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REVIEW
Leslie L Chang, Adam D DeVore, Bradi B Granger, Zubin J Eapen, Dan Ariely, Adrian F Hernandez
Behavioral challenges are often present in human illness, so behavioral economics is increasingly being applied in healthcare settings to better understand why patients choose healthy or unhealthy behaviors. The application of behavioral economics to healthcare settings parallels recent shifts in policy and reimbursement structures that hold providers accountable for outcomes that are dependent on patient behaviors. Numerous studies have examined the application of behavioral economics principles to policy making and health behaviors, but there are limited data on applying these concepts to the management of chronic conditions, such as heart failure (HF)...
August 22, 2017: Circulation
#2
S Jawad Sher, Ranjani N Moorthi, Waqas Aftab, Sharon M Moe, Christopher S Weaver, Frank C Messina, Nancy M Martinez-Hoover, Melissa D Anderson, Michael T Eadon
BACKGROUND: Current estimates suggest 6,500 undocumented end-stage renal disease (ESRD) patients in the United States are ineligible for scheduled hemodialysis and require emergent dialysis. In order to remain in compliance with Emergency Medicaid, an academic health center altered its emergency dialysis criteria from those emphasizing interdialytic interval to a set emphasizing numerical thresholds. We report the impact of this administrative change on the biochemical parameters, utilization, and adverse outcomes in an undocumented patient cohort...
August 17, 2017: Clinical Nephrology
#3
Bradley Kamstra, Mark K Huntington
Population health management (PHM) is a new health care model being implemented. It has been defined as "the health outcomes of a group of individuals, including the distribution of such outcomes within the group." This includes health outcomes and patterns of health determinants, and policies and interventions that link these two. Moving from a fee-for-service payment system to a quality- or value-based system, this model places on the clinician more responsibility for the costs of health care and its reimbursements...
2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
#4
Björn Stollenwerk, Sergio Iannazzo, Kerry Cooper, Vasily Belozeroff
AIMS: This study explored the use of a value-based pricing approach for the new calcimimetic etelcalcetide indicated for the treatment of secondary hyperparathyroidism (SHPT) in patients receiving hemodialysis. It used the US payer perspective and applied the cost-effectiveness framework. Because etelcalcetide is an intravenous therapy that can be titrated for individual patients, and because its utilization is yet to be assessed in real world settings, a range of plausible doses were estimated for etelcalcetide to define a range of prices...
August 14, 2017: Journal of Medical Economics
#5
Tatjana S Potpara, Elina Trendafilova, Gheorghe-Andrei Dan, Artan Goda, Zumreta Kusljugic, Sime Manola, Ljilja Music, Viktor Gjini, Belma Pojskic, Mircea Ioakim Popescu, Catalina Arsenescu Georgescu, Elena S Dimitrova, Delyana Kamenova, Uliks Ekmeciu, Denis Mrsic, Ana Nenezic, Sandro Brusich, Srdjan Milanov, Ivan Zeljkovic, Gregory Y H Lip
INTRODUCTION: Data on management of atrial fibrillation (AF) in the Balkan Region are scarce. To capture the patterns in AF management in contemporary clinical practice in the Balkan countries a prospective survey was conducted between December 2014 and February 2015, and we report results pertinent to the use of non-vitamin K antagonist oral anticoagulants (NOACs). METHODS: A 14-week prospective, multicenter survey of consecutive AF patients seen by cardiologists or internal medicine specialists was conducted in Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Montenegro, Romania, and Serbia (a total of about 50 million inhabitants)...
August 9, 2017: Advances in Therapy
#6
Maurizio Pompili, Gloria Giordano, Mario Luciano, Valeria Del Vecchio, Gianluca Serafini, Gaia Sampogna, Denise Erbuto, Peter Falkai, Andrea Fiorillo
The objectives of this article are to describe current trends in the treatment of schizophrenia and the most interesting new approaches to optimizing outcome and fostering the development of new schizophrenia treatments. RESULTS: Increasing utilization of diverse types of atypical antipsychotic drugs (AAPDs), e.g. clozapine-type serotonin (5-HT)2A and weak dopamine (DA) D2 antagonist, amisulpride, a D2/D3/5-HT7 antagonist, and cariprazine, a D3 partial agonist with additional neurotransmitter targets, is occurring as their advantages in efficacy, especially for cognitive impairment and mood symptoms, and side effects is becoming appreciated...
August 3, 2017: CNS & Neurological Disorders Drug Targets
#7
Vitaly Zholudev, Ilan J Safir, Isabella M Issa, Mark N Painter, John A Petros, Christopher P Filson, Muta M Issa
OBJECTIVES: To compare costs associated with teleurology versus face-to-face clinic visits for initial outpatient hematuria evaluation. METHODS: The analysis included three cost domains: transportation, clinic operations, and patient time. Transportation cost was based on standard government travel reimbursement. Clinic staff cost was based on hourly salary plus fringe benefits. For a face-to face clinic encounter, patient time included time spent for travel, parking, walking to and from clinic, check-in and check-out times, nursing evaluation, urological evaluation, laboratory time, and waiting time...
