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https://www.readbyqxmd.com/read/29452562/deciphering-the-sunshine-act-transparency-regulation-and-financial-conflicts-in-health-care
#1
Richard S Saver
The Physician Payments Sunshine Act ("Sunshine Act"), enacted to address financial conflicts in health care, is the first comprehensive federal legislation mandating public reporting of payments between drug companies, device manufacturers, and medicine. This article analyzes the Sunshine Act's uneven record, exploring how the law serves as an intriguing example of the uncertain case for transparency regulation in health care. The Sunshine Act's bumpy rollout demonstrates that commanding transparency through legislation can be arduous because of considerable implementation challenges...
November 2017: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29452549/characterizing-potentially-preventable-cancer-and-chronic-disease-related-emergency-department-use-in-the-year-after-treatment-initiation-a-regional-study
#2
Laura Panattoni, Catherine Fedorenko, Mikael Anne Greenwood-Hickman, Karma Kreizenbeck, Julia R Walker, Renato Martins, Keith D Eaton, John W Rieke, Ted Conklin, Bruce Smith, Gary Lyman, Scott D Ramsey
PURPOSE: As new quality metrics and interventions for potentially preventable emergency department (ED) visits are implemented, we sought to compare methods for evaluating the prevalence and costs of potentially preventable ED visits that were related to cancer and chronic disease among a commercially insured oncology population in the year after treatment initiation. METHODS: We linked SEER records in western Washington from 2011 to 2016 with claims from two commercial insurers...
February 8, 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29450487/systolic-blood-pressure-and-outcomes-in-patients-with-heart-failure-with-preserved-ejection-fraction
#3
Apostolos Tsimploulis, Phillip H Lam, Cherinne Arundel, Steven N Singh, Charity J Morgan, Charles Faselis, Prakash Deedwania, Javed Butler, Wilbert S Aronow, Clyde W Yancy, Gregg C Fonarow, Ali Ahmed
Importance: Lower systolic blood pressure (SBP) levels are associated with poor outcomes in patients with heart failure. Less is known about this association in heart failure with preserved ejection fraction (HFpEF). Objective: To determine the associations of SBP levels with mortality and other outcomes in HFpEF. Design, Setting, and Participants: A propensity score-matched observational study of the Medicare-linked Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) registry included 25 354 patients who were discharged alive; 8873 (35...
February 14, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29449950/impact-of-malnutrition-on-survival-and-healthcare-utilization-in-medicare-beneficiaries-with-diabetes-a-retrospective-cohort-analysis
#4
Naseer Ahmed, Yong Choe, Vikkie A Mustad, Sumita Chakraborty, Scott Goates, Menghua Luo, Jeffrey I Mechanick
Objective: The aim of this study was to examine the impact of pre-existing malnutrition on survival and economic implications in elderly patients with diabetes. Research design and methods: A retrospective observational study was conducted to examine the impact of malnutrition with or without other significant health conditions on survival time and healthcare costs using the Centers for Medicare and Medicaid Services (CMS) data from 1999 to 2014 for beneficiaries with a confirmed first date of initial diagnosis of diabetes (n=15 121 131)...
2018: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/29449946/prescriber-continuity-and-medication-availability-in-older-adults-with-cardiometabolic-conditions
#5
Matthew L Maciejewski, Bradley G Hammill, Corrine I Voils, Laura Ding, Elizabeth A Bayliss, Lesley H Curtis, Virginia Wang
Background: Many older adults have multiple conditions and see multiple providers, which may impact their use of essential medications. Objective: We examined whether the number of prescribers of these medications was associated with the availability of medications, a surrogate for adherence, to manage diabetes, hypertension or dyslipidemia. Methods: A retrospective cohort of 383,145 older adults with diabetes, hypertension or dyslipidemia in the US Medicare program living in 10 states...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29446874/transplant-recipients-are-vulnerable-under-the-medicare-part-d-benefit
#6
Lisa M Potter, Angela Q Maldonado, Krista L Lentine, Mark A Schnitzler, Zidong Zhang, Gregory P Hess, Edward Garrity, Bertram L Kasiske, David A Axelrod
Transplant immunosuppressants are often used off-label due to insufficient randomized prospective trial data to achieve organ-specific US Food and Drug Administration (FDA) approval. Transplant recipients who rely on Medicare Part D for immunosuppressant drug coverage are vulnerable to coverage denial for off-label prescriptions, unless use is supported by Centers for Medicare & Medicaid Services (CMS)-approved compendia. An integrated data set including national transplant registry data and 3 years of dispensed pharmacy records was used to identify the prevalence of immunosuppression use that is both off-label and not supported by CMS-approved compendia...
