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https://www.readbyqxmd.com/read/28829924/the-10-conditions-that-increased-vermont-s-readiness-to-implement-statewide-health-system-transformation
#1
David Grembowski, Miriam Marcus-Smith
Following an arduous, 6-year policy-making process, Vermont is the first state implementing a unified, statewide all-payer integrated delivery system with value-based payment, along with aligned medical and social service reforms, for almost all residents and providers in a state. Commercial, Medicare, and Medicaid value-based payment for most Vermonters will be administered through a new statewide accountable care organization in 2018-2022. The purpose of this article is to describe the 10 conditions that increased Vermont's readiness to implement statewide system transformation...
August 22, 2017: Population Health Management
https://www.readbyqxmd.com/read/28828915/equity-in-medicaid-reimbursement-for-otolaryngologists
#2
Joseph H Conduff, Daniel H Coelho
Objective To study state Medicaid reimbursement rates for inpatient and outpatient otolaryngology services and to compare with federal Medicare benchmarks. Study Design State and federal database query. Setting Not applicable. Methods Based on Medicare claims data, 26 of the most common Current Procedural Terminology codes reimbursed to otolaryngologists were selected and the payments recorded. These were further divided into outpatient and operative services. Medicaid payment schemes were queried for the same services in 49 states and Washington, DC...
August 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28822996/examining-bias-in-studies-of-statin-treatment-and-survival-in-patients-with-cancer
#3
Louise Emilsson, Xabier García-Albéniz, Roger W Logan, Ellen C Caniglia, Mette Kalager, Miguel A Hernán
Importance: Patients with cancer who use statins appear to have a substantially better survival than nonusers in observational studies. However, this inverse association between statin use and mortality may be due to selection bias and immortal-time bias. Objective: To emulate a randomized trial of statin therapy initiation that is free of selection bias and immortal-time bias. Design, Setting, and Participants: We used observational data on 17 372 patients with cancer from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database (2007-2009) with complete follow-up until 2011...
August 20, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28822325/are-there-regional-tendencies-toward-controversial-screening-practices-a-study-of-prostate-and-breast-cancer-screening-in-a-medicare-population
#4
Eric Raffin, Tracy Onega, Julie Bynum, Andrea Austin, Donald Carmichael, Kristen Bronner, Philip Goodney, Elias S Hyams
INTRODUCTION: Prostate and breast cancer screening in older patients continue to be controversial. Balancing the desire for early detection with avoidance of over-diagnosis has led to competing and contradictory guidelines for both practices. Despite similarities, it is not known how these screening practices are related at the regional level. In this study, we examined how screening PSA and mammography are related within healthcare regions, and, to better understand what may be driving these practices, whether they are associated with local intensity of care...
August 16, 2017: Cancer Epidemiology
https://www.readbyqxmd.com/read/28819930/association-between-patient-satisfaction-and-short-term-outcomes-after-major-cancer-surgery
#5
Deborah R Kaye, Caroline R Richardson, Zaojun Ye, Lindsey A Herrel, Chad Ellimoottil, David C Miller
OBJECTIVE: The aim of this study was to investigate whether patient satisfaction, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, is associated with short-term outcomes after major cancer surgery. MATERIALS AND METHODS: We first used national Medicare claims to identify patients who underwent a major extirpative cancer surgery from 2011 to 2013. Next, we used Hospital Compare data to assign the HCAHPS score to the hospital where the patient underwent surgery...
August 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28818215/age-is-not-a-barrier-to-good-outcomes-after-varicose-vein-procedures
#6
Danielle C Sutzko, Elizabeth A Andraska, Andrea T Obi, Mikel Sadek, Lowell S Kabnick, Thomas W Wakefield, Nicholas H Osborne
BACKGROUND: The Vascular Quality Initiative (VQI) Varicose Vein Registry (VVR) represents a patient-centered database launched in January 2015. Previous work describing overall trends and outcomes of varicose vein procedures across the United States demonstrates a benefit from these procedures. The existing gaps in evidence to support current and future Medicare coverage of varicose vein procedures necessitate further description of clinical outcomes in patients ≥65 years old compared with the population <65 years old...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28817348/palliative-care-consults-in-u-s-nursing-homes-not-just-for-the-dying
#7
Julie C Lima, Susan C Miller
BACKGROUND: Little is known about nursing home (NH) residents who receive palliative care (PC) consults in the United States. OBJECTIVE: Separately by short versus long (≥90 days) stays, to describe NH residents with PC consults compared to a prevalent NH sample. DESIGN: Descriptive longitudinal study. SETTING/SUBJECTS: NH residents in 2008-2010 in 54 NHs. MEASUREMENTS: Resident characteristics came from merged Medicare and NH data from the Centers for Medicare and Medicaid Services and consult information from two PC organizations that were the sole PC consult providers in the study NHs...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28817295/does-the-offer-of-free-prescriptions-increase-generic-prescribing
#8
Bruce Stuart, Franklin Hendrick, J Samantha Dougherty, Jing Xu
OBJECTIVES: To test if offering zero generic co-pays for oral antidiabetic drugs (OADs) and statins increases generic dispensing for low-income subsidy (LIS) recipients with diabetes enrolled in Medicare Part D. STUDY DESIGN: We analyzed a natural experiment in which LIS recipients were randomized to Part D plans in 2008. Some plans placed selected generic OADs and statins on zero co-pay tiers whereas others did not. Randomization eliminated selection effects which could bias the study findings...