August 2, 2017: Urology
#8
REVIEW
John G Bartlett
Clostridium difficile infection is a major health care challenge in terms of patient and economic consequences. For the patient, it is a morbid and sometimes a life-threatening iatrogenic complication of antibiotic treatment. In the United States, the provider's institution may face financial penalties, because the Centers for Disease Control and Prevention views this as an iatrogenic health care-associated complication that may not be reimbursable by the Centers for Medicare and Medicaid Services; this has resulted in substantial incentives for new approaches to prevention and treatment...
September 2017: Infectious Disease Clinics of North America
#9
Aris Angelis, Panos Kanavos
Escalating drug prices have catalysed the generation of numerous "value frameworks" with the aim of informing payers, clinicians and patients on the assessment and appraisal process of new medicines for the purpose of coverage and treatment selection decisions. Although this is an important step towards a more inclusive Value Based Assessment (VBA) approach, aspects of these frameworks are based on weak methodologies and could potentially result in misleading recommendations or decisions. In this paper, a Multiple Criteria Decision Analysis (MCDA) methodological process, based on Multi Attribute Value Theory (MAVT), is adopted for building a multi-criteria evaluation model...
June 20, 2017: Social Science & Medicine
#10
Laura McCullagh, Susanne Schmitz, Michael Barry, Cathal Walsh
BACKGROUND: In Ireland, all new drugs for which reimbursement by the healthcare payer is sought undergo a health technology assessment by the National Centre for Pharmacoeconomics. The National Centre for Pharmacoeconomics estimate expected value of perfect information but not partial expected value of perfect information (owing to computational expense associated with typical methodologies). OBJECTIVE: The objective of this study was to examine the feasibility and utility of estimating partial expected value of perfect information via a computationally efficient, non-parametric regression approach...
August 2, 2017: PharmacoEconomics
#11
Ana P Nunes, Melissa K Richmond, Kelly Marzano, Carolyn Swenson, Jodi Lockhart
The US Surgeon General recently issued a comprehensive report indicating that substance use is a major public health concern that must be addressed using a number of strategies. Screening, brief intervention, and referral to treatment (SBIRT) is one such strategy. SBIRT Colorado funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), has implemented a state-wide initiative for the past ten years which has provided ample opportunities to identify key components for successful implementation...
August 1, 2017: Substance Abuse
#12
Herbert Y Meltzer
The objectives of this article are to describe current trends in the treatment of schizophrenia and the most interesting new approaches to optimizing outcome and fostering the development of new schizophrenia treatments. RESULTS: Increasing utilization of diverse types of atypical antipsychotic drugs (AAPDs), e.g. clozapine-type serotonin (5-HT)2A and weak dopamine (DA) D2 antagonist, amisulpride, a D2/D3/5-HT7 antagonist, and cariprazine, a D3 partial agonist with additional neurotransmitter targets, is occurring as their advantages in efficacy, especially for cognitive impairment and mood symptoms, and side effects is becoming appreciated...
July 28, 2017: CNS & Neurological Disorders Drug Targets
#13
Monique T Barakat, Robert J Huang, Nirav C Thosani, Abhishek Choudhary, Mohit Girotra, Subhas Banerjee
BACKGROUND AND AIMS: Biliary strictures after orthotopic liver transplantation (OLT) are typically managed by sequential ERCP procedures, with incremental dilation of the stricture and stent exchange (IDSE) and placement of new stents. This approach resolves >80% of strictures after 12 months, but requires costly, lengthy ERCPs with significant patient radiation exposure. Increasing awareness of the harmful effects of radiation, escalating health care costs, and decreasing reimbursement for procedures mandate maximal efficiency in performing ERCP...
July 27, 2017: Gastrointestinal Endoscopy
#14
REVIEW
Dawn Driscoll, Stephanie Farnia, Panos Kefalas, Richard T Maziarz
Cellular therapies and other regenerative medicines are emerging as potentially transformative additions to modern medicine, but likely at a staggering financial cost. Public health care systems' budgets are already strained by growing and aging populations, and many private insurer's budgets are equally stretched. The current systems that most payers employ to manage their cash flow are not structured to absorb a sudden onslaught of very expensive prescriptions for a large portion of their covered population...
