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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/29162106/extent-regional-variation-and-impact-of-gynecologist-payment-models-in-routine-pelvic-examinations-a-nationwide-cross-sectional-study
#2
Ingvild Mathiesen Rosenlund, Linda Leivseth, Ingard Nilsen, Olav Helge Førde, Arthur Revhaug
BACKGROUND: Based on moderate quality evidence, routine pelvic examination is strongly recommended against in asymptomatic women. The aims of this study was to quantify the extent of routine pelvic examinations within specialized health care in Norway, to assess if the use of these services differs across hospital referral regions and to assess if the use of colposcopy and ultrasound differs with gynecologists' payment models. METHODS: Nationwide cross-sectional study including all women aged 18 years and older in Norway in the years 2014-16 (2,038,747)...
November 21, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/29157566/is-health-care-payment-reform-impacting-nurses-work-settings-roles-and-education-preparation
#3
Mary Val Palumbo, Betty Rambur, Vicki Hart
This study explores nurses' work settings and educational preparation in the five years before passage of the Affordable Care Act (ACA) and five years after ACA passage, with the aim of identifying areas for nurse educators' attention. The study setting was one small state undergoing rapid transition away from fee-for-service service and thus provided the ideal laboratory to assess the impact of health reform on the nursing workforce. A secondary analysis of data gathered during relicensure compared the nursing workforce at an interval of one decade, with surveys in 2005 (n=4075; 65% response rate) and in 2015 (n=6723; 97% response rate)...
November 2017: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
https://www.readbyqxmd.com/read/29149139/reversal-of-growth-of-utilization-of-interventional-techniques-in-managing-chronic-pain-in-medicare-population-post-affordable-care-act
#4
Laxmaiah Manchikanti, Amol Soin, Dharam P Mann, Sanjay Bakshi, Vidyasagar Pampati, Joshua A Hirsch
BACKGROUND: Over the past 2 decades, the increase in the utilization of interventional techniques has been a cause for concern. Despite multiple regulations to reduce utilization of interventional techniques, growth patterns continued through 2009. A declining trend was observed in a previous evaluation; however, a comparative analysis of utilization patterns of interventional techniques has not been performed showing utilization before and after the enactment of the Affordable Care Act (ACA)...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29145463/the-chicken-or-the-egg-exploring-bi-directional-associations-between-newcastle-disease-vaccination-and-village-chicken-flock-size-in-rural-tanzania
#5
Julia de Bruyn, Peter C Thomson, Brigitte Bagnol, Wende Maulaga, Elpidius Rukambile, Robyn G Alders
Newcastle disease (ND) is a viral disease of poultry with global importance, responsible for the loss of a potential source of household nutrition and economic livelihood in many low-income food-deficit countries. Periodic outbreaks of this endemic disease result in high mortality amongst free-ranging chicken flocks and may serve as a disincentive for rural households to invest time or resources in poultry-keeping. Sustainable ND control can be achieved through vaccination using a thermotolerant vaccine administered via eyedrop by trained "community vaccinators"...
2017: PloS One
https://www.readbyqxmd.com/read/29143169/predictors-and-patterns-of-psychiatric-treatment-dropout-during-pregnancy-among-low-income-women
#6
Sara L Kornfield, Christina D Kang-Yi, David S Mandell, C Neill Epperson
Objective This study compared psychiatric treatment discontinuation rates among pregnant women using psychotropic medications, outpatient psychotherapy, or both before conception. Methods Using data from Pennsylvania Medicaid Fee-For-Service and Managed Care Organization claims and Medicaid enrollment, 3030 women were identified who gave birth between 2007 and 2009, had ≥ 1 claim for psychiatric treatment during the 120 days prior to pregnancy, and were enrolled in Medicaid until they delivered. Kaplan-Meier and Cox regression analyses were used to estimate psychiatric treatment dropout rate during pregnancy and examine relationships between treatment dropout and age, race/ethnicity, and pre-pregnancy psychiatric diagnosis and treatment pattern...
November 15, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29141787/the-five-things-we-all-need-to-know-about-macra-and-alternative-payment-systems-to-compete-and-flourish
#7
REVIEW
Michael C Dalsing
Changes in how patient care will be reimbursed in the future are being determined right now. The law has changed to eliminate the past method of fee for service funded by the sustainable growth rate formula to payment based on quality. You need to know how the system functions to prevent a 4% reduction in Medicare reimbursement in 2019. You need to know this now because data collected today in 2017 will determine your rate for 2019. This review provides you knowledge of how the system has changed, what is required of you right now to be successful, and how you can succeed in the future...
