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Medicare for All

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https://www.readbyqxmd.com/read/29691265/effects-of-a-pharmacist-driven-intervention-program-on-hospital-readmissions
#1
Mariel T Shull, Leonard E Braitman, Shana D Stites, Angelo DeLuca, Deborah Hauser
PURPOSE: Results of a study to determine whether routine use of a multifaceted medication-focused intervention at a safety-net hospital was feasible and could reduce hospital readmissions in a Medicare fee-for-service population are reported. METHODS: A quality-improvement cohort study of 1,059 admissions of 667 patients at an inner-city hospital was conducted. Patients in the intervention groups received some or all components of the multifaceted "Medication REACH" intervention, with direct pharmacist involvement from admission through postdischarge aftercare...
May 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29691171/risk-adjustment-is-necessary-in-medicare-bundled-payment-models-for-total-hip-and-knee-arthroplasty
#2
P Maxwell Courtney, Daniel D Bohl, Edmund C Lau, Kevin L Ong, Joshua J Jacobs, Craig J Della Valle
BACKGROUND: Concerns exist that high-risk patients in alternative payment models may face difficulties with access to care without proper risk adjustment. The purpose of this study is to identify the effect of medical and orthopedic specific risk factors on the cost of a 90-day episode of care following total hip (THA) and knee arthroplasty (TKA). METHODS: We queried the Medicare 5% Limited Data Set for all patients undergoing primary THA and TKA from 2010 to 2014...
March 17, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29691152/readmission-patterns-over-90-day-episodes-of-care-among-medicare-fee-for-service-beneficiaries-discharged-to-post-acute-care
#3
Addie Middleton, Yong-Fang Kuo, James E Graham, Amol Karmarkar, Yu-Li Lin, James S Goodwin, Allen Haas, Kenneth J Ottenbacher
OBJECTIVE: Examine readmission patterns over 90-day episodes of care in persons discharged from hospitals to post-acute settings. DESIGN: Retrospective cohort study. SETTING: Acute care hospitals. PARTICIPANTS: Medicare fee-for-service enrollees (N = 686,877) discharged from hospitals to post-acute care in 2013-2014. The cohort included beneficiaries >65 years of age hospitalized for stroke, joint replacement, or hip fracture and who survived for 90 days following discharge...
April 21, 2018: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29689434/estimating-the-cost-effectiveness-of-lung-cancer-screening-with-low-dose-computed-tomography-for-high-risk-smokers-in-australia
#4
Stephen Wade, Marianne Weber, Michael Caruana, Yoon-Jung Kang, Henry Marshall, Renee Manser, Shalini Vinod, Nicole Rankin, Kwun Fong, Karen Canfell
BACKGROUND: Health economic evaluations of lung cancer screening with low dose computerised tomography (LDCT) that are underpinned by clinical outcomes are few. METHODS: We assessed the cost-effectiveness of LDCT lung screening in Australia by applying Australian cost and survival data to the outcomes observed in the U.S. National Lung Screening Trial (NLST), in which a 20% lung cancer mortality benefit was demonstrated for three rounds of annual screening among high-risk smokers aged 55-74 years...
April 21, 2018: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/29688041/post-compromise-democrats-medicare-for-all-and-the-possible-futures-of-american-health-policy
#5
Scott Greer
No abstract text is available yet for this article.
January 1, 2018: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/29687743/clinical-outcomes-of-treatment-with-filgrastim-versus-a-filgrastim-biosimilar-and-febrile-neutropenia-associated-costs-among-patients-with-nonmyeloid-cancer-undergoing-chemotherapy
#6
Lee S Schwartzberg, Lincy S Lal, Sanjeev Balu, Kim Campbell, Lee Brekke, Andrew DeLeon, Caitlin Elliott, Stephanie Korrer
BACKGROUND: Granulocyte colony-stimulating factors such as filgrastim are used to decrease the incidence of febrile neutropenia (FN) among patients with nonmyeloid cancers undergoing chemotherapy treatment. Although the biosimilar filgrastim-sndz has been approved in the United States since 2015, limited real-world comparisons of filgrastim-sndz versus reference filgrastim (filgrastim-ref) have been conducted. OBJECTIVE: To compare FN incidence and assess overall FN-related health care resource utilization and medical costs among U...
April 24, 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29687467/estimating-lead-time-bias-in-lung-cancer-diagnosis-of-patients-with-previous-cancers
#7
Zhiyun Ge, Daniel F Heitjan, David E Gerber, Lei Xuan, Sandi L Pruitt
Surprisingly, survival from a diagnosis of lung cancer has been found to be longer for those who experienced a previous cancer than for those with no previous cancer. A possible explanation is lead-time bias, which, by advancing the time of diagnosis, apparently extends survival among those with a previous cancer even when they enjoy no real clinical advantage. We propose a discrete parametric model to jointly describe survival in a no-previous-cancer group (where, by definition, lead-time bias cannot exist) and in a previous-cancer group (where lead-time bias is possible)...