August 2017: Stem Cells Translational Medicine
#15
Ganesan Karthikeyan, Umesh Shirodkar, Meeta Rajiv Lochan, Stephen Birch
BACKGROUND: Elective coronary interventional procedures are often overused and sometimes inappropriately used. The incentives for overuse are greater in low- and middle-income countries, where much of healthcare is provided by poorly regulated, fee-for-service systems. Overuse and inappropriate use increase healthcare costs and are potentially harmful to patients. Linking appropriate use of elective procedures to their reimbursement might deter overuse. METHODS: We explored the feasibility of introducing appropriateness criteria as a precondition to settling reimbursement claims in a publicly funded health insurance scheme in Maharashtra, India...
January 2017: National Medical Journal of India
#16
REVIEW
Giovanni B Frisoni, Marina Boccardi, Frederik Barkhof, Kaj Blennow, Stefano Cappa, Konstantinos Chiotis, Jean-Francois Démonet, Valentina Garibotto, Panteleimon Giannakopoulos, Anton Gietl, Oskar Hansson, Karl Herholz, Clifford R Jack, Flavio Nobili, Agneta Nordberg, Heather M Snyder, Mara Ten Kate, Andrea Varrone, Emiliano Albanese, Stefanie Becker, Patrick Bossuyt, Maria C Carrillo, Chiara Cerami, Bruno Dubois, Valentina Gallo, Ezio Giacobini, Gabriel Gold, Samia Hurst, Anders Lönneborg, Karl-Olof Lovblad, Niklas Mattsson, José-Luis Molinuevo, Andreas U Monsch, Urs Mosimann, Alessandro Padovani, Agnese Picco, Corinna Porteri, Osman Ratib, Laure Saint-Aubert, Charles Scerri, Philip Scheltens, Jonathan M Schott, Ida Sonni, Stefan Teipel, Paolo Vineis, Pieter Jelle Visser, Yutaka Yasui, Bengt Winblad
The diagnosis of Alzheimer's disease can be improved by the use of biological measures. Biomarkers of functional impairment, neuronal loss, and protein deposition that can be assessed by neuroimaging (ie, MRI and PET) or CSF analysis are increasingly being used to diagnose Alzheimer's disease in research studies and specialist clinical settings. However, the validation of the clinical usefulness of these biomarkers is incomplete, and that is hampering reimbursement for these tests by health insurance providers, their widespread clinical implementation, and improvements in quality of health care...
August 2017: Lancet Neurology
#17
REVIEW
Carolyn M Rutledge, Karen Kott, Patty A Schweickert, Rebecca Poston, Christianne Fowler, Tina S Haney
Telehealth is becoming a vital process for providing access to cost-effective quality care to patients at a distance. As such, it is important for nurse practitioners, often the primary providers for rural and disadvantaged populations, to develop the knowledge, skills, and attitudes needed to utilize telehealth technologies in practice. In reviewing the literature, very little information was found on programs that addressed nurse practitioner training in telehealth. This article provides an overview of both the topics and the techniques that have been utilized for training nurse practitioners and nurse practitioner students in the delivery of care utilizing telehealth...
2017: Advances in Medical Education and Practice
#18
Iga Lipska, Neil McAuslane, Hubert Leufkens, Anke Hövels
OBJECTIVES: The objective of this study is to illustrate and provide a better understanding of the role of health technology assessment (HTA) processes in decision making for drug reimbursement in Poland and how this approach could be considered by other countries of limited resources. METHODS: We analyzed the evolution of the HTA system and processes in Poland over the past decade and current developments based on publicly available information. RESULTS: The role of HTA in drug-reimbursement process in Poland has increased substantially over the recent decade, starting in 2005 with the formation the Agency for Health Technology Assessment and Tariff System (AOTMiT)...
July 19, 2017: International Journal of Technology Assessment in Health Care
#19
Esther Suter, Sara Mallinson, Renee Misfeldt, Omenaa Boakye, Louise Nasmith, Sabrina T Wong
BACKGROUND: We analyzed and compared primary health care (PHC) policies in British Columbia, Alberta and Saskatchewan to understand how they inform the design and implementation of team-based primary health care service delivery. The goal was to develop policy imperatives that can advance team-based PHC in Canada. METHODS: We conducted comparative case studies (n = 3). The policy analysis included: Context review: We reviewed relevant information (2007 to 2014) from databases and websites...
July 17, 2017: BMC Health Services Research
#20
Yoshinori Nakata, Tatsuya Yoshimura, Yuichi Watanabe, Hiroshi Otake, Giichiro Oiso, Tomohiro Sawa
Purpose The purpose of this paper is to determine the characteristics of healthcare facilities that produce the most efficient inpatient orthopedic surgery using a large-scale medical claims database in Japan. Design/methodology/approach Reimbursement claims data were obtained from April 1 through September 30, 2014. Input-oriented Banker-Charnes-Cooper model of data envelopment analysis (DEA) was employed. The decision-making unit was defined as a healthcare facility where orthopedic surgery was performed...
July 10, 2017: International Journal of Health Care Quality Assurance
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