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Medicare for All

Ashley Fox, Roland Poirier
Described as "universal prepayment," the national health insurance (or single-payer) model of universal health coverage is increasingly promoted by international actors as a means of raising revenue for health care and improving social risk protection in low- and middle-income countries. Likewise, in the United States, the recent failed efforts to repeal and replace the Affordable Care Act have renewed debate about where to go next with health reform and arguably opened the door for a single-payer, Medicare-for-All plan, an alternative once considered politically infeasible...
January 1, 2018: International Journal of Health Services: Planning, Administration, Evaluation
Junya Zhu, G Caleb Alexander, Saman Nazarian, Jodi B Segal, Albert W Wu
OBJECTIVE: Since 2010, several non-vitamin K antagonist oral anticoagulants (NOACs) have been brought to the U.S. market, yet little is known regarding their evolving adoption for prophylaxis of atrial fibrillation (AF) related stroke. We examined temporal trends in choice of oral anticoagulants (OACs) among incident OAC users with AF and its association with patient demographic and clinical characteristics. METHODS: We conducted a serial cross-sectional analysis of medical and pharmacy claims for commercial and Medicare Advantage enrollees in a large, private, U...
June 19, 2018: Pharmacotherapy
Veronica Wendy Setiawan, Daniel O Stram, Jacqueline Porcel, Suresh T Chari, Gertraud Maskarinec, Loïc Le Marchand, Lynne R Wilkens, Christopher A Haiman, Stephen J Pandol, Kristine R Monroe
Background: Diabetes has been proposed to be a risk factor for and a consequence of pancreatic cancer (PC). The relationship between recent-onset diabetes and PC is not well understood, and data in minorities are sparse. We examined the relationships between recent-onset diabetes and PC incidence in African Americans and Latinos in the Multiethnic Cohort. Methods: A total of 48 995 African Americans and Latinos without prior diabetes and cancer at baseline (1993-1996) were included in the study...
June 18, 2018: Journal of the National Cancer Institute
Sudha R Raman, Bradley G Hammill, Robin M Queen, Samuel B Adams, Lesley H Curtis
BACKGROUND: Linking clinical registries to administrative claims data enables researchers to capitalize on the specific strengths of each data source with respect to the depth, breadth, and completeness of information. The objectives of this study were to link a health-system-based orthopaedic surgery registry to U.S. Medicare claims data without the use of unique identifiers and to assess the representativeness of the linked records. METHODS: The registry included clinical data for patients ≥65 years of age who underwent elective, inpatient total ankle arthroplasty (TAA) in a single health system during the period of 2007 through 2012...
June 20, 2018: Journal of Bone and Joint Surgery. American Volume
Jesse A Columbo, Ravinder Kang, Andrew W Hoel, Jeanwen Kang, Kathleen A Leinweber, Karissa S Tauber, Regis Hila, Niveditta Ramkumar, Art Sedrakyan, Philip P Goodney
OBJECTIVE: The accurate measurement of reintervention after endovascular aneurysm repair (EVAR) is critical during postoperative surveillance. The purpose of this study was to compare reintervention rates after EVAR from three different data sources: the Vascular Quality Initiative (VQI) alone, VQI linked to Medicare claims (VQI-Medicare), and a "gold standard" of clinical chart review supplemented with telephone interviews. METHODS: We reviewed the medical records of 729 patients who underwent EVAR at our institution between 2003 and 2013...
June 15, 2018: Journal of Vascular Surgery
Jesse A Columbo, Pablo Martinez-Camblor, Todd A MacKenzie, Ravinder Kang, Spencer W Trooboff, Philip P Goodney, A James O'Malley
BACKGROUND: The value of carotid intervention is predicated on long-term survival for patients to derive a stroke prevention benefit. Randomized trials report no significant difference in survival after carotid endarterectomy (CEA) vs carotid artery stenting (CAS), whereas observational studies of "real-world" outcomes note that CEA is associated with a survival advantage. Our objective was to examine long-term mortality after CEA vs CAS using a propensity-matched cohort. METHODS: We studied all patients who underwent CEA or CAS within the Vascular Quality Initiative from 2003 to 2013 (CEA, n = 29,235; CAS, n = 4415)...
