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https://www.readbyqxmd.com/read/28448784/a-motivational-interviewing-intervention-by-pharmacy-students-to-improve-medication-adherence
#1
Susan Abughosh, Xin Wang, Omar Serna, Tara Esse, Amanda Mann, Santhi Masilamani, Marcia McDonnell Holstad, Ekere James Essien, Marc Fleming
BACKGROUND: Diabetes mellitus (DM) patients with comorbid hypertension (HTN) are at a higher risk of developing microvascular and macrovascular DM complications. Through guideline-driven recommendations, angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are highly recommended for these patients. Unfortunately, medication adherence to these products, though crucial to achieving therapeutic benefit, is frequently suboptimal. Motivational interviewing (MI) is a patient-centered collaborative communication style that is used to strengthen internal motivation for change that may prove effective in enhancing adherence...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28438503/expanding-role-of-certified-electronic-health-records-technology-in-radiology-the-macra-mandate
#2
Gregory N Nicola, Andrew B Rosenkrantz, Joshua A Hirsch, Ezequiel Silva, Keith J Dreyer, Michael P Recht
Radiology has historically been at the forefront of innovation and the advancement of technology for the benefit of patient care. However, challenges to early implementation prevented most radiologists from adopting and integrating certified electronic health record technology (CEHRT) into their daily workflow despite the early and potential advantages it offered. This circumstance places radiology at a disadvantage in the two payment pathways of the Medicare Access and CHIP Reauthorization Act of 2015: the Merit-Based Incentive Payment System (MIPS) and advanced alternative payment models (APMs)...
April 19, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28416120/diabetes-complications-severity-index-dcsi-update-and-icd-10-translation
#3
William P Glasheen, Andrew Renda, Yanting Dong
AIMS: The Diabetes Complications Severity Index (DCSI) converts diagnostic codes and laboratory results into a 14-level metric quantifying the long-term effects of diabetes on seven body systems. Adoption of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) necessitates translation from ICD-9-CM and creates refinement opportunities. METHODS: ICD-9 codes for secondary and primary diabetes plus all five ICD-10 diabetes categories were incorporated into an updated tool...
March 14, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28414044/the-impact-of-the-medicare-access-and-chip-reauthorization-act-macra-on-the-field-of-ophthalmology
#4
Brenton Kinker, Kaitlyn Dobesh, Nariman Nassiri, Mark S Juzych, M Roy Wilson
PURPOSE: To analyze the impact of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) on the field of ophthalmology. DESIGN: A perspective on the effects of MACRA's Quality Payment Program after analysis of the proposed rule, final rule, and commentary submitted by relevant stakeholders. RESULTS: Physicians will need to use one of two payment structures: Merit Based Incentive Payment Systems (MIPS), or Alternative Payment Models (APMs)...
April 13, 2017: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/28388857/inappropriate-utilization-in-fee-for-service-medicare-and-medicare-advantage-plans
#5
Shriram Parashuram, Seung Kim, Bryan Dowd
This study uses a national multi-payer claims database to test for differences in potentially inappropriate emergency department (ED) visits and ambulatory care sensitive (ACS) admissions in fee-for-service (FFS) Medicare and Medicare Advantage (MA) plans. Rates of ACS admissions for MA enrollees were approximately one third those of FFS beneficiaries, controlling for covariates, which included the beneficiary's health status as represented by their risk score. This study then compared FFS and MA beneficiaries when they moved from one type of health plan to another...
April 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28379722/clinical-pathways-management-of-quality-and-cost-in-oncology-networks-in-the-metastatic-colorectal-cancer-setting
#6
Peter G Ellis, Bert H O'Neil, Martin F Earle, Stephanie McCutcheon, Hans Benson, Melinda Krebs, Kathy Lokay, Amanda Barry
PURPOSE: Via Pathways (clinical pathways for cancer) provide evidence-based guidance for specific patient presentations based on the merit of efficacy, then toxicity, and finally cost (if efficacy and toxicity are comparable). We evaluated the impact of a change to the guidance in the metastatic colorectal cancer (mCRC) setting across two large, integrated health networks. METHODS: Cetuximab and panitumumab were determined to have equal efficacy in the treatment of mCRC with no significant difference in toxicity based on recent data from key clinical studies...
April 5, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28374489/improving-medical-record-retrieval-for-validation-studies-in-medicare-data
#7
Nicole C Wright, Elizabeth S Delzell, Wilson K Smith, Fei Xue, Tarun Auroa, Jeffrey R Curtis
PURPOSE: The purpose of the study is to describe medical record retrieval for a study validating claims-based algorithms used to identify seven adverse events of special interest (AESI) in a Medicare population. METHODS: We analyzed 2010-2011 Medicare claims of women with postmenopausal osteoporosis and men ≥65 years of age in the Medicare 5% national sample. The final cohorts included beneficiaries covered continuously for 12+ months by Medicare parts A, B, and D and not enrolled in Medicare Advantage before starting follow-up...
