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Physician reimbursement

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https://www.readbyqxmd.com/read/28545402/regional-variations-of-perceived-problems-in-ambulatory-care-from-the-perspective-of-general-practitioners-and-their-patients-an-exploratory-focus-group-study-in-urban-and-rural-regions-of-northern-germany
#1
H Hansen, N J Pohontsch, L Bole, I Schäfer, M Scherer
BACKGROUND: Patients from rural and urban regions should have equitable access to health care. In Germany, the physician-patient-ratio and the supply of medical services vary greatly between urban and rural areas. The aim of our study was to explore the regional variations of the perceived health care problems in ambulatory care from the perspective of affected professionals and laypersons i.e. general practitioners and their patients. METHODS: We conducted 27 focus groups with general practitioners (n = 65) and patients (n = 145) from urban areas, environs and rural areas in northern Germany...
May 25, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28544284/the-national-healthcare-system-claims-databases-in-france-sniiram-and-egb-powerful-tools-for-pharmacoepidemiology
#2
Julien Bezin, Mai Duong, Régis Lassalle, Cécile Droz, Antoine Pariente, Patrick Blin, Nicholas Moore
The French health care system is based on universal coverage by one of several health care insurance plans. The SNIIRAM database merges anonymous information of reimbursed claims from all these plans, linked to the national hospital-discharge summaries database system (PMSI) and the national death registry. It now covers 98.8% of the French population, over 66 million persons, from birth (or immigration) to death (or emigration), making it possibly the world's largest continuous homogeneous claims database...
May 24, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28538427/return-on-investment-of-advanced-practice-medical-degrees-nps-vs-pas
#3
Christopher K Craig, James H Holmes, Jeffery E Carter
As the United States faces a predicted physician shortage over the next 2 decades, physician assistants (PAs) and NPs are expected to fill the void. At the same time, because education is expensive, student loan and tuition increases have many potential applicants assessing differences in reimbursement and wondering about their return on investment (ROI). An analysis compared PA and NP salaries by incorporating national salary data, federal income tax, and student loans for a comparative analysis of each career pathway...
June 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28536176/cost-of-alteplase-has-more-than-doubled-over-the-past-decade
#4
Dawn Kleindorfer, Joseph Broderick, Bart Demaerschalk, Jeffrey Saver
BACKGROUND AND PURPOSE: Intravenous alteplase (tissue-type plasminogen activator) has been shown to be cost-effective because of savings in long-term disability. In October of 2005, an increased DRG payment to hospitals for alteplase-treated stroke patients was introduced. We sought to describe the trends in the cost of alteplase over time, in comparison to trends in hospital reimbursement in the United States. METHODS: Using publicly available information on the Centers for Medicare and Medicaid Services (CMS) website (www...
May 23, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28531565/efficiency-cost-effectiveness-and-need-of-inversion-in-nutritional-therapy-importance-of-detecting-and-documenting-undernutrition
#5
Jesús Manuel Morán López, María Piedra León, Belén Beneítez Moralejo, Fidel Jesús Enciso Izquierdo, Luis Miguel Luengo Pérez, José Antonio Amado Señaris
Disease Related Malnutrition (DRM) is highly prevalent in Spanish hospitals. WHO estimates that 20-40% of health-associated expenses are lost due to inefficiency. Demonstration that DRM is a component of inefficiency and hiring a specialist physician for its detection and treatment is cost-effective. MATERIAL AND METHODS: Comparison between nutritional diagnosis and procedures detected and encoded at discharge using McNemar test. Recoding of 162 discharge reports including nutritional diagnoses and procedures...
June 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28529910/generalizable-items-of-quantitative-and-qualitative-cornerstones-for-personnel-requirement-of-physicians-in-anesthesia
#6
REVIEW
Manfred Weiss, Rolf Rossaint, Thomas Iber
Anesthesiologists perform a broad spectrum of tasks. However, in many countries, there is no legal basis for personnel staffing of physicians in anesthesia. Also, the German diagnosis related groups system for refunding does not deliver such a basis. Thus, in 2006 a new calculation base for the personnel requirement that included an Excel calculation sheet was introduced by the German Board of Anesthesiologists (BDA) and the German Society of Anesthesiology and Intensive Care Medicine (DGAI), and updated in 2009 and 2015...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28520605/reducing-postsurgical-wound-complications-a-critical-review
#7
Barbara Delmore, Joshua Mitchell Cohen, Daniel O'Neill, Andy Chu, Vinh Pham, Ernest Chiu
GENERAL PURPOSE: To provide information on risk factors for surgical site infections (SSIs) and actions to mitigate that risk. TARGET AUDIENCE: This continuing education activity is intended for surgeons, surgical teams, physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to:1...
