knee-arthroplasty
#6
P Maxwell Courtney, Brian Darrith, Daniel D Bohl, Nicholas B Frisch, Craig J Della Valle
BACKGROUND: Concerns about financial incentives and increased costs prompted legislation limiting the expansion of physician-owned hospitals in 2010. Supporters of physician-owned hospitals argue that they improve the value of care by improving quality and reducing costs. The purpose of the present study was to determine whether physician-owned and non-physician-owned hospitals differ in terms of costs, outcomes, and patient satisfaction in the setting of total hip arthroplasty (THA) and total knee arthroplasty (TKA)...
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29135608/the-epidemiology-of-vertebral-osteomyelitis-in-the-united-states-from-1998-to-2013
#7
Kimona Issa, Bassel G Diebo, Michael Faloon, Qais Naziri, Sina Pourtaheri, Carl B Paulino, Arash Emami
STUDY DESIGN: This is a epidemiological database analysis. OBJECTIVES: The objectives of this article are to assess the following characteristics of vertebral osteomyelitis (VO): (1) incidence and patient demographics, (2) mortality rate, (3) length-of-stay (LOS), and (4) admission costs. SUMMARY OF BACKGROUND: VO is a serious disease with potentially devastating clinical consequences. At present, there is limited data on the epidemiology of VO in the United States as previous reports are based on older studies with small sample sizes...
November 10, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29131897/comparison-of-hospital-resource-use-and-outcomes-among-hospitalists-primary-care-physicians-and-other-generalists
#8
Jennifer P Stevens, David J Nyweide, Sha Maresh, Laura A Hatfield, Michael D Howell, Bruce E Landon
Importance: A physician's prior experience caring for a patient may be associated with patient outcomes and care patterns during and after hospitalization. Objective: To examine differences in the use of health care resources and outcomes among hospitalized patients cared for by hospitalists, their own primary care physicians (PCPs), or other generalists. Design, Setting, and participants: This retrospective study analyzed admissions for the 20 most common medical diagnoses among elderly fee-for-service Medicare patients from January 1 through December 31, 2013...
November 13, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29128869/association-of-the-hospital-readmissions-reduction-program-implementation-with-readmission-and-mortality-outcomes-in-heart-failure
#9
Ankur Gupta, Larry A Allen, Deepak L Bhatt, Margueritte Cox, Adam D DeVore, Paul A Heidenreich, Adrian F Hernandez, Eric D Peterson, Roland A Matsouaka, Clyde W Yancy, Gregg C Fonarow
Importance: Public reporting of hospitals' 30-day risk-standardized readmission rates following heart failure hospitalization and the financial penalization of hospitals with higher rates have been associated with a reduction in 30-day readmissions but have raised concerns regarding the potential for unintended consequences. Objective: To examine the association of the Hospital Readmissions Reduction Program (HRRP) with readmission and mortality outcomes among patients hospitalized with heart failure within a prospective clinical registry that allows for detailed risk adjustment...
November 12, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29125784/identifying-the-population-with-serious-illness-the-denominator-challenge
#10
Amy S Kelley, Evan Bollens-Lund
BACKGROUND: To ensure seriously ill people and their families receive high-quality primary and specialty palliative care services, rigorous methods are needed to prospectively identify this population. OBJECTIVE: To define and operationalize a definition of serious illness for the purpose of identifying patients and caregivers who need primary or specialty palliative care services. DESIGN/SETTING: Two stages of work included (1) building expert consensus around a conceptual definition of serious illness and (2) using the National Health and Aging Trends Study linked to Medicare claims data to test a range of operational definitions composed of diagnoses, utilization, and markers of care needs...
