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https://www.readbyqxmd.com/read/28634181/outcomes-after-observation-stays-among-older-adult-medicare-beneficiaries-in-the-usa-retrospective-cohort-study
#1
Kumar Dharmarajan, Li Qin, Maggie Bierlein, Jennie E S Choi, Zhenqiu Lin, Nihar R Desai, Erica S Spatz, Harlan M Krumholz, Arjun K Venkatesh
Objective To characterize rates and trends over time of emergency department treatment-and-discharge stays, repeat observation stays, inpatient stays, any hospital revisit, and death within 30 days of discharge from observation stays.Design Retrospective cohort study.Setting 4750 hospitals in the USA.Participants Nationally representative sample of Medicare fee for service beneficiaries aged 65 or over discharged after 363 037 index observation stays, 2 540 000 index emergency department treatment-and-discharge stays, and 2 667 525 index inpatient stays from 2006-11...
June 20, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28634166/development-and-validation-of-the-pediatric-medical-complexity-algorithm-pmca-version-2-0
#2
Tamara D Simon, Mary Lawrence Cawthon, Jean Popalisky, Rita Mangione-Smith
BACKGROUND AND OBJECTIVES: The Pediatric Medical Complexity Algorithm (PMCA) was developed to stratify children by level of medical complexity. We sought to refine PMCA and evaluate its performance based on the duration of eligibility and completeness of Medicaid data. METHODS: PMCA version 1.0 was applied to a cohort of 299 children insured by Washington State Medicaid with ≥1 Seattle Children's Hospital outpatient, emergency department, and/or inpatient encounter in 2012...
June 20, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28633152/state-of-pelvic-and-acetabular-surgery-in-the-developing-world-a-global-survey-of-orthopaedic-surgeons-at-surgical-implant-generation-network-sign-hospitals
#3
Paul S Whiting, Duane R Anderson, Daniel D Galat, Lewis G Zirkle, Douglas W Lundy, Hassan R Mir
OBJECTIVES: To document the current state of pelvic and acetabular surgery in the developing world and to identify critical areas for improvement in the treatment of these complex injuries. DESIGN: A 50-question online survey. SETTING: International, multicenter. PATIENTS/PARTICIPANTS: One hundred eighty-one orthopaedic surgeons at Surgical Implant Generation Network (SIGN) hospitals, which represent a cross-section of institutions in low- and middle-income countries that treat high-energy musculoskeletal trauma...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28626249/knowledge-of-free-delivery-policy-among-women-who-delivered-at-health-facilities-in-oudomxay-province-lao-pdr
#4
Tengbriacheu Chankham, Eiko Yamamoto, Joshua A Reyer, Rahman Arafat, Innoukham Khonemany, Sayamoungkhoun Panome, Dalavong Hongkham, Phommalaysith Bounfeng, Xeuthvongsa Anonh, Nobuyuki Hamajima
To promote the utilization of maternal health services and reduce financial barriers, the Laos government introduced its "Free Maternal Health Services Policy" in 2012. This policy provides free maternal health services for pregnant women, which includes costs related to treatment, transportation, food fees, referral and an incentive for four antenatal care appointments. This study aims to ascertain the knowledge level regarding this policy among Lao women and determine their level of satisfaction with the maternal service provision...
February 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/28623153/cognitive-status-of-older-adults-on-admission-to-a-skilled-nursing-facility-according-to-a-hospital-discharge-diagnosis-of-dementia
#5
Brian Downer, Kali S Thomas, Vincent Mor, James S Goodwin, Kenneth J Ottenbacher
OBJECTIVE: Describe the cognitive status on admission to a skilled nursing facility (SNF) according to a hospital discharge diagnosis of dementia in a national sample of Medicare beneficiaries. DESIGN: Retrospective cohort design. SETTING: SNFs in the United States. PARTICIPANTS: Medicare-fee-for-service beneficiaries newly admitted to an SNF within 3 days of discharge from an acute hospital during 2013-2014 (n = 1,885,015)...
June 13, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28622186/a-90-day-bundled-payment-for-primary-single-level-lumbar-discectomy-decompression-what-does-big-data-say
#6
Nikhil Jain, Sohrab S Virk, Frank M Phillips, Elizabeth Yu, Safdar N Khan
Episode-based bundling may become the major form of reimbursement for many elective spine procedures. As the amount for a 90-day episode of care is not known for a lumbar discectomy, we analyzed the previous reimbursements from Commercial payers (2007-Q2 2015), Medicare Advantage (2007-Q2 2015), and Medicare (2005-2012) for a primary single-level lumbar discectomy/decompression. Distribution of payments among various service providers was studied and a 90-day bundle was simulated. Depending on the payer type, the average facility costs constituted 59...