June 15, 2018: Journal of Vascular Surgery
Steven M Kurtz, Edmund C Lau, Min-Sun Son, Ellen T Chang, Werner Zimmerli, Javad Parvizi
BACKGROUND: Periprosthetic joint infection (PJI) is a potentially deadly complication of total joint arthroplasty. This study was designed to address how the incidence of PJI and outcome of treatment, including mortality, are changing in the population over time. METHODS: Primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients with PJI from the 100% Medicare inpatient data set (2005-2015) were identified. Cox proportional hazards regression models for risk of PJI after THA/TKA (accounting for competing risks) or risk of all-cause mortality after PJI were adjusted for patient and clinical factors, with year included as a covariate to test for time trends...
June 1, 2018: Journal of Arthroplasty
Yeunkyung Kim, Caroline P Thirukumaran, Yue Li
BACKGROUND: Accountable Care Organizations in the Medicare Shared Savings Program (MSSP) have financial incentives to reduce the cost and improve the quality of care delivered to Medicare beneficiaries that they serve. However, previous research about the impact of the MSSP on readmissions is limited and mixed. OBJECTIVE: To examine the association between hospital participation in the MSSP during the 2012-2013 period and reductions in 30-day risk-standardized readmission rates for Medicare patients initially admitted for acute myocardial infarction, heart failure (HF), pneumonia, or any cause...
June 15, 2018: Medical Care
Emily Zhang, Daniel H Coelho
OBJECTIVE: To study postoperative hearing outcomes in older adult cochlear implant recipients who did not meet Medicare candidacy criteria by sentence testing in quiet. STUDY DESIGN: Case Control Series. SETTING: University Based Tertiary Referral Cochlear Implant Center. PATIENTS: Fifty-four patients age 60 or greater with bilateral moderate to profound sensorineural hearing loss who underwent cochlear implantation...
June 15, 2018: Otology & Neurotology
Angela K Shen, Rob Warnock, Steve Chu, Jeffrey A Kelman
Annual influenza vaccination campaigns emphasize the importance of getting vaccinated against influenza. These campaigns offer potential opportunities to raise awareness of all vaccines. We explored the peak timing of the receipt of influenza and other routinely recommended vaccinations. We examined administrative claims data of 31 million Medicare fee-for-service beneficiaries, eligible to receive vaccinations administered from 2013 to 2015 from Medicare Part B (medical insurance) and Medicare Part D (prescription drug benefit)...
June 13, 2018: Vaccine
Charles A Herzog, Tanya Natwick, Shuling Li, David M Charytan
OBJECTIVES: The authors aimed to analyze temporal trends in cardiac stress testing in U.S. Medicare beneficiaries from 2008 to 2012, types of stress testing, and comparative utilization related to the presence and severity of chronic kidney disease (CKD). BACKGROUND: A long-held perception depicts patients with CKD as being treated less intensively for cardiovascular disease than nonrenal patients. We wondered whether use of diagnostic testing for ischemic heart disease is affected by the presence of CKD...
June 8, 2018: JACC. Cardiovascular Imaging
Krista L Haines, Suresh Agarwal, Hee Soo Jung
INTRODUCTION: Asian-Americans and Pacific Islanders are often considered as a uniform group when examining race in health outcomes. However, the generally favorable economic outcomes in this group belie significant socioeconomic variance between its heterogeneous subgroups. This study evaluates the impact of socioeconomic status on the health outcomes of Asian trauma patients. METHODS: From 2012 to 2015, 52,704 Asians who presented to trauma centers were registered with the National Trauma Data Bank with known disposition...
August 2018: Journal of Surgical Research
Danielle C Sutzko, Elizabeth A Andraska, Andrew A Gonzalez, Apurba K Chakrabarti, Nicholas H Osborne
BACKGROUND: There is a growing interest in providing high quality and low-cost care to Americans. A pursuit exists to measure not only how well hospitals are performing but also at what cost. We examined the variation in costs associated with carotid endarterectomy (CEA), to determine which components contribute to the variation and what drives increased payments. MATERIALS AND METHODS: Patients undergoing CEA between 2009 and 2012 were identified in the Medicare provider and analysis review database...