April 23, 2018: Statistics in Medicine
https://www.readbyqxmd.com/read/29683880/economic-analysis-of-neoadjuvant-chemotherapy-versus-primary-debulking-surgery-for-advanced-epithelial-ovarian-cancer-using-an-aggressive-surgical-paradigm
#8
Ashley L Cole, Emma L Barber, Anagha Gogate, Arthur-Quan Tran, Stephanie B Wheeler
OBJECTIVES: Neoadjuvant chemotherapy (NACT) versus primary debulking surgery (PDS) for advanced epithelial ovarian cancer (AEOC) remains controversial in the United States. Generalizability of existing trial results has been criticized because of less aggressive debulking procedures than commonly used in the United States. As a result, economic evaluations using input data from these trials may not accurately reflect costs and outcomes associated with more aggressive primary surgery. Using data from an ongoing trial performing aggressive debulking, we investigated the cost-effectiveness and cost-utility of NACT versus PDS for AEOC...
April 21, 2018: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/29680480/the-receipt-of-industry-payments-is-associated-with-prescribing-promoted-alpha-blockers-and-overactive-bladder-medications
#9
Parth K Modi, Ye Wang, Peter S Kirk, James M Dupree, Eric A Singer, Steven L Chang
OBJECTIVE: To determine the impact of physicians' financial relationships with the pharmaceutical industry on prescribing marketed alpha-blockers and overactive bladder medications. We also aim to examine if the number or total value of transactions is influential. MATERIALS AND METHODS: We linked the Open Payments Program database of industry payments to prescribers with Medicare Part D prescription data. We used binomial logistic regression to identify the association between receipt of industry payment and prescribing of marketed alpha-blockers (silodosin) and overactive bladder (OAB) medications (fesoterodine, solifenacin, and mirabegron)...
April 19, 2018: Urology
https://www.readbyqxmd.com/read/29678620/coronary-artery-bypass-graft-readmission-rates-and-risk-factors-a-retrospective-cohort-study
#10
T Robert Feng, Robert S White, Licia K Gaber-Baylis, Zachary A Turnbull, Lisa Q Rong
BACKGROUND: Hospital readmissions contribute substantially to the overall healthcare cost. Coronary artery bypass graft (CABG) is of particular interest due to its relatively high short-term readmission rates and mean hospital charges. METHODS: A retrospective review was performed on 2007-2011 data from California, Florida, and New York from the State Inpatient Databases, Healthcare Cost and Utilization Project. All patients ≥18 years of age who underwent isolated CABG and met inclusion/exclusion criteria were included...
April 17, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29678177/healthcare-resource-use-and-economic-burden-attributable-to-respiratory-syncytial-virus-in-the-united-states-a-claims-database-analysis
#11
Caroline Amand, Sabine Tong, Alexia Kieffer, Moe H Kyaw
BACKGROUND: Despite several studies that have estimated the economic impact of Respiratory Syncytial Virus (RSV) in infants, limited data are available on healthcare resource use and costs attributable to RSV across age groups. The aim of this study was to quantify age-specific RSV-related healthcare resource use and costs on the US healthcare system. METHODS: This retrospective case-control study identified patients aged ≥1 year with an RSV event in the Truven Health Marketscan® Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits databases between August 31, 2012 and August 1, 2013...
April 20, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29675692/uptake-of-and-expenditure-on-direct-acting-antiviral-agents-for-hepatitis-c-treatment-in-australia
#12
Barbara de Graaff, Kwang Chien Yee, Philip Clarke, Andrew Palmer
BACKGROUND: Direct-acting antiviral agents (DAAs) have revolutionised treatment for the hepatitis C virus (HCV). Currently, treatment costs between 20,000 and 80,000 Australian dollars ($A) per patient. The Australian Federal Government provided $A1 billion over 5 years to subsidise these drugs. OBJECTIVE: The aim of this paper was to evaluate the uptake and financial impact of DAA prescribing in Australia. METHODS: We undertook a retrospective analysis of Medicare prescription and expenditure data for March 2016 to August 2017...
April 19, 2018: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/29674340/opioid-analgesics-and-adverse-outcomes-among-hemodialysis-patients
#13
Julie H Ishida, Charles E McCulloch, Michael A Steinman, Barbara A Grimes, Kirsten L Johansen
BACKGROUND AND OBJECTIVES: Patients on hemodialysis frequently experience pain and may be particularly vulnerable to opioid-related complications. However, data evaluating the risks of opioid use in patients on hemodialysis are limited. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using the US Renal Data System, we conducted a cohort study evaluating the association between opioid use (modeled as a time-varying exposure and expressed in standardized oral morphine equivalents) and time to first emergency room visit or hospitalization for altered mental status, fall, and fracture among 140,899 Medicare-covered adults receiving hemodialysis in 2011...