November 10, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29124542/uptake-of-hpv-testing-and-extended-cervical-cancer-screening-intervals-following-cytology-alone-and-pap-hpv-cotesting-in-women-aged-30-65%C3%A2-years
#11
Michelle I Silver, Anne F Rositch, Darcy F Phelan-Emrick, Patti E Gravitt
OBJECTIVE: To evaluate the adoption of HPV testing and recommended extended cervical cancer screening intervals in clinical practice, we described yearly uptake of Pap/HPV cotesting and estimated length of time between normal screens by patient characteristics. METHODS: We examined 55,575 Pap/HPV records from 27,035 women aged 30-65 years from the Johns Hopkins Hospital Pathology Data System between 2006 and 2013. Cotest uptake and median times to next screening test for cotests and cytology only were calculated...
November 9, 2017: Cancer Causes & Control: CCC
https://www.readbyqxmd.com/read/29118227/nonadherence-to-statins-and-antihypertensives-and-hospitalizations-among-elderly-medicare-beneficiaries-with-incident-cancer
#12
Ishveen Chopra, Nilanjana Dwibedi, Malcolm D Mattes, Xi Tan, Patricia Findley, Usha Sambamoorthi
Background: Incident cancer diagnosis may increase the risk of coronary artery disease (CAD)-related hospitalizations, especially in older individuals. Adherence to statins and/or angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin II receptor blockers (ARBs)/β-blockers reduces CAD-related hospitalizations. This study examined the relationship between medication adherence and CAD-related hospitalizations immediately following cancer diagnosis. Patients and Methods: A retrospective observational longitudinal study was conducted using SEER-Medicare data...
November 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29112234/impact-of-the-insurance-type-of-head-and-neck-cancer-patients-on-their-hospitalization-utilization-patterns
#13
Avni Gupta, Stephen T Sonis, Eric B Schneider, Alessandro Villa
BACKGROUND: Head and neck cancer (HNC) patients with Medicaid, Medicare, or no insurance show poor outcomes in comparison with privately insured patients. It was hypothesized that nonprivate insurance coverage biases the selection of the treatment site to favor hospitals that are not associated with optimum treatment outcomes. This study assessed the relation between the insurance type of HNC patients and the hospital type for inpatient care. METHODS: Adult HNC patients were identified from the Nationwide Inpatient Sample (2012 and 2013)...
November 7, 2017: Cancer
https://www.readbyqxmd.com/read/29112226/new-institutionalization-in-long-term-care-after-hospital-discharge-to-skilled-nursing-facility
#14
Addie Middleton, Shuang Li, Yong-Fang Kuo, Kenneth J Ottenbacher, James S Goodwin
BACKGROUND/OBJECTIVES: Approximately half of individuals newly admitted to long-term care (LTC) nursing homes (NHs) experienced a prior hospitalization followed by discharge to a skilled nursing facility (SNF). The objective was to examine characteristics associated with new institutionalizations of older adults on this care trajectory. DESIGN: Retrospective cohort study. SETTING: SNFs and LTC NHs. PATIENTS: Medicare fee-for-service beneficiaries admitted to 7,442 SNFs in 2013 (N = 597,986)...
November 7, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29106674/allopurinol-and-the-risk-of-incident-peripheral-arterial-disease-in-the-elderly-a-us-medicare-claims-data-study
#15
Jasvinder A Singh, John Cleveland
Objective: The aim was to examine whether allopurinol use is independently associated with a reduction in the risk of incident peripheral arterial disease (PAD) in the US elderly. Methods: We used the 5% random Medicare sample from 2006 to 2012 to examine the association of allopurinol use and duration of use with the risk or hazard of incident PAD in a retrospective cohort study using a new user design. Multivariable Cox regression models adjusted for demographics, co-morbidity, cardiac medications and cardiac conditions...
July 3, 2017: Rheumatology
https://www.readbyqxmd.com/read/29106473/trends-in-acute-pericarditis-hospitalizations-and-outcomes-among-the-elderly-in-the-united-states-1999-2012
#16
Purav Mody, Behnood Bikdeli, Yun Wang, Massimo Imazio, Harlan M Krumholz
Aim: The elderly are at risk of pericarditis from conditions such as malignancy, renal disease and after cardiac surgery. However, the burden of pericarditis and especially long-term outcomes associated with pericarditis have not been described before among the elderly. Methods and results: We examined hospitalization rates; in-hospital, 30-day, and 1-year all-cause mortality rates; all-cause 30-day readmission rates; length of stay and healthcare expenditure for Medicare beneficiaries aged 65 years or older with a principal discharge diagnosis of pericarditis from 1999 to 2012...
