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https://www.readbyqxmd.com/read/28540648/impact-of-2015-update-to-the-beers-criteria-on-estimates-of-prevalence-and-costs-associated-with-potentially-inappropriate-use-of-antimuscarinics-for-overactive-bladder
#1
Brandon T Suehs, Cralen Davis, Daniel B Ng, Katherine Gooch
BACKGROUND: Research has demonstrated that the use of potentially inappropriate medication (PIM) is highly prevalent among older individuals and may lead to increased healthcare costs, adverse drug reactions, hospitalizations, and mortality. OBJECTIVES: The purpose of this study was to examine the impact of the 2015 updates to the Beers Criteria on estimates of prevalence and cost associated with potentially inappropriate use of antimuscarinic medications indicated for treatment of overactive bladder (OAB)...
May 24, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28535119/comparison-of-effectiveness-and-safety-of-treatment-with-apixaban-vs-other-oral-anticoagulants-among-elderly-nonvalvular-atrial-fibrillation-patients
#2
Steven Deitelzweig, Xuemei Luo, Kiran Gupta, Jeffrey Trocio, Jack Mardekian, Tammy Curtice, Melissa Lingohr-Smith, Brandy Menges, Jay Lin
OBJECTIVE: To compare the risk of stroke/systemic embolism (S/SE) and major bleeding (MB) of elderly (≥65 years of age) nonvalvular atrial fibrillation (NVAF) patients initiating apixaban vs. rivaroxaban, dabigatran, or warfarin. METHODS: NVAF patients with Medicare Advantage coverage in the US initiating oral anticoagulants (OACs, index event) were identified from the Humana database (1/1/2013-9/30/2015) and grouped into cohorts depending on OAC initiated. Propensity score matching (PSM), 1:1, was conducted among patients treated with apixaban vs...
May 23, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28498498/impact-of-prescription-drug-monitoring-programs-pdmps-on-opioid-utilization-among-medicare-beneficiaries-in-10-u-s-states
#3
Patience Moyo, Linda Simoni-Wastila, Beth Ann Griffin, Eberechukwu Onukwugha, Donna Harrington, G Caleb Alexander, Francis Palumbo
BACKGROUND AND AIMS: Prescription Drug Monitoring Programs (PDMPs) are a principal strategy used in the USA to address prescription drug abuse. We (1) compared opioid use pre- and post-PDMP implementation and (2) estimated differences of PDMP impact by reason for Medicare eligibility and plan type. DESIGN: Analysis of opioid prescription claims in US states that implemented PDMPs relative to non-PDMP states during 2007-2012. SETTING: Florida, Louisiana, Nebraska, New Jersey, Vermont, Georgia, Wisconsin, Maryland, New Hampshire, and Arkansas, USA...
May 12, 2017: Addiction
https://www.readbyqxmd.com/read/28498094/predictors-of-all-cause-30-day-readmission-among-medicare-patients-with-type-2-diabetes
#4
Jenna Collins, Ibrahim M Abbass, Raymond Harvey, Brandon Suehs, Claudia Uribe, Jonathan Bouchard, Todd Prewitt, Tony DeLuzio, Elsie Allen
OBJECTIVE: Readmission is costly among patients with type 2 diabetes (T2DM) in Medicare Advantage Prescription Drug Plans; identifying high-risk patients is necessary for targeting reduction programs. The objective of this study was to develop a claims-based algorithm to predict all-cause 30-day readmission among patients with T2DM. METHODS: This study used administrative data from 1/1/2012 through 1/31/2014. The cohort included hospitalized T2DM patients, aged 18-90 with ≥12 months' continuous-enrollment before an unplanned hospital admission and ≥1 month of enrollment post-discharge, excluding patients in long-term care >30 days pre-index...
May 12, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28492826/association-of-cost-sharing-with-use-of-home-health-services-among-medicare-advantage-enrollees
#5
Qijuan Li, Laura M Keohane, Kali Thomas, Yoojin Lee, Amal N Trivedi
Importance: Several policy proposals advocate introducing copayments for home health care in the Medicare program. To our knowledge, no prior studies have assessed this cost-containment strategy. Objective: To determine the association of home health copayments with use of home health services. Design, Setting, and Participants: A difference-in-differences case-control study of 18 Medicare Advantage (MA) plans that introduced copayments for home health care between 2007 and 2011 and 18 concurrent control MA plans...
May 8, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28483105/comprehensive-and-individualized-patient-care-in-idiopathic-pulmonary-fibrosis-refining-approaches-to-diagnosis-prognosis-and-treatment
#6
Fernando J Martinez, Kevin R Flaherty
As seen in this CME online activity (available at http://courses.elseviercme.com/chest16/647e), idiopathic pulmonary fibrosis (IPF) is a specific form of chronic progressive fibrotic lung disease of unknown cause. It is the most common form of idiopathic interstitial pneumonia in adults. Its prevalence among US Medicare beneficiaries has more than doubled in the past 14 years. With the approval of two agents that reduce functional decline and disease progression, and the 2015 update of the American Thoracic Society guidelines on the treatment of IPF, the options for appropriate clinical management of the disease have become well defined...
May 2017: Chest
https://www.readbyqxmd.com/read/28473189/a-tale-of-two-cancers-traveling-to-treat-pancreatic-and-thyroid-cancer
#7
Michael G White, Megan K Applewhite, Edwin L Kaplan, Peter Angelos, Dezheng Huo, Raymon H Grogan
BACKGROUND: Patients diagnosed with a malignancy must decide whether to travel for care at an academic center or receive treatment at a nearby hospital. Here we examine differences in demographics, treatment, and outcomes of those traveling to academic centers for their care vs those not traveling, as well as compare travel for an aggressive vs indolent malignancy. STUDY DESIGN: All patients with papillary thyroid carcinoma (PTC) or pancreatic ductal adenocarcinoma (PDAC) undergoing surgical resection and in the National Cancer Database were examined...
March 25, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28466088/combining-contrast-mining-with-logistic-regression-to-predict-healthcare-utilization-in-a-managed-care-population
#8
Lincoln Sheets, Gregory F Petroski, Yan Zhuang, Michael A Phinney, Bin Ge, Jerry C Parker, Chi-Ren Shyu
BACKGROUND: Because 5% of patients incur 50% of healthcare expenses, population health managers need to be able to focus preventive and longitudinal care on those patients who are at highest risk of increased utilization. Predictive analytics can be used to identify these patients and to better manage their care. Data mining permits the development of models that surpass the size restrictions of traditional statistical methods and take advantage of the rich data available in the electronic health record (EHR), without limiting predictions to specific chronic conditions...
May 3, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28461353/the-medicare-access-and-chip-reauthorization-act-and-the-corporate-transformation-of-american-medicine
#9
Lawrence P Casalino
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) may accelerate the movement of physicians into corporate employment by hospitals and, to a lesser extent, by health insurers and other corporations. This article briefly summarizes the demographics of US physician practice, the potential advantages and disadvantages of physician employment by large corporations, and the evidence to date on the performance of large versus small physician practices and hospital-employed versus independent physicians...
May 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28448784/a-motivational-interviewing-intervention-by-pharmacy-students-to-improve-medication-adherence
#10
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
#11
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
#12
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...
June 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
#13
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
#14
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
#15
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...
May 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28374489/improving-medical-record-retrieval-for-validation-studies-in-medicare-data
#16
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
#17
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
#18
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
#19
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
#20
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
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