April 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28369691/adapting-the-vulnerable-elders-survey-13-to-predict-mortality-using-responses-to-the-medicare-health-outcomes-survey
#8
Megan K Beckett, Marc N Elliott, Douglas Ritenour, Laura A Giordano, Susan C Grace, Rochelle Malinoff, Debra Saliba
OBJECTIVES: To use items from the Medicare Health Outcomes Survey (HOS) to adapt or validate a simple method for identifying community-dwelling older adults at greater risk of death and to extend the method to identify a very high-risk group. DESIGN: Analysis of longitudinal data. SETTING: National sample of beneficiaries from Medicare Advantage plans with 500 or more enrollees. PARTICIPANTS: Medicare beneficiaries aged 65 and older responding to 2009 baseline and 2011 follow-up HOS (N = 238,687)...
April 3, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28345441/prevalence-and-cost-of-subsequent-fractures-among-u-s-patients-with-an-incident-fracture
#9
Jessica Weaver, Shiva Sajjan, E Michael Lewiecki, Steven T Harris, Panagiotis Marvos
BACKGROUND: The prevalence and cost of subsequent fractures among patients with an incident fracture are not well defined. OBJECTIVE: To assess the prevalence of, and costs associated with, subsequent fractures in the year after an incident fracture. METHODS: This was a retrospective claims database analysis using data from Humana Medicare Advantage claims (Medicare group) and Optum Insight Clinformatics Data Mart commercial claims (commercial group)...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28345144/adapting-evaluations-of-alternative-payment-models-to-a-changing-environment
#10
Thomas W Grannemann, Randall S Brown
OBJECTIVE: To identify the most robust methods for evaluating alternative payment models (APMs) in the emerging health care delivery system environment. STUDY DESIGN (APPROACH): We assess the impact of widespread testing of alternative payment models on the ability to find credible comparison groups. We consider the applicability of factorial research designs for assessing the effects of these models. PRINCIPAL FINDINGS: The widespread adoption of alternative payment models could effectively eliminate the possibility of comparing APM results with a "pure" control or comparison group unaffected by other interventions...
March 27, 2017: Health Services Research
https://www.readbyqxmd.com/read/28318667/paying-medicare-advantage-plans-to-level-or-tilt-the-playing-field
#11
Jacob Glazer, Thomas G McGuire
Medicare beneficiaries are eligible for health insurance through the public option of traditional Medicare (TM) or may join a private Medicare Advantage (MA) plan. Both are highly subsidized but in different ways. Medicare pays for most of costs directly in TM, and subsidizes MA plans based on a "benchmark" for each beneficiary choosing a private plan. The level of this benchmark is arguably the most important policy decision Medicare makes about the MA program. Many analysts recommend equalizing Medicare's subsidy across the options - referred to in policy circles as a "level playing field...
December 29, 2016: Journal of Health Economics
https://www.readbyqxmd.com/read/28314797/effect-of-2013-acc-aha-blood-cholesterol-guidelines-on-statin-treatment-patterns-and-low-density-lipoprotein-cholesterol-in-atherosclerotic-cardiovascular-disease-patients
#12
Ted Okerson, Jeetvan Patel, Stefan DiMario, Tanya Burton, Jerald Seare, David J Harrison
BACKGROUND: Preceding release of the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) cholesterol guidelines, prescribers aimed for specific low-density lipoprotein cholesterol (LDL-C) goals in patients with atherosclerotic cardiovascular disease (ASCVD). The 2013 guidelines changed this focus to treating patients with appropriate statin intensity given their ASCVD risk. We examined statin use and LDL-C levels before and after the 2013 ACC/AHA guidelines in patients with clinical ASCVD as defined in the guidelines...
March 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28295261/the-role-of-medicare-s-inpatient-cost-sharing-in-medicaid-entry
#13
Laura M Keohane, Amal N Trivedi, Vincent Mor
OBJECTIVE: To isolate the effect of greater inpatient cost-sharing on Medicaid entry among Medicare beneficiaries. DATA SOURCES: Medicare administrative data (years 2007-2010) were linked to nursing home assessments and area-level socioeconomic indicators. STUDY DESIGN: Medicare beneficiaries who are readmitted to a hospital must pay an additional deductible ($1,100 in 2010) if their readmission occurs more than 59 days following discharge...