April 19, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29673963/no-difference-in-cardiovascular-risk-of-tocilizumab-versus-abatacept-for-rheumatoid-arthritis-a-multi-database-cohort-study
#14
Seoyoung C Kim, Daniel H Solomon, James R Rogers, Sara Gale, Micki Klearman, Khaled Sarsour, Sebastian Schneeweiss
OBJECTIVES: While tocilizumab may increase serum lipid levels, recent studies do not suggest a link between tocilizumab use and clinical cardiovascular risk in patients with rheumatoid arthritis (RA). METHODS: To compare cardiovascular safety of tocilizumab with abatacept, we conducted a cohort study using data from Medicare (2010-2013), IMS PharMetrics (2011-2014) and MarketScan (2011-6/2015). RA patients aged ≥18 years who newly started tocilizumab or abatacept entered the cohort on the day of their first use of tocilizumab or abatacept after a continuous enrollment period for ≥365 days...
March 22, 2018: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/29673891/burden-of-acute-myeloid-leukemia-among-older-newly-diagnosed-patients-retrospective-analysis-of-data-from-the-2010-2012-medicare-limited-data-set
#15
Naomi C Sacks, Philip L Cyr, Arthur C Louie, Yanmei Liu, Michael T Chiarella, Abhishek Sharma, Karen C Chung
PURPOSE: Acute myeloid leukemia (AML) disproportionately affects older adults; the prognosis in this subpopulation is generally poor, with variable use of inpatient chemotherapy. This study characterizes treatment patterns, hospitalizations, and outcomes among older patients with AML. METHODS: Using the Centers for Medicare & Medicaid Services' 2010-2012 100% Limited Data Set (LDS), data from all hospital claims from fee-for-service Medicare beneficiaries between 60 and 75 years of age with newly diagnosed AML and ≥1 hospitalization were analyzed...
April 16, 2018: Clinical Therapeutics
https://www.readbyqxmd.com/read/29673463/sex-differences-in-high-intensity-statin-use-following-myocardial-infarction-in-the-united-states
#16
Sanne A E Peters, Lisandro D Colantonio, Hong Zhao, Vera Bittner, Yuling Dai, Michael E Farkouh, Keri L Monda, Monika M Safford, Paul Muntner, Mark Woodward
BACKGROUND: Historically, women have been less likely than men to receive guideline-recommended statin therapy for the secondary prevention of myocardial infarction (MI). OBJECTIVES: The authors examined contemporary sex differences in prescription fills for high-intensity statin therapy following an MI, overall and across population subgroups, and assessed whether sex differences were attenuated following recent efforts to reduce sex disparities in the use of cardiovascular disease preventive therapies...
April 24, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29672366/mohs-micrographic-surgery-volume-and-payment-patterns-among-dermatologists-in-the-medicare-population-2013
#17
Cameron Johnstone, Keith A Joiner, John Pierce, Robert S Krouse
OBJECTIVES: Mohs micrographic surgery (MMS) has expanded markedly in recent years but there is limited information on volume, practice patterns or reimbursement. This study characterizes MMS utilization in the Medicare population. MATERIALS AND METHODS: We analyzed the Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File Calendar Year 2013 data set for provider service volume and reimbursement for dermatologists who did and did not perform MMS procedures...
April 18, 2018: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29672356/improving-documentation-of-inpatient-problem-list-in-electronic-health-record-a-quality-improvement-project
#18
Prabi Rajbhandari, Moises Auron, Sarah Worley, Michelle Marks
BACKGROUND: The problem list is critical in electronic documentation. It is a powerful tool for clinical decision-making because it provides a concise view of all patient problems in one place and is also a criterion for the Medicare meaningful use incentive program. OBJECTIVE: To measure the rate of utilization of problem list in electronic health records (EHR) in a pediatric hospital medicine unit and implement sequential interventions to increase the rate of use of problem list to more than 80% by the end of 2015, as measured by at least one documented hospital problem at discharge...
April 19, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29669452/association-between-provider-specialty-and-healthcare-costs-and-glycemic-control-for-patients-with-diabetes
#19
Max Gill, Harmeet Chhabra, Mona Shah, Cyrus Zhu, Howard Lando, Felice Caldarella
AIMS: To analyze the association between provider, healthcare costs, and glycemic control for patients with diabetes mellitus (DM). MATERIALS AND METHODS: This cross-sectional study identified adults with type 1 or 2 DM (T1D, T2D) in the Optum database. The main independent variable was provider (endocrinologist or primary care). Regression analysis compared total medical and pharmacy costs, adjusting for health status and other patient differences, by provider...
April 19, 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29669197/complications-of-total-hip-arthroplasty-in-patients-with-ankylosing-spondylitis
#20
Michael M Ward
BACKGROUND: To compare the risks of complications of primary total hip arthroplasty (THA) between patients with ankylosing spondylitis (AS) and those without AS. METHODS: In this population-based study, we examined U.S. Medicare beneficiaries (< 75 years old) with AS and a comparison group without AS who had primary THA in 1999 - 2013. Complications were based on the 2013 Centers for Medicare & Medicaid Services THA Complication Measure, which included myocardial infarction, pneumonia, and sepsis within 7 days; surgical site bleeding, pulmonary embolus, or venous thrombosis within 30 days; and mechanical complications or local infection within 90 days...
April 18, 2018: Arthritis Care & Research
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