February 15, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29446829/injection-testosterone-and-adverse-cardiovascular-events-a-case-crossover-analysis
#7
J Bradley Layton, Dongmei Li, Christoph R Meier, Julie L Sharpless, Til Stürmer, M Alan Brookhart
CONTEXT: Exogenous testosterone administration may affect blood clotting, polycythemia, and may increase atherosclerosis, though any association with cardiovascular events is unclear. While the literature is inconclusive, some studies have suggested testosterone use may increase short-term risk of cardiovascular events and stroke, and injection testosterone may convey higher risks than other dosage forms. OBJECTIVE: We sought to evaluate the short-term cardiovascular risk of receiving injection testosterone...
February 15, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29445299/choosing-wisely-after-publication-of-level-i-evidence-in-breast-cancer-radiotherapy
#8
Joshua R Niska, Sameer R Keole, Barbara A Pockaj, Michele Y Halyard, Samir H Patel, Donald W Northfelt, Richard J Gray, Nabil Wasif, Carlos E Vargas, William W Wong
Background: Recent trials in early-stage breast cancer support hypofractionated whole-breast radiotherapy (WBRT) as part of breast-conserving therapy (BCT). Evidence also suggests that radiotherapy (RT) omission may be reasonable for some patients over 70 years. Among radiation-delivery techniques, intensity-modulated RT (IMRT) is more expensive than 3-dimensional conformal RT (3DCRT). Based on this evidence, in 2013, the American Society for Radiation Oncology (ASTRO) recommended hypofractionated schedules for women aged ≥50 years with early-stage breast cancer and avoiding routine use of IMRT for WBRT...
2018: Breast Cancer: Targets and Therapy
https://www.readbyqxmd.com/read/29444552/optometry-facilitated-teleophthalmology-an-audit-of-the-first-year-in-western-australia
#9
Stephen E Bartnik, Stephen P Copeland, Angela J Aicken, Angus W Turner
BACKGROUND: Lions Outback Vision has run a state-wide teleophthalmology service since 2011. In September 2015 the Australian federal government introduced a Medicare reimbursement for optometry-facilitated teleophthalmology consultations under specific circumstances. This audit demonstrates the first 12 months experience with this scheme. We aim to provide practical insights for others looking to embed a telemedicine program as part of delivering outreach clinical services. METHODS: A 12-month retrospective audit was performed between September 2015 and August 2016, inclusive...
February 14, 2018: Clinical & Experimental Optometry: Journal of the Australian Optometrical Association
https://www.readbyqxmd.com/read/29443647/system-level-health-care-integration-and-the-costs-of-cancer-care-across-the-disease-continuum
#10
Deborah R Kaye, Hye Sung Min, Edward C Norton, Zaojun Ye, Jonathan Li, James M Dupree, Chad Ellimoottil, David C Miller, Lindsey A Herrel
PURPOSE: Policy reforms in the Affordable Care Act encourage health care integration to improve quality and lower costs. We examined the association between system-level integration and longitudinal costs of cancer care. METHODS: We used linked SEER-Medicare data to identify patients age 66 to 99 years diagnosed with prostate, bladder, esophageal, pancreatic, lung, liver, kidney, colorectal, breast, or ovarian cancer from 2007 to 2012. We attributed each patient to one or more phases of care (ie, initial, continuing, and end of life) according to time from diagnosis until death or end of study interval...
