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Reimbursement approaches

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https://www.readbyqxmd.com/read/29445515/telementoring-with-project-echo-a-pilot-study-in-europe
#1
Clíona Ní Cheallaigh, Aisling O'Leary, Shay Keating, Aileen Singleton, Sheila Heffernan, Eamon Keenan, Lisa Robson, Jess Sears, John Moloney, Sanjeev Arora, Colm Bergin, Suzanne Norris
The Extension of Community Healthcare Outcomes (ECHO) project is a novel educational intervention designed in New Mexico to transfer subspecialty knowledge about hepatitis C virus (HCV) to primary care providers, thereby increasing patient access to HCV care. The ECHO model has been shown to deliver educational benefits and to result in good treatment outcomes for HCV-infected individuals in the USA; however, this approach has not been assessed in a European setting. We sought to evaluate the feasibility, acceptability and implementation of the ECHO model in Ireland using a pilot study...
July 2017: BMJ Innovations
https://www.readbyqxmd.com/read/29417402/cost-effectiveness-of-routine-laryngoscopy-in-the-surgical-treatment-of-differentiated-thyroid-cancer
#2
Kyle Zanocco, David J Kaltman, James X Wu, Abbey Fingeret, Keith S Heller, James A Lee, Michael W Yeh, Julie Ann Sosa, Cord Sturgeon
BACKGROUND: Some surgeons perform flexible fiberoptic laryngoscopy (FFL) in all patients prior to thyroid cancer operations. Given the low likelihood of recurrent laryngeal nerve (RLN) or aerodigestive invasion in clinically low-risk thyroid cancers, the value of routine FFL in this group is controversial. We hypothesized that routine preoperative FFL would not be cost effective in low-risk differentiated thyroid cancer (DTC). METHODS: A decision model was constructed comparing preoperative FFL versus surgery without FFL in a clinical stage T2 N0 DTC patient without voice symptoms...
February 7, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29392552/a-decision-analytic-model-to-assess-the-cost-effectiveness-of-etelcalcetide-vs-cinacalcet
#3
Björn Stollenwerk, Sergio Iannazzo, Ron Akehurst, Michael Adena, Andrew Briggs, Bastian Dehmel, Patrick Parfrey, Vasily Belozeroff
INTRODUCTION: Etelcalcetide is a novel intravenous calcimimetic for the treatment of secondary hyperparathyroidism (SHPT) in haemodialysis patients. The clinical efficacy and safety of etelcalcetide (in addition to phosphate binders and vitamin D and/or analogues [PB/VD]) was evaluated in three phase III studies, including two placebo-controlled trials and a head-to-head study versus the oral calcimimetic cinacalcet. OBJECTIVE: The objective of this study was to develop a decision-analytic model for economic evaluation of etelcalcetide compared with cinacalcet...
February 2, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29392355/risk-equivalent-t-score-adjustment-for-using-lumbar-spine-trabecular-bone-score-tbs-the-manitoba-bmd-registry
#4
W D Leslie, E Shevroja, H Johansson, E V McCloskey, N C Harvey, J A Kanis, D Hans
Lumbar spine trabecular bone score (TBS) can be used to modify the output from the fracture risk assessment tool, FRAX, to enhance fracture prediction. An alternative approach for using TBS in clinical practice, based upon an adjustment to the bone mineral density (BMD) T-score, may be helpful in regions where intervention guidelines and/or reimbursement are primarily based on BMD T-score. INTRODUCTION: The aim of this study is to develop an approach for using TBS in clinical practice based upon a "risk-equivalent" adjustment to the BMD T-score...
February 1, 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29385551/society-of-behavioral-medicine-sbm-position-statement-improving-access-to-psychosocial-care-for-individuals-with-persistent-pain-supporting-the-national-pain-strategy-s-call-for-interdisciplinary-pain-care
#5
E Amy Janke, Martin Cheatle, Francis J Keefe, Lara Dhingra
Policy makers have articulated a need for clear, evidence-based guidance to help inform pain policy. Persistent pain is common, expensive, and debilitating, and requires comprehensive assessment and treatment planning. Recently released opioid prescribing guidelines by the CDC (2016) emphasize the importance of using nonopioid therapies before considering opioid treatment for those without a malignant illness. The National Pain Strategy (2016) underscores the importance of comprehensive, interdisciplinary pain care...
January 27, 2018: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/29382230/how-to-optimize-the-prescription-of-laboratory-tests-success-and-failures-in-an-academic-hospital
#6
Catherine Fillée, Claire Beguin, Laurence Habimana, Catherine Hubert, Marianne Philippe
In the context of the flat-rate reimbursements in healthcare, we reviewed physicians' behavior towards laboratory test ordering. We demonstrated how it could be improved when a specific stage of the patient management is considered. We took a multi-step approach to analyze the laboratory test orders in the context of planned laparoscopic cholecystectomy in a general teaching hospital. A reference order set was defined through a collaborative analysis between clinicians and laboratory physicians. The clinical and financial impacts were then evaluated over a period of 24 months...
January 30, 2018: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/29378584/development-of-a-5as-based-technology-assisted-weight-management-intervention-for-veterans-in-primary-care
#7
Katrina F Mateo, Natalie B Berner, Natalie L Ricci, Pich Seekaew, Sandeep Sikerwar, Craig Tenner, Joanna Dognin, Scott E Sherman, Adina Kalet, Melanie Jay
BACKGROUND: Obesity is a worldwide epidemic, and its prevalence is higher among Veterans in the United States. Based on our prior research, primary care teams at a Veterans Affairs (VA) hospital do not feel well-equipped to deliver effective weight management counseling and often lack sufficient time. Further, effective and intensive lifestyle-based weight management programs (e.g. VA MOVE! program) are underutilized despite implementation of systematic screening and referral at all VA sites...