August 2018: Journal of Surgical Research
Xi Zhong, Zhexu Guo, Peng Gao, Yongxi Song, Jingxu Sun, Xiaowan Chen, Yu Sun, Zhenning Wang
BACKGROUND: Most race/ethnicity-oriented investigations focus on Caucasian Americans (whites) and African Americans (blacks), leaving Asians, Hispanic white (Hispanics), and other minorities less well studied. Adjuvant chemotherapy (CT) after curative resection is critical to patients with locally advanced colon cancer (LACC). We studied the racial disparities in the adjuvant CT of LACC to aid in selecting optimal treatments for people from different races/ethnicities in this era of precision medicine...
August 2018: Journal of Surgical Research
M Kelsey Kirkwood, Amy Hanley, Suanna S Bruinooge, Elizabeth Garrett-Mayer, Laura A Levit, Caroline Schenkel, Jerome E Seid, Blase N Polite, Richard L Schilsky
PURPOSE: To describe the US hematology and medical oncology practice landscape and to report findings of the sixth annual ASCO Oncology Practice Census survey. PARTICIPANTS AND METHODS: ASCO used Medicare Physician Compare data to characterize oncology practices in the United States. Practice size, number of care sites, and geographic distribution were determined. Trends in the number and size of practices from 2013 to 2017 were examined. All US oncology practices were targeted for the survey; survey responses were linked to the practices identified from Physician Compare to augment results and assess generalizability...
June 15, 2018: Journal of Oncology Practice
Sarah Streeter Hutcheson, Victoria Phillips, Rachel Patzer, Andrew Smith, J David Vega, Alanna A Morris
BACKGROUND: Medicaid insurance in Georgia provides limited reimbursement for heart transplant (HT) and left ventricular assist devices (LVAD). We examined whether insurance type affects eligibility for and survival after receipt of HT or LVAD. METHODS AND RESULTS: We retrospectively identified patients evaluated for HT/LVAD from 2012 to 2016. We used multivariable logistic and Cox proportional hazards regression to examine the association of insurance type on treatment eligibility and one year survival...
June 15, 2018: Clinical Transplantation
Kevin Li, Sami P Moubayed, Emily Spataro, Sam P Most
Importance: Initial treatment of nasal fractures can result in long-standing cosmetic or functional defects, but the risk factors for subsequent septorhinoplasty have not been explored. Objective: To assess the risk factors for septorhinoplasty after the initial treatment of isolated nasal fracture. Design, Setting, and Participants: This retrospective population-based analysis of US patients diagnosed with nasal fracture between January 1, 2007, and December 31, 2015, used insurance claims data from the Commercial and Medicare Supplemental categories of the Truven Health MarketScan database...
June 14, 2018: JAMA Facial Plastic Surgery
Arhana Chattopadhyay, Clifford C Sheckter, Chao Long, Yvonne Karanas
Air ambulances rapidly transport burn patients to regional centers, expediting treatment. However, limited guidelines on transport introduce the risk for inappropriate triage and overuse. Given the additional costs of air vs ground transport, evaluation of transportation use is prudent. A retrospective review of all burn patients transported by helicopter to a single burn center from May 2013 to January 2016 was performed. Data gathered included patient demographics, transfer origin, burn characteristics, and inpatient hospital stay...
June 13, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
MaryAnn Zhang, Daniel H Solomon, Rishi J Desai, Eun Ha Kang, Jun Liu, Tuhina Neogi, Seoyoung C Kim
Background -Hyperuricemia and gout are associated with increased risk of cardiovascular disease (CVD). Xanthine oxidase inhibitors (XOI), allopurinol and febuxostat, are the mainstay of urate lowering treatment for gout and may have different effects on cardiovascular risk in patients with gout. Methods -Using U.S. Medicare claims data (2008-2013), we conducted a cohort study for comparative cardiovascular safety of initiating febuxostat versus allopurinol among gout patients aged ≥65 years. The primary outcome was a composite endpoint of hospitalization for myocardial infarction (MI) or stroke...
June 13, 2018: Circulation
Chancellor F Gray, Hernan A Prieto, Andrew T Duncan, Hari K Parvataneni
Background: Total joint arthroplasty (TJA) remains the highest expenditure in the Centers for Medicare and Medicaid Services (CMS) budget. One model to control cost is the Comprehensive Care for Joint Replacement (CJR) model. There has been no published literature to date examining the efficacy of CJR on value-based outcomes. The purpose of this study was to determine the efficacy and sustainability of a multidisciplinary care redesign for total joint arthroplasty under the CJR paradigm at an academic tertiary care center...
June 2018: Arthroplasty Today
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