November 2, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29103917/physician-specialty-and-radiologist-characteristics-associated-with-higher-medicare-patient-complexity
#17
Andrew B Rosenkrantz, Wenyi Wang, Arvind Vijayasarathi, Richard Duszak
RATIONALE AND OBJECTIVES: Meaningfully measuring physician outcomes and resource utilization requires appropriate patient risk adjustment. We aimed to assess Medicare patient complexity by physician specialty and to further identify radiologist characteristics associated with higher patient complexity. MATERIALS AND METHODS: The average beneficiary Hierarchical Condition Category (HCC) risk scores (Medicare's preferred measure of clinical complexity) were identified for all physicians using 2014 Medicare claims data...
November 3, 2017: Academic Radiology
https://www.readbyqxmd.com/read/29103033/economic-burden-mortality-and-institutionalization-in-patients-newly-diagnosed-with-alzheimer-s-disease
#18
Christopher M Black, Howard Fillit, Lin Xie, Xiaohan Hu, M Furaha Kariburyo, Baishali M Ambegaonkar, Onur Baser, Huseyin Yuce, Rezaul K Khandker
BACKGROUND: Current information is scarce regarding comorbid conditions, treatment, survival, institutionalization, and health care utilization for Alzheimer's disease (AD) patients. OBJECTIVES: Compare all-cause mortality, rate of institutionalization, and economic burden between treated and untreated newly-diagnosed AD patients. METHODS: Patients aged 65-100 years with ≥1 primary or ≥2 secondary AD diagnoses (ICD-9-CM:331.0] with continuous medical and pharmacy benefits for ≥12 months pre-index and ≥6 months post-index date (first AD diagnosis date) were identified from Medicare fee-for-service claims 01JAN2011-30JUN2014...
October 30, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29102470/long-term-survival-trends-of-medicare-patients-after-in-hospital-cardiac-arrest-insights-from-get-with-the-guidelines-resuscitation-%C3%A2
#19
Lauren E Thompson, Paul S Chan, Fengming Tang, Brahmajee K Nallamothu, Saket Girotra, Sarah M Perman, Somnath Bose, Stacie L Daugherty, Steven M Bradley
BACKGROUND: Although rates of survival to hospital discharge after in-hospital cardiac arrest (IHCA) have improved over the last decade, it is unknown if these survival gains are sustained after hospital discharge. OBJECTIVE: To examine 1-year survival trends overall and by rhythm after IHCA. METHODS: Using Medicare beneficiaries (age≥65years) with IHCA occurring between 2000 and 2011 at Get With The Guidelines®-Resuscitation Registry participating hospitals we used multivariable regression, to examine temporal trends in risk-adjusted rates of 1-year survival...
November 1, 2017: Resuscitation
https://www.readbyqxmd.com/read/29101972/access-to-lung-cancer-screening-services-preliminary%C3%A2-analysis-of-geographic-service-distribution-using-the-acr-lung-cancer-screening-registry
#20
Paniz Charkhchi, Giselle E Kolenic, Ruth C Carlos
PURPOSE: Lung cancer has the highest mortality rate among all types of cancer in the United States. The National Lung Screening Trial demonstrated that low-dose CT for lung cancer screening decreases both lung cancer-related mortality and all-cause mortality. Currently, the only CMS-approved lung cancer screening registry is the Lung Cancer Screening Registry (LCSR) administered by the ACR. The aims of this study were to assess access to lung cancer screening services as estimated by the number and distribution of screening facilities participating in the LCSR, by state, and to evaluate state-level covariates that correlate with access...
November 2017: Journal of the American College of Radiology: JACR
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