June 15, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28621152/racial-disparities-in-health-service-utilization-among-medicare-fee-for-service-beneficiaries-adjusting-for-multiple-chronic-conditions
#7
Krupa Gandhi, Eunjung Lim, James Davis, John J Chen
OBJECTIVE: To examine racial disparities in health services utilization in Hawaii among Medicare fee-for-service beneficiaries aged 65 years and above. METHOD: All-cause utilization of inpatient, outpatient, emergency, home health agency, and skilled nursing facility admissions were investigated using 2012 Medicare data. For each type of service, multivariable logistic regression model was used to investigate racial disparities adjusting for sociodemographic factors and multiple chronic conditions...
June 1, 2017: Journal of Aging and Health
https://www.readbyqxmd.com/read/28617175/operator-models-for-delivering-municipal-solid-waste-management-services-in-developing-countries-part-a-the-evidence-base
#8
David C Wilson, Jennifer Bangirana Kanjogera, Reka Soós, Cosmin Briciu, Stephen R Smith, Andrew D Whiteman, Sandra Spies, Barbara Oelz
This article presents the evidence base for 'operator models' - that is, how to deliver a sustainable service through the interaction of the 'client', 'revenue collector' and 'operator' functions - for municipal solid waste management in emerging and developing countries. The companion article addresses a selection of locally appropriate operator models. The evidence shows that no 'standard' operator model is effective in all developing countries and circumstances. Each city uses a mix of different operator models; 134 cases showed on average 2...
June 1, 2017: Waste Management & Research
https://www.readbyqxmd.com/read/28614267/regional-cost-and-experience-not-size-or-hospital-inclusion-helps-predict-aco-success
#9
John Schulz, Matthew DeCamp, Scott A Berkowitz
The Medicare Shared Savings Program (MSSP) continues to expand and now includes 434 accountable care organizations (ACOs) serving more than 7 million beneficiaries. During 2014, 86 of these ACOs earned over $300 million in shared savings payments by promoting higher-quality patient care at a lower cost.Whether organizational characteristics, regional cost of care, or experience in the MSSP are associated with the ability to achieve shared savings remains uncertain.Using financial results from 2013 and 2014, we examined all 339 MSSP ACOs with a 2012, 2013, or 2014 start-date...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28614244/impact-of-patient-race-and-geographical-factors-on-initiation-and-adherence-to-adjuvant-endocrine-therapy-in-medicare-breast-cancer-survivors
#10
Fabian T Camacho, Xi Tan, Héctor E Alcalá, Surbhi Shah, Roger T Anderson, Rajesh Balkrishnan
To evaluate variations in the use of adjuvant endocrine therapy (AET) by race and geography, this research examined their influence on initiation and adherence to AET in female Medicare enrollees with breast cancer, diagnosed between 2007 and 2011.Using SEER (Surveillance, Epidemiology, and End Results Program)-Medicare data from 2007 to 2001, logistic regressions with random intercept for county of residence were used to predict AET initiation during 1st year and AET adherence assessed by the medication possession ratio (MPR) during year after initiation in a sample of fee-for-service medicare beneficiaries...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28606088/developing-a-standardized-healthcare-cost-data-warehouse
#11
Sue L Visscher, James M Naessens, Barbara P Yawn, Megan S Reinalda, Stephanie S Anderson, Bijan J Borah
BACKGROUND: Research addressing value in healthcare requires a measure of cost. While there are many sources and types of cost data, each has strengths and weaknesses. Many researchers appear to create study-specific cost datasets, but the explanations of their costing methodologies are not always clear, causing their results to be difficult to interpret. Our solution, described in this paper, was to use widely accepted costing methodologies to create a service-level, standardized healthcare cost data warehouse from an institutional perspective that includes all professional and hospital-billed services for our patients...
June 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28599810/comparative-cost-benefit-analysis-of-tele-homecare-for-community-dwelling-elderly-in-japan-non-government-versus-government-supported-funding-models
#12
Miki Akiyama, Chon Abraham
OBJECTIVE: Tele-homecare is gaining prominence as a viable care alternative, as evidenced by the increase in financial support from international governments to fund initiatives in their respective countries. The primary reason for the funding is to support efforts to reduce lags and increase capacity in access to care as well as to promote preventive measures that can avert costly emergent issues from arising. These efforts are especially important to super-aged and aging societies such as in Japan, many European countries, and the United States (US)...
August 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28590150/impact-of-home-based-patient-centered-support-for-people-with-advanced-illness-in-an-open-health-system-a-retrospective-claims-analysis-of-health-expenditures-utilization-and-quality-of-care-at-end-of-life
#13
Sylvia Ek Sudat, Anjali Franco, Alice R Pressman, Kenneth Rosenfeld, Elizabeth Gornet, Walter Stewart
BACKGROUND: Home-based care coordination and support programs for people with advanced illness work alongside usual care to promote personal care goals, which usually include a preference for home-based end-of-life care. More research is needed to confirm the efficacy of these programs, especially when disseminated on a large scale. Advanced Illness Management is one such program, implemented within a large open health system in northern California, USA. AIM: To evaluate the impact of Advanced Illness Management on end-of-life resource utilization, cost of care, and care quality, as indicators of program success in supporting patient care goals...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28583465/functional-status-is-associated-with-30-day-potentially-preventable-hospital-readmissions-following-inpatient-rehabilitation-among-aged-medicare-fee-for-service-beneficiaries
#14
Addie Middleton, James E Graham, Kenneth J Ottenbacher
OBJECTIVE: To determine the association between patients' functional status at discharge from inpatient rehabilitation and 30-day potentially preventable hospital readmissions. A secondary objective was to examine the conditions resulting in these potentially preventable readmissions. DESIGN: Retrospective cohort study. SETTING: Inpatient rehabilitation facilities submitting claims to Medicare. PARTICIPANTS: National cohort of 371,846 inpatient rehabilitation discharges among aged Medicare fee-for-service beneficiaries in 2013-2014...