June 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28816929/effectiveness-and-value-of-prophylactic-5-layer-foam-sacral-dressings-to-prevent-hospital-acquired-pressure-injuries-in-acute-care-hospitals-an-observational-cohort-study
#9
William V Padula
PURPOSE: The purpose of this study was to examine the effectiveness and value of prophylactic 5-layer foam sacral dressings to prevent hospital-acquired pressure injury rates in acute care settings. DESIGN: Retrospective observational cohort. SAMPLE AND SETTING: We reviewed records of adult patients 18 years or older who were hospitalized at least 5 days across 38 acute care hospitals of the University Health System Consortium (UHC) and had a pressure injury as identified by Patient Safety Indicator #3 (PSI-03)...
August 15, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28816220/incidents-of-violence-against-doctors-in-india-can-these-be-prevented
#10
Neeraj Nagpal
Violence against doctors is on the rise all over the world. However, India has a unique problem. Meagre government spending on healthcare has resulted in poor infrastructure and human resource crunch in government hospitals. Hence, people are forced to seek private healthcare. Small and medium private healthcare establishments, which provide the bulk of healthcare services, are isolated, disorganized and vulnerable to violence. Violence against health service providers is only a manifestation of this malady...
March 2017: National Medical Journal of India
https://www.readbyqxmd.com/read/28813635/standardization-and-scaling-of-a-community-based-palliative-care-model
#11
Janet Bull, Arif H Kamal, Matthew Harker, Donald H Taylor, Lindsay Bonsignore, John Morris, Lisa Massie, Parampal Singh Bhullar, Mary Howell, Mark Hendrix, Deeana Bennett, Amy Abernethy
BACKGROUND: Although limited, the descriptions of Community-Based Palliative Care (CBPC) demonstrates variability in team structures, eligibility, and standardization across care settings. OBJECTIVE: In 2014, Four Seasons Compassion for Life, a nonprofit hospice and palliative care (PC) organization in Western North Carolina (WNC), was awarded a Centers for Medicare and Medicaid Services Health Care Innovation (CMMI) Award to expand upon their existing innovative model to implement, evaluate, and demonstrate CBPC in the United States...
August 16, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28812229/economics-and-cost-effectiveness-of-multiple-sclerosis-therapies-in-the-usa
#12
REVIEW
Daniel M Hartung
Multiple sclerosis (MS) is a disabling, chronic disease that imposes a significant economic burden on patients and the US healthcare system. The largest cost component for individuals with MS are prescription drugs, specifically disease-modifying therapies (DMTs). Despite an increase in the number and diversity of DMTs over the past 10 years, acquisition costs for all DMTs have escalated dramatically at rates substantially higher than medical inflation. Currently, costs for most DMTs exceed $70,000 a year. Recent cost-effectiveness studies suggest the cost for nearly all DMTs exceeds generally accepted thresholds for what is considered a good value in the USA, even after factoring expected rebates...
August 15, 2017: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/28809035/nurse-staffing-patterns-and-patient-experience-of-care-an-empirical-analysis-of-u-s-hospitals
#13
Eva-Maria Oppel, Gary J Young
OBJECTIVE: To examine the relationship between nurse staffing patterns and patients' experience of care in hospitals with a particular focus on staffing flexibility. DATA SOURCES/STUDY SETTING: The study sample comprised U.S. general hospitals between 2010 and 2012. Nurse staffing data came from the American Hospital Association Annual Survey, and patient experience data came from the Medicare Hospital Consumer Assessment of Healthcare Providers and Systems. STUDY DESIGN: An observational research design was used entailing a pooled, cross-sectional data set...