November 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29139330/comparing-care-for-dual-eligibles-across-coverage-models-empirical-evidence-from-oregon
#8
Hyunjee Kim, Christina J Charlesworth, K John McConnell, Jennifer B Valentine, David C Grabowski
Dual-eligible beneficiaries or "duals" are individuals enrolled in both the Medicare and Medicaid programs. For both Medicare and Medicaid, they may be enrolled in fee-for-service or managed care, creating a mix of possible coverage models. Understanding these different models is essential to improving care for duals. Using All-Payer All-Claims data, we empirically described health service use and quality of care for Oregon duals across five coverage models with different combinations of fee-for-service, managed care, and plan alignment status across Medicare and Medicaid...
November 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29139055/downstream-breast-imaging-following-screening-mammography-in-medicare-patients-with-advanced-cancer-a-population-based-study
#9
Gelareh Sadigh, Richard Duszak, Kevin C Ward, Renjian Jiang, Jeffrey M Switchenko, Kimberly E Applegate, Ruth C Carlos
BACKGROUND: Screening tests are generally not recommended in patients with advanced cancer and limited life expectancy. Nonetheless, screening mammography still occurs and may lead to follow-up testing. OBJECTIVE: We assessed the frequency of downstream breast imaging following screening mammography in patients with advanced colorectal or lung cancer. DESIGN: Population-based study. PARTICIPANTS: The study included continuously enrolled female fee-for-service Medicare beneficiaries ≥65 years of age with advanced colorectal (stage IV) or lung (stage IIIB-IV) cancer reported to a Surveillance, Epidemiology, and End Results (SEER) registry between 2000 and 2011...
November 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29136217/smoking-cessation-benefit-utilization-comparing-methodologies-for-measurement-using-new-york-state-s-medicaid-data
#10
Kevin Malloy, Anisa Proj, Haven Battles, Theresa Juster, Christina Ortega-Peluso, Meng Wu, Harlan Juster
Introduction: Pharmacotherapy and counseling for tobacco cessation are evidence based methods that increase successful smoking cessation attempts. Medicaid programs are required to provide coverage for smoking cessation services. Monitoring utilization is desirable for program evaluation and quality improvement. Various methodologies have been used to study utilization. Many factors can influence results, perhaps none more than how smokers are identified. This study evaluated utilization of smoking cessation services using various methods to estimate the number of smokers within New York State's (NYS's) Medicaid program in 2015...
November 9, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/29135621/efficacy-of-implementation-of-a-chest-pain-center-at-a-community-hospital
#11
Alexandra Davis, Jason Chiu, Stanley K Lau, Yih Jen Kok, Jonathan Y H Wu
INTRODUCTION: Chest pain is the second leading cause for emergency department (ED) visits in the United States; however, <20% of the patients have acute coronary syndrome that require immediate attention. The HEART score is designed for rapid risk stratification of ED chest pain patients using the following criteria: history, electrocardiogram, age, risk factors, and troponin. It has been shown to be superior in identifying patients with low (HEART score 0-3) and high (7-10) risk of major adverse cardiac events, who can then be rapidly discharged or admitted for intervention...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29135615/diffusion-of-bevacizumab-across-oncology-practices-an-observational-study
#12
Nancy L Keating, Haiden A Huskamp, Deborah Schrag, John M McWilliams, Barbara J McNeil, Bruce E Landon, Michael E Chernew, Sharon-Lise T Normand
BACKGROUND: Technological advances can improve care and outcomes but are a primary driver of health care spending growth. Understanding diffusion and use of new oncology therapies is important, given substantial increases in prices and spending on such treatments. OBJECTIVES: Examine diffusion of bevacizumab, a novel (in 2004) and high-priced biologic cancer therapy, among US oncology practices during 2005-2012 and assess variation in use across practices. RESEARCH DESIGN: Population-based observational study...
November 10, 2017: Medical Care
https://www.readbyqxmd.com/read/29132990/beneficiary-characteristics-and-vaccinations-in-the-end-stage-renal-disease-medicare-beneficiary-population-an-analysis-of-claims-data-2006-2015
#13
Angela K Shen, Jeffrey A Kelman, Rob Warnock, Weiwei Zhang, Stephaeno Brereton, Stephen McKean, Michael Wernecke, Steve Chu, Bruce G Gellin
BACKGROUND: The Advisory Committee on Immunization Practices (ACIP) routinely recommends three vaccines - influenza, hepatitis B, and pneumococcal vaccines - for End-Stage Renal Disease (ESRD) dialysis patients. METHODS: We sought to assess vaccination coverage among fee-for-service (FFS) Medicare beneficiaries with ESRD who received Part B dialysis services at any point from January 1, 2006 through December 31, 2015 (through June 30, 2016 for influenza). To assess influenza vaccination rates in a given influenza season, we restricted the population to beneficiaries who were continuously enrolled in Medicare Parts A and B throughout all twelve months of that season...