June 2, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28579193/relativity-screens-for-misvalued-medical-services-impact-on-noninvasive-diagnostic-radiology
#15
Andrew B Rosenkrantz, Ezequiel Silva, C Matthew Hawkins
PURPOSE: In 2006, the AMA/Specialty Society Relative Value Scale Update Committee (RUC) introduced ongoing relativity screens to identify potentially misvalued medical services for payment adjustments. We assess the impact of these screens upon the valuation of noninvasive diagnostic radiology services. METHODS: Data regarding relativity screens and relative value unit (RVU) changes were obtained from the 2016 AMA Relativity Assessment Status Report. All global codes in the 2016 Medicare Physician Fee Schedule with associated work RVUs were classified as noninvasive diagnostic radiology services versus remaining services...
June 1, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28578605/mortality-differences-between-traditional-medicare-and-medicare-advantage-a-risk-adjusted-assessment-using-claims-data
#16
Roy A Beveridge, Sean M Mendes, Arial Caplan, Teresa L Rogstad, Vanessa Olson, Meredith C Williams, Jacquelyn M McRae, Stefan Vargas
Medicare Advantage (MA) has grown rapidly since the Affordable Care Act; nearly one-third of Medicare beneficiaries now choose MA. An assessment of the comparative value of the 2 options is confounded by an apparent selection bias favoring MA, as reflected in mortality differences. Previous assessments have been hampered by lack of access to claims diagnosis data for the MA population. An indirect comparison of mortality as an outcome variable was conducted by modeling mortality on a traditional fee-for-service (FFS) Medicare data set, applying the model to an MA data set, and then evaluating the ratio of actual-to-predicted mortality in the MA data set...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28577702/the-role-of-patient-reported-outcome-measures-in-value-based-payment-reform
#17
Lee Squitieri, Kevin J Bozic, Andrea L Pusic
The U.S. health care system is currently experiencing profound change. Pressure to improve the quality of patient care and control costs have caused a rapid shift from traditional volume-driven fee-for-service reimbursement to value-based payment models. Under the 2015 Medicare Access and Children's Health Insurance Program Reauthorization Act, providers will be evaluated on the basis of quality and cost efficiency and ultimately receive adjusted reimbursement as per their performance. Although current performance metrics do not incorporate patient-reported outcome measures (PROMs), many wonder whether and how PROMs will eventually fit into value-based payment reform...
June 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28577695/mind-the-gap-hospitalizations-from-multiple-sources-in-a-longitudinal-study
#18
Samuel T Savitz, Sally C Stearns, Jennifer S Groves, Anna M Kucharska-Newton, Lindsay G S Bengtson, Lisa Wruck
BACKGROUND: Medicare claims and prospective studies with self-reported utilization are important sources of hospitalization data for epidemiologic and outcomes research. OBJECTIVES: To assess the concordance of Medicare claims merged with interview-based surveillance data to determine factors associated with source completeness. METHODS: The Atherosclerosis Risk in Communities (ARIC) study recruited 15,792 cohort participants aged 45 to 64 years in the period 1987 to 1989 from four communities...
June 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28566134/medicare-claims-data-resources-a-primer-for-policy-focused-radiology-health-services-researchers
#19
Andrew B Rosenkrantz, Danny R Hughes, Richard Duszak
As societal stakeholders call for increased evidence-based health policy, considerable attention has focused on Medicare, the country's largest payer. Concurrently, medical imaging has come under considerable scrutiny as a contributor to rising health care expenditures. Accordingly, many recent studies have focused on multiple factors related to the utilization of imaging among Medicare beneficiaries. This article summarizes several national Medicare fee-for-service data sources relevant to supporting ongoing investigations...
May 27, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28566133/variation-in-screening-mammography-rates-among-medicare-advantage-plans
#20
Andrew B Rosenkrantz, Margaret Fleming, Richard Duszak
PURPOSE: Prior studies have shown higher screening mammography rates for beneficiaries in capitated managed care Medicare Advantage (MA) plans compared with traditional fee-for-service Medicare. The aim of this study was to explore variation in screening mammography rates at the level of MA managed care plans. METHODS: Using the 2016 MA Healthcare Effectiveness Data and Information Set Public Use File, screening mammography rates were identified for all 385 reporting MA plans...
May 27, 2017: Journal of the American College of Radiology: JACR
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