August 14, 2017: Health Services Research
https://www.readbyqxmd.com/read/28808668/physician-preferences-for-aggressive-treatment-at-the-end-of-life-and-area-level-health-care-spending-the-johns-hopkins-precursors-study
#14
Joseph J Gallo, Martin S Andersen, Seungyoung Hwang, Lucy Meoni, Ravishankar Jayadevappa
Objective: To determine whether physician preferences for end-of-life care were associated with variation in health care spending. Method: We studied 737 physicians who completed the life-sustaining treatment questionnaire in 1999 and were linked to end-of-life care data for the years 1999 to 2009 from Medicare-eligible beneficiaries from the Dartmouth Atlas of Health Care (in hospital-related regions [HRRs]). Using latent class analysis to group physician preferences for end-of-life treatment into most, intermediate, and least aggressive categories, we examined how physician preferences were associated with health care spending over a 7-year period...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/28805961/reducing-branded-prescription-drug-prices-a-review-of-policy-options
#15
G Caleb Alexander, Jeromie Ballreich, Mariana P Socal, Taruja Karmarkar, Antonio Trujillo, Jeremy Greene, Joshua Sharfstein, Gerard Anderson
The high prices of specialty pharmaceuticals are causing some public programs to ration care and many private insurers, including Medicare drug plans, to place specialty drugs on high cost sharing tiers. As a result, access to these drugs is severely restricted, and only a small portion of the population with the disease is receiving treatment. This concern has generated a wide range of proposed solutions. We conducted a literature review and identified fifty-two solutions in the peer reviewed literature that we classified into five broad categories: revising the patent system; encouraging research to increase development of new drugs; altering pharmaceutical regulation; decreasing market demand; and developing innovative pricing strategies...
August 14, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28805473/the-impact-of-persistence-with-mirabegron-usage-versus-switching-to-onabotulinumtoxina-on-healthcare-costs-and-resource-utilization-in-patients-with-overactive-bladder-in-the-united-states
#16
Daniel Bin Ng, Robert Espinosa, Scott J Johnson, David Walker, Katherine Gooch
Aims To compare healthcare costs and resource utilization in patients with overactive bladder (OAB) in the United States who switch from mirabegron to onabotulinumtoxinA (onabotA) with those who persist on mirabegron. Materials and methods A retrospective observational claims analysis of the OptumHealth Administrative Claims database conducted between April 1, 2012 and September 30, 2015 used medical and pharmacy claims to identify patients with at least one OAB diagnosis who switched from mirabegron to onabotA (onabotA group) or persisted on mirabegron for at least 180 days (mirabegron persisters)...
August 14, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28805423/patterns-of-psychiatric-emergency-department-utilization-among-community-dwelling-medicare-beneficiaries-under-65
#17
Jingjing Qian, Saranrat Wittayanukorn, Richard A Hansen
This study estimated patterns and trends in all-cause (any reason, including psychiatry related) and psychiatric emergency department (ED) utilization among Medicare beneficiaries under 65 who were residing in community settings (i.e., noninstitutionalized or in their own homes). Medicare beneficiaries under the age of 65 enrolled in Medicare for Social Security Disability Insurance (SSDI) due to permanent physical or mental disabilities are a population with poor health conditions and high utilization of health services; however, this vulnerable population has received limited attention from researchers and policymakers compared to the Medicare beneficiaries 65 years and older...
August 2017: Psychological Services
https://www.readbyqxmd.com/read/28802813/evaluating-hospital-readmission-rates-after-discharge-from-inpatient-rehabilitation
#18
Laura Coots Daras, Melvin J Ingber, Jessica Carichner, Daniel Barch, Anne Deutsch, Laura M Smith, Alan Levitt, Joel Andress
OBJECTIVE: To examine facility-level rates of all-cause, unplanned hospital readmissions for 30 days following discharge from inpatient rehabilitation facilities (IRFs). DESIGN: Using an observational design, we analyzed Medicare claims in order to develop an all-cause, risk-adjusted hospital readmission measure. SETTING: We used national Medicare inpatient claims and enrollment data for Medicare beneficiaries who were discharged from IRFs in 2013-2014 and met specific inclusion criteria (1,166 IRFs)...
August 9, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28801110/risk-factors-for-30-day-readmission-in-patients-with-congestive-heart-failure
#19
Katelin A Mirkin, Laura M Enomoto, Gregory M Caputo, Christopher S Hollenbeak
BACKGROUND: Risk of readmission is elevated in patients congestive heart failure (CHF), and clinical decision makers need to better understand risk factors for 30-day readmissions. OBJECTIVE: To identify risk factors for readmission in patients with CHF. METHODS: We studied all admissions for patients with CHF during 2011 using a statewide discharge data set from Pennsylvania. The primary outcome was readmission to any Pennsylvania hospital within 30 days of discharge...
August 8, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28800918/the-timing-of-hip-arthroscopy-after-intra-articular-hip-injection-affects-postoperative-infection-risk
#20
Dean Wang, Christopher L Camp, Anil S Ranawat, Struan H Coleman, Bryan T Kelly, Brian C Werner
PURPOSE: To evaluate the association of preoperative intra-articular hip injection with surgical site infection after hip arthroscopy. METHODS: A large administrative database was used to identify all patients undergoing hip arthroscopy from 2007 to 2015 within a single private insurer and from 2005 to 2012 within Medicare in the United States. Those that received an ipsilateral preoperative intra-articular hip injection were identified. The patients were then divided into the following groups based on the interval between preoperative injection and ipsilateral hip arthroscopy: (1) <3 months, (2) 3 to 6 months, and (3) 6 to 12 months...
August 8, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
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