March 13, 2017: Health Services Research
https://www.readbyqxmd.com/read/28264957/provider-offered-medicare-advantage-plans-recent-growth-and-care-quality
#14
Garret Johnson, Zoe M Lyon, Austin Frakt
Hospitals and health systems are increasingly offering their own insurance products, a type of consolidation known as "vertical integration." The relationship between plan-provider vertical integration and quality of care has not been examined extensively or over time. We created a new data set of all vertically integrated Medicare Advantage contracts operating in the period 2011-15 and tracked their characteristics and quality over time. While the percentage of vertically integrated contracts increased slightly between 2011 and 2015, the percentage of all Medicare Advantage enrollees in them declined from 24...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28251556/retrospective-study-on-the-impact-of-adherence-in-achieving-glycemic-goals-in-type-2-diabetes-mellitus-patients-receiving-canagliflozin
#15
Erin K Buysman, Amy Anderson, Shaffeeulah Bacchus, Mike Ingham
INTRODUCTION: Adherence is poor among patients taking antihyperglycemic agents (AHAs) for type 2 diabetes mellitus (T2DM). Inadequate adherence has been linked to decreased glycemic control and increased healthcare costs and hospitalizations. We examined the impact of real-world adherence on glycemic control in T2DM patients treated with canagliflozin. METHODS: This retrospective study used US administrative claims data from commercial and Medicare Advantage healthcare enrollees...
March 1, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28245661/value-based-contracting-innovated-medicare-advantage-healthcare-delivery-and-improved-survival
#16
Aloke K Mandal, Gene K Tagomori, Randell V Felix, Scott C Howell
OBJECTIVES: In Medicare Advantage (MA) with its CMS Hierarchical Condition Categories (CMS-HCC) payment model, CMS reimburses private plans (Medicare Advantage Organizations [MAOs]) with prospective, monthly, health-based or risk-adjusted, capitated payments. The effect of this payment methodology on healthcare delivery remains debatable. How value-based contracting generates cost efficiencies and improves clinical outcomes in MA is studied. STUDY DESIGN: A difference in contracting arrangements between an MAO and 2 provider groups facilitated an intervention-control, preintervention-postintervention, difference-in-differences approach among statistically similar, elderly, community-dwelling MA enrollees within one metropolitan statistical area...
February 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28245655/economic-burden-of-hypoglycemia-with-basal-insulin-in-type-2-diabetes
#17
Vivian Fonseca, Engels Chou, Hsing-Wen Chung, Charles Gerrits
OBJECTIVES: To assess the impact of hypoglycemia and potential underlying factors of economic burden in patients with type 2 diabetes (T2D) who are initiating basal insulin therapy. STUDY DESIGN: This retrospective cohort study combined commercial insurance and Medicare Advantage data from the Clinformatics Data Mart. METHODS: Adults with T2D on oral antidiabetes drugs initiating basal insulin (n = 18,918) were assessed at baseline (12 months prior to insulin initiation) and follow-up (1 and 2 years)...
February 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28245653/synchronized-prescription-refills-and-medication-adherence-a-retrospective-claims-analysis
#18
Jalpa A Doshi, Raymond Lim, Pengxiang Li, Peinie P Young, Victor F Lawnicki, Andrea B Troxel, Kevin G Volpp
OBJECTIVES: Medication adherence is often suboptimal, especially among patients on multiple chronic medications. We examined the association between synchronized medication refill schedules-which typically reduce organizational effort and logistical demands-and adherence. STUDY DESIGN: Retrospective study among patients enrolled in Medicare Advantage prescription drug plans. METHODS: We used 2012 pharmacy, medical, and enrollment data linked with consumer meta-data for Medicare patients filling 2 or more maintenance prescriptions for antihypertensives, lipid-lowering agents, antidiabetic agents, antidepressants, and/or antiosteoporotic agents...
February 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28237647/utilization-of-the-national-inpatient-sample-for-abdominal-aortic-aneurysm-research
#19
Anahita Dua, Fadwa Ali, Elizabeth Traudt, Sapan S Desai
Large administrative databases, including the Medicare database by the Centers for Medicare and Medicaid Services, the National Surgical Quality Improvement Project database sponsored by the American College of Surgeons, and the National Inpatient Sample, have been used by major public health agencies for years. More recently, medical researchers have turned to database research to power studies on diseases that are noted to be relatively scarce. This study aimed to review and discuss the utilization of the National Inpatient Sample for abdominal aortic aneurysm research, inclusive of its advantages, disadvantages, and best practices...
February 22, 2017: Surgery
https://www.readbyqxmd.com/read/28230454/adherence-persistence-and-health-care-costs-for-patients-receiving-dipeptidyl-peptidase-4-inhibitors
#20
Karen L Rascati, Karen Worley, Yunus Meah, Damian Everhart
BACKGROUND: The dipeptidyl peptidase-4 (DPP-4) inhibitors are among the newer, yet more established, classes of diabetes medications. OBJECTIVE: To compare adherence, persistence, and health care costs among patients taking DPP-4 inhibitors. METHODS: Claims were extracted from Humana Medicare Advantage Prescription Drug (MAPD) or commercial plans for patients aged > 18 years with ≥ 1 prescription filled for a DPP-4 inhibitor between July 1, 2011, and March 31, 2013...
March 2017: Journal of Managed Care & Specialty Pharmacy
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