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Medicare preventive services

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https://www.readbyqxmd.com/read/28329251/factors-associated-with-accelerated-hospitalization-and-re-hospitalization-among-medicare-home-health-patients
#1
Matthew C Lohman, Emily A Scherer, Karen L Whiteman, Rebecca L Greenberg, Martha L Bruce
Background: Preventing hospitalizations and re-hospitalizations of older adults receiving Medicare home health (HH) services is a key goal for patients and care providers. This study aimed to identify factors related to greater risk of and earlier hospitalizations from HH, a key step in targeting preventive efforts. Methods: Data come from Medicare mandated start-of-care assessments from 87,780 HH patients served by 132 agencies in 32 states, collected from January 2013 to March 2015...
January 19, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28301646/traumatic-facial-injuries-among-elderly-nursing-home-residents-never-event-or-frequent-occurrence
#2
Michael Bobian, Nour El-Kashlan, Curtis J Hanba, Peter F Svider, Adam J Folbe, Jean Anderson Eloy, Giancarlo F Zuliani, Michael Carron
Importance: As the nursing home population continues to increase, an understanding of preventable injuries becomes exceedingly important. Although other fall-related injuries have been characterized, little attention has been dedicated to facial trauma. Objectives: To estimate the incidence of facial trauma among nursing home residents and detail mechanisms of injury, injury characteristics, and patient demographic data. Design, Setting, and Participants: The National Electronic Injury Surveillance System was used to calculate a weighted national incidence of facial trauma among individuals older than 60 years from a nationally representative collection of emergency departments from January 1, 2011, through December 31, 2015...
March 16, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28290933/leveraging-the-partnership-for-patients-initiative-to-improve-patient-safety-and-quality-within-the-military-health-system
#3
Heidi B King, Kimberly Kesling, Carmen Birk, Theodore Walker, Heather Taylor, Michael Datena, Brittany Burgess, Lyndsay Bower
INTRODUCTION: Partnership for Patients (PfP) was a national initiative sponsored by the Department of Health and Human Services, Centers for Medicare and Medicaid Services, to reduce preventable hospital acquired conditions (HACs) by 40% and readmissions (within 30 days) by 20%, by the end of 2013 (as compared to the baseline of CY2010). Along with partners across the nation, the Assistant Secretary of Defense for Health Affairs, Dr. Jonathan Woodson, pledged to support PfP in June 2011...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28273181/evaluating-lung-cancer-screening-in-china-implications-for-eligibility-criteria-design-from-a-microsimulation-modeling-approach
#4
Deirdre F Sheehan, Steven D Criss, G Scott Gazelle, Pari V Pandharipande, Chung Yin Kong
More than half of males in China are current smokers and evidence from western countries tells us that an unprecedented number of smoking-attributable deaths will occur as the Chinese population ages. We used the China Lung Cancer Policy Model (LCPM) to simulate effects of computed tomography (CT)-based lung cancer screening in China, comparing the impact of a screening guideline published in 2015 by a Chinese expert group to a version developed for the United States by the U.S. Centers for Medicare & Medicaid Services (CMS)...
2017: PloS One
https://www.readbyqxmd.com/read/28264942/impact-of-the-ymca-of-the-usa-diabetes-prevention-program-on-medicare-spending-and-utilization
#5
Maria L Alva, Thomas J Hoerger, Ravikumar Jeyaraman, Peter Amico, Lucia Rojas-Smith
The YMCA of the USA received a Health Care Innovation Award from the Centers for Medicare and Medicaid Services to provide a diabetes prevention program to Medicare beneficiaries with prediabetes in seventeen regional networks of participating YMCAs nationwide. The goal of the program is to help participants lose weight and increase physical activity. We tested whether the program reduced medical spending and utilization in the Medicare population. Using claims data to compute total medical costs for fee-for-service Medicare participants and a matched comparison group of nonparticipants, we found that the overall weighted average savings per member per quarter during the first three years of the intervention period was $278...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28263369/hospital-variation-in-rates-of-new-institutionalizations-within-6-months-of-discharge
#6
Addie Middleton, Jie Zhou, Kenneth J Ottenbacher, James S Goodwin
OBJECTIVES: Hospitalization in community-dwelling elderly is often accompanied by functional loss, increasing the risk for continued functional decline and future institutionalization. The primary objective of our study was to examine the hospital-level variation in rates of new institutionalizations among Medicare beneficiaries. DESIGN: Retrospective cohort study. SETTING: Hospitals and nursing homes. PARTICIPANTS: Medicare fee-for-service beneficiaries discharged from 4,469 hospitals in 2013 (N = 4,824,040)...