February 13, 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29442992/emergency-department-visits-by-patients-aged-45-and-over-with-diabetes-united-states-2015
#11
Margaret J Hall, Pinyao Rui, Alexander Schwartzman
In 2015, there were an estimated 12 million emergency department (ED) visits by patients aged 45 and over with diabetes, a rate of 92 per 1,000 persons aged 45 and over. The percentage of all ED visits for patients aged 45 and over made by those with diabetes increased from 2012 to 2015. The diabetes ED visit rate was about 2.5 times higher for those aged 75 and over than the rate for those aged 45-64. Twenty-four percent of the diabetes ED visits for those aged 45-64 had Medicare as the primary expected payment source, compared with 14% of the ED visits for patients aged 45-64 without diabetes...
February 2018: NCHS Data Brief
https://www.readbyqxmd.com/read/29442297/a-single-center-cost-analysis-of-treating-primary-and-metastatic-brain-cancers-with-either-brain-laser-interstitial-thermal-therapy-litt-or-craniotomy
#12
Eric C Leuthardt, Jeff Voigt, Albert H Kim, Pete Sylvester
BACKGROUND: Brain laser interstitial thermal therapy (LITT) under magnetic resonance imaging (MRI) guidance has recently gained US clinical approval for the ablation of soft, neurological tissue. LITT is a minimally invasive alternative to craniotomy. OBJECTIVE: While safety and efficacy are the focus of most current LITT studies, it is unclear how acute care costs (inpatient care ± aftercare) of LITT compare to craniotomy in an academic medical center. Therefore, the purpose of this analysis is to examine these costs of using brain LITT under MRI guidance compared to craniotomy in complex anatomies...
March 2017: PharmacoEconomics Open
https://www.readbyqxmd.com/read/29440035/readmissions-following-a-hospitalization-for-cardiovascular-events-in-dialysis-patients-a-retrospective-cohort-study
#13
James B Wetmore, Julia T Molony, Jiannong Liu, Yi Peng, Charles A Herzog, Allan J Collins, David T Gilbertson
BACKGROUND: Hospitalization for cardiovascular disease (CVD) is common among patients receiving maintenance dialysis, but patterns of readmissions following cardiovascular events are underexplored. METHODS AND RESULTS: In this retrospective analysis of prevalent, Medicare-eligible patients receiving dialysis in 2012-2013, all live-discharge hospitalizations attributed to CVD were ascertained. Rates of all-cause, CVD-related, and non-CVD-related readmissions and death in the ensuing 10 and 30 days were calculated...
February 13, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29438483/statin-use-and-risks-of-influenza-related-outcomes-among-older-adults-receiving-standard-dose-or-high-dose-influenza-vaccines-through-medicare-during-2010-2015
#14
Hector S Izurieta, Yoganand Chillarige, Jeffrey A Kelman, Richard Forshee, Yandong Qiang, Michael Wernecke, Jill M Ferdinands, Yun Lu, Yuqin Wei, Wenjie Xu, Michael Lu, Alicia Fry, Douglas Pratt, David K Shay
Background: Statins are used to reduce cardiovascular disease risk. Recent studies suggest that statin use may be associated with an increased influenza risk among influenza vaccinees. We used Medicare data to evaluate associations between statins and risks of influenza-related encounters among vaccinees. Methods: In this retrospective cohort study, we identified Medicare beneficiaries aged >65 years who received high-dose (HD) or standard-dose (SD) influenza vaccines at pharmacies from 2010-11 through 2014-15...
February 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29436260/treatment-patterns-and-associated-health-care-costs-before-and-after-treatment-initiation-among-pulmonary-arterial-hypertension-patients-in-the-united-states
#15
Charles D Burger, A Burak Ozbay, Howard M Lazarus, Ellen Riehle, Leslie B Montejano, Gregory Lenhart, R James White
BACKGROUND: Despite multiple treatment options, the prognosis of pulmonary arterial hypertension (PAH) remains poor. PAH patients experience a high economic burden due to comorbidities, hospitalizations, and medication costs. Although combination therapy has been shown to reduce hospitalizations, the relationship between treatment, health care utilization, and costs remains unclear. OBJECTIVE: To provide a characterization of health care utilization and costs in real-world settings by comparing periods before and after initiating PAH-specific treatment...