June 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28508011/mandated-health-insurance-and-provider-reimbursement-via-private-insurance-evidence-from-the-massachusetts-health-reform
#8
Andrew Friedson, Allison Marier
In 2006, Massachusetts passed a reform that required individuals to purchase health insurance and provided subsidized health insurance to low-income individuals. The US Patient Protection and Affordable Care Act (ACA) was modeled after this reform, making Massachusetts an ideal place to look at potential outcomes from the ACA. Postreform, the proportion of the health-insured population in Massachusetts greatly increased, which potentially changed physician reimbursement for procedures as usage of care, particularly preventative care for children increased...
January 2017: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/28506979/impact-of-ezetimibe-on-the-rate-of-cardiovascular-related-hospitalizations-and-associated-costs-among-patients-with-a-recent-acute-coronary-syndrome-results-from-the-improve-it-trial-improved-reduction-of-outcomes-vytorin-efficacy-international-trial
#9
Yashashwi Pokharel, Khaja Chinnakondepalli, Katherine Vilain, Kaijun Wang, Daniel B Mark, Glenn Davies, Michael A Blazing, Robert P Giugliano, Eugene Braunwald, Christopher P Cannon, David J Cohen, Elizabeth A Magnuson
BACKGROUND: Ezetimibe, when added to simvastatin therapy, reduces cardiovascular events after recent acute coronary syndrome. However, the impact of ezetimibe on cardiovascular-related hospitalizations and associated costs is unknown. METHODS AND RESULTS: We used patient-level data from the IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial) to examine the impact of simvastatin-ezetimibe versus simvastatin-placebo on cardiovascular-related hospitalizations and related costs (excluding drug costs) over 7 years follow-up...
May 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28506398/integration-of-pharmacists-into-patient-centered-medical-homes-in-federally-qualified-health-centers-in-texas
#10
Shui Ling Wong, Jamie C Barner, Kristina Sucic, Michelle Nguyen, Karen L Rascati
OBJECTIVES: To describe the integration and implementation of pharmacy services in patient-centered medical homes (PCMHs) as adopted by federally qualified health centers (FQHCs) and compare them with usual care (UC). SETTING: Four FQHCs (3 PCMHs, 1 UC) in Austin, TX, that provide care to the underserved populations. PRACTICE DESCRIPTION: Pharmacists have worked under a collaborative practice agreement with internal medicine physicians since 2005...
May 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28502549/reimbursement-in-hospital-based-vascular-surgery-physician-and-practice-perspective
#11
Jennifer L Perri, Robert M Zwolak, Philip P Goodney, Gretchen A Rutherford, Richard J Powell
OBJECTIVE: The purpose of this study was to determine change in value of a vascular surgery division to the health care system during 6 years at a hospital-based academic practice and to compare physician vs hospital revenue earned during this period. METHODS: Total revenue generated by the vascular surgery service line at an academic medical center from 2010 through 2015 was evaluated. Total revenue was measured as the sum of physician (professional) and hospital (technical) net revenue for all vascular-related patient care...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28501293/gender-differences-in-physician-service-provision-using-medicare-claims-data
#12
Michael A Mahr, Sharonne N Hayes, Tait D Shanafelt, Jeff A Sloan, Jay C Erie
OBJECTIVE: To determine differences in the provision of Medicare services based on physician gender in the United States. PATIENTS AND METHODS: Participants included all 2013 Medicare fee-for-service physicians and their patients, a population that is predominantly older than 65 years. The 2013 Medicare Provider Utilization and Payment Data for services rendered between January 1, 2013, and December 31, 2013, were combined with the 2015 Physician Compare National Downloadable files and 2015 Berenson-Eggers Type of Service classification files...
May 10, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28499920/patient-understanding-expectations-and-satisfaction-regarding-rotator-cuff-injuries-and-surgical-management
#13
Brian J Cole, Eric J Cotter, Kevin C Wang, Annabelle Davey
Rotator cuff injuries are among the most common in orthopaedics, with rotator cuff repair surgery consistently reported as one of the most commonly performed orthopaedic procedures. Patient satisfaction is becoming an increasingly important outcome metric as health care continues to evolve with regard to quality measures affecting physician reimbursement. Evidence supports that postoperative patient satisfaction, an important quality outcome metric, is highly influenced by preoperative patient expectations, which are in turn governed by patient knowledge and understanding...