March 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28263280/disparities-in-potentially-preventable-hospitalizations-between-american-indian-and-alaska-native-and-non-hispanic-white-medicare-enrollees
#7
Joan O'Connell, Jennifer Rockell, Judith C Ouellet, Mark LeBeau
OBJECTIVE: A number of health care initiatives seek to improve health outcomes by increasing access to outpatient services while reducing preventable acute events. We evaluated disparities between American Indian and Alaska Native (AI/AN) and non-Hispanic white (white) Medicare enrollees in access to outpatient preventive, primary, and specialty services by comparing their potentially preventable hospitalizations (PPHs). RESEARCH DESIGN: The study population included 121,311 adult AI/AN Medicare enrollees registered to use services funded by the Indian Health Service and 5,915,011 adult white enrollees living in the same counties...
March 3, 2017: Medical Care
https://www.readbyqxmd.com/read/28230451/positive-medication-changes-resulting-from-comprehensive-and-noncomprehensive-medication-reviews-in-a-medicare-part-d-population
#8
Allison Buhl, Jill Augustine, Ann M Taylor, Rose Martin, Terri L Warholak
BACKGROUND: Health care organizations face the challenge of reducing costs while improving health outcomes. Currently, more than 39 million seniors are enrolled in a Medicare Part D prescription benefit plan, many of whom also qualify for medication therapy management (MTM) services. MTM programs provide valuable services designed to prevent or resolve medication-related problems (MRPs). Two core components of all MTM programs include comprehensive medication reviews (CMRs) with followup interventions and focused non-CMR interventions...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28209490/surgical-site-infection-in-gynecologic-surgery-pathophysiology-and%C3%A2-prevention
#9
REVIEW
Holly L Steiner, Eric A Strand
Surgical-site infections (SSIs) represent a well-known cause of patient morbidity as well as added health care costs. In gynecologic surgery, particularly hysterectomy, SSIs are often the result of a number of risk factors that may or may not be modifiable. As both the Centers for Medicaid and Medicare Services and the Joint Commission on the Accreditation of Healthcare Organizations have identified SSIs as a patient safety priority, gynecologic surgeons continue to seek out the most effective interventions for SSI prevention...
February 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28201949/evaluating-efficacy-of-current-lung-cancer-screening-guidelines
#10
Barbara Nemesure, April Plank, Lisa Reagan, Denise Albano, Michael Reiter, Thomas V Bilfinger
Objective Current lung cancer screening criteria based primarily on outcomes from the National Lung Screening Trial may not adequately capture all subgroups of the population at risk. We aimed to evaluate the efficacy of lung cancer screening criteria recommended by the United States Preventive Services Task Force, Centers for Medicare and Medicaid Services, and the National Comprehensive Cancer Network in identifying known cases of lung cancer. Methods An investigation of the Stony Brook Cancer Center Lung Cancer Evaluation Center's database identified 1207 eligible, biopsy-proven lung cancer cases diagnosed between January 1996 and March 2016...
January 1, 2017: Journal of Medical Screening
https://www.readbyqxmd.com/read/28192676/crossing-boundaries
#11
Leighton Ku, Erika Steinmetz, Tyler Bysshe, Brian K Bruen
OBJECTIVES: Previous state interagency collaborations have led to successful tobacco cessation initiatives. The objective of this study was to assess the roles and interaction of state Medicaid and public health agency efforts to support tobacco cessation for low-income Medicaid beneficiaries. METHODS: We interviewed Medicaid and state public health agency officials in 8 states in September and October 2015 about collaborations in policy development and implementation for Medicaid tobacco cessation, including Medicaid coverage policies, quitlines, and monitoring...
March 2017: Public Health Reports
https://www.readbyqxmd.com/read/28161033/hepatitis-c-antibody-testing-in-a-commercially-insured-population-2005-2014
#12
Cheryl J Isenhour, Susan H Hariri, Craig M Hales, Claudia J Vellozzi
INTRODUCTION: In the U.S., the burden of hepatitis C virus (HCV) infection and associated sequelae is substantial. HCV prevalence is highest among those born in 1945-1965 (Birth Cohort). Newly diagnosed infections are increasing in younger people concurrent with rising opioid/heroin use. The Centers for Disease Control and Prevention (2012) and U.S. Preventive Services Task Force (2013) recommend HCV testing for at-risk individuals and one-time testing for the Birth Cohort. This study describes national trends in HCV antibody testing from 2005 to 2014...