February 13, 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29436112/cost-effectiveness-of-focal-impulse-and-rotor-modulation-guided-ablation-added-to-pulmonary-vein-isolation-for-atrial-fibrillation
#16
Tina Baykaner, Steve Duff, James T Hasegawa, Michael S Mafilios, Mintu P Turakhia
BACKGROUND: Although ablation with focal impulse and rotor modulation (FIRM), as an adjunct to pulmonary vein isolation (PVI), has been shown to decrease atrial fibrillation (AF) recurrence, cost-effectiveness has not been assessed. OBJECTIVE: We aimed to evaluate the cost effectiveness of FIRM-guided ablation when added to PVI in a mixed AF population. METHODS AND RESULTS: We used a Markov model to estimate the costs, quality-adjusted survival, and cost effectiveness of adding FIRM ablation to PVI...
February 13, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29435896/readmission-rates-and-diagnoses-following-total-hip-replacement-in-relation-to-insurance-payer-status-race-and-ethnicity-and-income-status
#17
Robert S White, Dahniel L Sastow, Licia K Gaber-Baylis, Virginia Tangel, Andrew D Fisher, Zachary A Turnbull
BACKGROUND: Total hip replacements (THRs) are the sixth most common surgical procedure performed in the USA. Readmission rates are estimated at between 4.0 and 10.9%, and mean costs are between $10,000 and $19,000. Readmissions are influenced by the quality of care received. We sought to examine differences in readmissions by insurance payer, race and ethnicity, and income status. METHODS: We analyzed all THRs from 2007 to 2011 in California, Florida, and New York from the State Inpatient Databases, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality...
February 12, 2018: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/29433960/identifying-the-causes-of-the-changes-in-the-prevalence-patterns-of-diabetes-in-older-u-s-adults-a-new-trend-partitioning-approach
#18
Igor Akushevich, Arseniy P Yashkin, Julia Kravchenko, Fang Fang, Konstantin Arbeev, Frank Sloan, Anatoliy I Yashin
AIMS: To identify how efforts to control the diabetes epidemic and the resulting changes in diabetes mellitus, type II (T2D) incidence and survival have affected the time-trend of T2D prevalence. METHODS: A newly developed method of trend decomposition was applied to a 5% sample of Medicare administrative claims filed between 1991 and 2012. RESULTS: Age-adjusted prevalence of T2D for adults age 65+ increased at an average annual percentage change of 2...
January 6, 2018: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/29433953/affordable-care-act-impact-on-medicaid-coverage-of-smoking-cessation-treatments
#19
Sara B McMenamin, Sara W Yoeun, Helen A Halpin
INTRODUCTION: Four sections of the Affordable Care Act address the expansion of Medicaid coverage for recommended smoking-cessation treatments for: (1) pregnant women (Section 4107), (2) all enrollees through a financial incentive (1% Federal Medical Assistance Percentage increase) to offer comprehensive coverage (Section 4106), (3) all enrollees through Medicaid formulary requirements (Section 2502), and (4) Medicaid expansion enrollees (Section 2001). The purpose of this study is to document changes in Medicaid coverage for smoking-cessation treatments since the passage of the Affordable Care Act and to assess how implementation has differentially affected Medicaid coverage policies for: pregnant women, enrollees in traditional Medicaid, and Medicaid expansion enrollees...
February 9, 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29429818/undertreatment-of-older-patients-with-newly-diagnosed-multiple-myeloma-in-the-era-of-novel-therapies
#20
Bita Fakhri, Mark A Fiala, Sascha A Tuchman, Tanya M Wildes
BACKGROUND: With the expanding armamentarium of therapeutic agents for multiple myeloma (MM), it is important to identify any undertreated patient populations to mitigate outcome disparities. MATERIALS AND METHODS: We extracted the data for all plasma cell myeloma cases (International Classification of Disease for Oncology, third revision [ICD-O-3] code 9732) in the Surveillance, Epidemiology, End Results (SEER)-Medicare database from 2007 to 2011. The ICD-O-3 histologic code 9732 captures both active MM and smoldering/asymptomatic myeloma...
January 31, 2018: Clinical Lymphoma, Myeloma & Leukemia
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