May 9, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28492444/neuro-ophthalmology-transitioning-from-old-to-new-models-of-health-care-delivery
#14
Larry P Frohman
In contradiction to fundamental laws of supply and demand, 2 decades of payment policies have led to some medical specialties experiencing declines in both manpower and reimbursement. This paradox has resulted in increasingly long wait times to see some specialists, some specialties becoming less attractive to potential trainees, and a dearth of new trainees entering these fields. Evolving models of health care delivery hold the promise of increasing patient access to most providers and may diminish costs and improve outcomes for most patients/conditions...
June 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/28484927/ethical-and-legal-considerations-in-the-management-of-an-unbefriended-patient-in-a-vegetative-state
#15
Alexandra Lloyd-Smith Sequeira, Ariane Lewis
BACKGROUND: Patients without surrogates are referred to as "unbefriended." Because these patients do not have representatives to assist with medical decision-making, patient autonomy and self-determination, fundamental concepts of American healthcare, are jeopardized. METHODS: We present a case of an unbefriended patient in a vegetative state and discuss the ethical and legal complications associated with management of unbefriended patients. RESULTS: An unbefriended patient was admitted to our hospital with a cardiac arrest in the setting of an intracerebral hemorrhage...
May 8, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28483892/a-hepatitis-c-treatment-program-based-in-a-safety-net-hospital-patient-centered-medical-home
#16
Karen E Lasser, Alexandra Heinz, Leandra Battisti, Alexandria Akoumianakis, Ve Truong, Judith Tsui, Glorimar Ruiz, Jeffrey H Samet
Hepatitis C virus (HCV) infection is a major public health problem. Urban safety-net hospitals are a prime location for HCV treatment delivery. Showing that physicians in primary care settings can deliver HCV infection care is important to expand treatment; models doing so in the era of newer oral HCV medications are needed. This article describes an innovative and successful HCV primary care treatment program in a patient-centered medical home based at an urban, safety-net hospital. The program is public health oriented in that a central team member is a public health social worker who performs population management and addresses underlying social determinants of health to facilitate engagement in HCV treatment...
May 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28483137/expanded-roles-of-registered-nurses-in-primary-care-delivery-of-the-future
#17
Laurie Bauer, Thomas Bodenheimer
BACKGROUND: Primary care in the United States is changing: practice size is increasing, there is a growing shortage of primary care practitioners, and there is a heightened prevalence of chronic disease. Given these trends, it is likely that registered nurses will become important members of the primary care team. PURPOSE: This paper explores the challenges and opportunities in primary care delivery in the 21st century and examines the likelihood of expanded roles for RNs to improve quality and add capacity to the primary care workforce...
April 7, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28480542/the-effect-of-non-steroidal-anti-inflammatory-drugs-on-risk-of-benign-prostatic-hyperplasia
#18
Lotta H Nygård, Kirsi Talala, Kimmo Taari, Teuvo L J Tammela, Anssi Auvinen, Teemu J Murtola
BACKGROUND: Inflammation may play a role in pathogenesis of benign prostatic hyperplasia (BPH). However, the role of non-steroidal anti-inflammatory drugs (NSAIDs) as BPH risk factor is unclear. The objective of this study was to examine risk of BPH by NSAID use in a population-based cohort. METHODS: A total of 74 754 Finnish men without previous BPH at baseline in 1996-1999 were linked to national medication reimbursement database for information on physician-prescribed NSAID purchases during 1995-2009...
June 2017: Prostate
https://www.readbyqxmd.com/read/28465766/biologic-disease-modifying-antirheumatic-drugs-in-a-national-privately-insured-population-utilization-expenditures-and-price-trends
#19
Christopher B Atzinger, Jeff J Guo
BACKGROUND: Spending on biologic drugs is a significant driver of drug expenditures for payers in private health plans. Biologic disease-modifying antirheumatic drugs (DMARDs) are some of the most effective and costly treatments in a physician's arsenal. Understanding the total annual expenditure, the average cost per prescription, and the impact of cost-sharing is important for drug benefit managers. OBJECTIVE: To assess drug utilization, expenditures, out-of-pocket (OOP) cost, and price trends of biologic DMARDs in patients with rheumatoid arthritis (RA) in a large managed care organization...
February 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28464188/-lysosomal-storage-diseases-challenges-in-multiprofessional-patient-care-with-enzyme-replacement-therapy
#20
Anibh Martin Das, Florian Lagler, Michael Beck, Maurizio Scarpa, Christina Lampe
Background Due to their rarity studies in (ultra-) rare diseases are difficult. Only for a minority of these diseases causal therapies are available. Development and production of enzyme replacement therapies (ERT) for example are challenging and expensive. The number of patients is low, costs per patient are high. We will focus on the challenges of providing long-term ERT to patients with lysosomal storage diseases (LSD) in an out- and inpatient setting based on a literature search in Pubmed and own experience...
May 2, 2017: Klinische Pädiatrie
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