February 1, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28158163/prevalence-of-specific-types-of-pain-diagnoses-in-a-sample-of-united-states-adults
#13
Kelly Ryan Murphy, Jing L Han, Siyun Yang, Syed Mohammed Qasim Hussaini, Aladine A Elsamadicy, Beth Parente, Jichun Xie, Promila Pagadala, Shivanand P Lad
BACKGROUND: Patients with pain conditions place significant demands on health care services globally. Health economists have reported the annual economic cost of pain in the United States as high as $635 billion. A common challenge in treating patients suffering from chronic pain conditions is accurate diagnosis and treatment. OBJECTIVE: The aim of this study was to determine the modern-day prevalence of individual types of pain diagnoses in adults. STUDY DESIGN: Retrospective analysis of Truven MarketScan® Commercial and Medicare Supplemental database...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28152833/understanding-total-cost-of-cancer-care-to-determine-strategic-interventions-to-improve-value
#14
Salimah Velji, Kavita Patel, Basit Chaudhry, Sonia Grizzle, Catherine A Lyons, Rogerio Lilenbaum
3 Background: Cancer centers across the country are largely unprepared to move toward value-based payment. Total cost of care data is not readily available and centers do not know how much of their patients' care is received at other hospitals, when in the trajectory of illness greatest cost is incurred, or the elements of care that present the greatest opportunity for savings. A previous examination of practice patterns Smilow Cancer Hospital (SCH) demonstrated that our patients had high rates of ED visits, hospital admissions and ICU use in their last month of life...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28148486/early-death-after-discharge-from-emergency-departments-analysis-of-national-us-insurance-claims-data
#15
Ziad Obermeyer, Brent Cohn, Michael Wilson, Anupam B Jena, David M Cutler
OBJECTIVE:  To measure incidence of early death after discharge from emergency departments, and explore potential sources of variation in risk by measurable aspects of hospitals and patients. DESIGN:  Retrospective cohort study. SETTING:  Claims data from the US Medicare program, covering visits to an emergency department, 2007-12. PARTICIPANTS:  Nationally representative 20% sample of Medicare fee for service beneficiaries...
February 1, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28144834/society-for-health-psychology-apa-division-38-and-society-of-behavioral-medicine-joint-position-statement-on-the-medicare-diabetes-prevention-program
#16
Stephanie L Fitzpatrick, Dawn K Wilson, Sherry L Pagoto
Beginning in January 2018, the Centers for Medicare and Medicaid Services (CMS) plans to cover the Diabetes Prevention Program (DPP), also referred to as Medicare DPP. The American Psychological Association Society for Health Psychology (SfHP) and the Society for Behavioral Medicine (SBM) reviewed the proposed plan. SfHP and SBM are in support of the CMS decision to cover DPP for Medicare beneficiaries but have a significant concern that aspects of the proposal will limit the public health impact. Concerns include the emphasis on weight outcomes to determine continued coverage and the lack of details regarding requirements for coaches...
January 31, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28122873/rising-stakes-for-healthcare-associated-infection-prevention-implications-for-the-clinical-microbiology-laboratory-revised
#17
Daniel J Diekema
Healthcare associated infection (HAI) rates are subject to public reporting, and are linked to hospital reimbursement from the Centers for Medicare and Medicaid Services (CMS). The increasing pressure to lower HAI rates comes at a time when advances in the clinical microbiology laboratory (CML) provide more precise and sensitive tests, altering HAI detection in ways that may increase reported HAI rates. I review how changing CML practices can impact HAI rates, and how the financial implications of HAI metrics may produce pressure to change diagnostic testing practices...
January 25, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28115082/the-esrd-quality-incentive-program-the-current-limitations-of-evidence-and-data-to-develop-measures-drive-improvement-and-incentivize-outcomes
#18
REVIEW
Louis H Diamond, Andrew D Howard
This article describes the current state of facilitating the integration of evidence into practice to support initiatives focused on patients with ESRD. We will use the Centers for Medicare and Medicaid Services (CMS) ESRD Quality Incentive Program (QIP) as an example, including a description of the health information infrastructure needed to support the translation of evidence into practice and some of the challenges encountered. The process from the generation of evidence to integration of this evidence into practice includes policy development leading to clinical practice guidelines, clinical performance measures, and clinical decision support tools...
November 2016: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28102988/medicaid-program-the-use-of-new-or-increased-pass-through-payments-in-medicaid-managed-care-delivery-systems-final-rule
#19
(no author information available yet)
This rule finalizes changes to the pass-through payment transition periods and the maximum amount of pass-through payments permitted annually during the transition periods under Medicaid managed care contract(s) and rate certification(s). This final rule prevents increases in pass-through payments and the addition of new pass-through payments beyond those in place when the pass-through payment transition periods were established, in the final Medicaid managed care regulations effective July 5, 2016.
January 18, 2017: Federal Register
https://www.readbyqxmd.com/read/28093055/low-rates-of-hiv-testing-among-adults-with-severe-mental-illness-receiving-care-in-community-mental-health-settings
#20
Christina Mangurian, Francine Cournos, Dean Schillinger, Eric Vittinghoff, Jennifer M Creasman, Bernard Lee, Penelope Knapp, Elena Fuentes-Afflick, James W Dilley
OBJECTIVE: This research aimed to characterize HIV testing rates among Medicaid recipients with severe mental illness who received public specialty mental health services. METHODS: This retrospective cohort study examined California Medicaid records from October 1, 2010, to September 30, 2011 (N=56,895). Study participants were between age 18 and 67, utilized specialty mental health care services, were prescribed antipsychotic medications, and were not dually eligible for Medicare...
January 17, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
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