November 10, 2017: Vaccine
https://www.readbyqxmd.com/read/29132952/use-of-welcome-to-medicare-visits-among-older-adults-following-the-affordable-care-act
#14
Arpit Misra, Jennifer T Lloyd, Larisa M Strawbridge, Suzanne G Wensky
INTRODUCTION: To encourage greater utilization of preventive services among Medicare beneficiaries, the 2010 Affordable Care Act waived coinsurance for the Welcome to Medicare visit, making this benefit free starting in 2011. The objective of this study was to determine the impact of the Affordable Care Act on Welcome to Medicare visit utilization. METHODS: A 5% sample of newly enrolled fee-for-service Medicare beneficiaries for 2005-2016 was used to estimate changes in Welcome to Medicare visit use over time...
November 10, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29131897/comparison-of-hospital-resource-use-and-outcomes-among-hospitalists-primary-care-physicians-and-other-generalists
#15
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/29130269/medicare-advantage-and-fee-for-service-performance-on-clinical-quality-and-patient-experience-measures-comparisons-from-three-large-states
#16
Justin W Timbie, Andy Bogart, Cheryl L Damberg, Marc N Elliott, Ann Haas, Sarah J Gaillot, Elizabeth H Goldstein, Susan M Paddock
OBJECTIVE: To compare performance between Medicare Advantage (MA) and Fee-for-Service (FFS) Medicare during a time of policy changes affecting both programs. DATA SOURCES/STUDY SETTING: Performance data for 16 clinical quality measures and 6 patient experience measures for 9.9 million beneficiaries living in California, New York, and Florida. STUDY DESIGN: We compared MA and FFS performance overall, by plan type, and within service areas associated with contracts between CMS and MA organizations...
December 2017: Health Services Research
https://www.readbyqxmd.com/read/29130267/long-term-impact-of-a-postdischarge-community-health-worker-intervention-on-health-care-costs-in-a-safety-net-system
#17
Alison A Galbraith, David J Meyers, Dennis Ross-Degnan, Marguerite E Burns, Catherine E Vialle-Valentin, Marc R Larochelle, Sharon Touw, Fang Zhang, Meredith Rosenthal, Richard B Balaban
OBJECTIVE: Patient navigators (PNs) may represent a cost-effective strategy to improve transitional care and reduce hospital readmissions. We evaluated the impact of a PN intervention on health system costs in the 180 days after discharge for high-risk patients in a safety-net system. DATA SOURCE/SETTING: Primary and secondary data from an academic safety-net health system. STUDY DESIGN: We compared per-patient utilization and costs, overall and by age, for high-risk, medical service patients randomized to the PN intervention relative to usual care between October 2011 and April 2013...
December 2017: Health Services Research
https://www.readbyqxmd.com/read/29129828/contemporary-epidemiology-of-heart-failure-in-fee-for-service-medicare-beneficiaries-across-healthcare-settings
#18
Rohan Khera, Ambarish Pandey, Colby R Ayers, Vijay Agusala, Sandi L Pruitt, Ethan A Halm, Mark H Drazner, Sandeep R Das, James A de Lemos, Jarett D Berry
BACKGROUND: To assess the current landscape of the heart failure (HF) epidemic and provide targets for future health policy interventions in Medicare, a contemporary appraisal of its epidemiology across inpatient and outpatient care settings is needed. METHODS AND RESULTS: In a national 5% sample of Medicare beneficiaries from 2002 to 2013, we identified a cohort of 2 331 939 unique fee-for-service Medicare beneficiaries ≥65-years-old followed for all inpatient and outpatient encounters over a 10-year period (2004-2013)...
November 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29129491/-population-based-analysis-of-the-healthcare-expenditure-in-catalonia-spain-what-and-who-consumes-more-resources
#19
Emili Vela, Montse Clèries, Vincenzo Alberto Vella, Cristina Adroher, Anna García-Altés
OBJECTIVE: To analyse the distribution of the expenditure according to the healthcare services and characteristics of patients, using the microdata of the Catalan population's use of healthcare services. METHODS: A fee or an indirect cost has been applied to all healthcare activities financed by CatSalut during 2014, computing the health expenditure made up by each person and adding it all up for the inhabitants of Catalonia (Spain). RESULTS: The sum of the healthcare expenditure made by all the inhabitants of Catalonia represents 97...
November 9, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/29128869/association-of-the-hospital-readmissions-reduction-program-implementation-with-readmission-and-mortality-outcomes-in-heart-failure
#20
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
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