January 29, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29377968/-preventive-dentistry-9-non-restorative-cavity-treatment-advanced-insight-or-controversial
#8
R J M Gruythuysen, A J P van Strijp
Non-Restorative Cavity Treatment (NRCT) is not as popular in paediatric dentistry as it should be. Substantial quantitative and qualitative evidence concerning the treatment has now been published that testifies to the success of the treatment. Some healthcare providers apply the method successfully, while others have no trust in this non-invasive cavity treatment and continue to favour the restoration of carious lesions. Reasons given for this are, among others, that NRCT is too bothersome, the patient's (or the patient's parents') compliance is low and the reimbursement is inadequate...
January 2018: Nederlands Tijdschrift Voor Tandheelkunde
https://www.readbyqxmd.com/read/29376557/excellent-outcome-of-direct-antiviral-treatment-for-chronic-hepatitis-c-in-switzerland
#9
Jacqueline Bachofner, Piero V Valli, Irina Bergamin, Arne Kröger, Patrizia Künzler, Adriana Baserga, Dominique L Braun, Burkhardt Seifert, Anja Moncsek, Jan Fehr, David Semela, Lorenzo Magenta, Beat Müllhaupt, Benedetta Terziroli Beretta-Piccoli, Joachim Mertens, The Swiss Hepatitis C Cohort Study
BACKGROUND: The introduction of direct acting antivirals (DAAs) for the therapy of chronic hepatitis C (CHC) has revolutionised treatment and marks a paradigm shift in the approach to this disease, rendering interferon-based therapies obsolete. AIMS OF THE STUDY: We retrospectively and prospectively evaluated treatment results after the introduction of DAA in Switzerland in a cohort of patients with CHC. METHODS: We examined 565 patients who received DAA treatment for CHC between November 2013 and June 2016 with regard to HCV genotype, fibrosis stadium, treatment and outcome...
January 29, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29368121/-assessing-the-benefits-of-digital-health-solutions-in-the-societal-reimbursement-context
#10
REVIEW
Urs-Vito Albrecht, Bertolt Kuhn, Jörg Land, Volker E Amelung, Ute von Jan
For a number of reasons, achieving reimbursability for digital health products has so far proven difficult. Demonstrating the benefits of the technology is the main hurdle in this context. The generally accepted evaluation processes, especially parallel group comparisons in randomized controlled trials (RCTs) for (clinical) benefit assessment, are primarily intended to deal with questions of (added) medical benefit. In contrast to drugs or classical medical devices, users of digital health solutions often profit from gaining autonomy, increased awareness and mindfulness, better transparency in the provision of care, and improved comfort, although there are also digital solutions with an interventional character targeting clinical outcomes (e...
January 24, 2018: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/29362952/the-role-of-the-clinician-in-the-multi-omics-era-are-you-ready
#11
Clara D M van Karnebeek, Saskia B Wortmann, Maja Tarailo-Graovac, Mirjam Langeveld, Carlos R Ferreira, Jiddeke M van de Kamp, Carla E Hollak, Wyeth W Wasserman, Hans R Waterham, Ron A Wevers, Tobias B Haack, Ronald J A Wanders, Kym M Boycott
Since Garrod's first description of alkaptonuria in 1902, and newborn screening for phenylketonuria introduced in the 1960s, P4 medicine (preventive, predictive, personalized, and participatory) has been a reality for the clinician serving patients with inherited metabolic diseases. The era of high-throughput technologies promises to accelerate its scale dramatically. Genomics, transcriptomics, epigenomics, proteomics, glycomics, metabolomics, and lipidomics offer an amazing opportunity for holistic investigation and contextual pathophysiologic understanding of inherited metabolic diseases for precise diagnosis and tailored treatment...
January 23, 2018: Journal of Inherited Metabolic Disease
https://www.readbyqxmd.com/read/29362948/genetic-counselors-experiences-and-interest-in-telegenetics-and-remote-counseling
#12
Heather A Zierhut, Ian M MacFarlane, Zahra Ahmed, Jill Davies
In 2009, the National Society of Genetic Counselors Service (NSGC) Delivery Model Task Force defined genetic counseling service delivery models including telephone (genetic counseling provided remotely by telephone) and telegenetics (counseling provided remotely using videoconferencing). Little is known about the experience of genetic counselors practicing telemedicine in the USA. We sought to evaluate perceived satisfaction, advantages, disadvantages, and barriers to the practice and implementation of telegenetics by practicing genetic counselors...
January 23, 2018: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/29353385/the-relative-importance-of-clinical-economic-patient-values-and-feasibility-criteria-in-cancer-drug-reimbursement-in-canada-a-revealed-preferences-analysis-of-recommendations-of-the-pan-canadian-oncology-drug-review-2011-2017
#13
Chris Skedgel, Dominika Wranik, Min Hu
BACKGROUND: Most Canadian provinces and territories rely on the pan-Canadian Oncology Drug Review (pCODR) to provide recommendations regarding public reimbursement of cancer drugs. The pCODR review process considers four dimensions of value-clinical benefit, economic evaluation, patient-based values and adoption feasibility-but they do not define weights for individual decision criteria or an acceptable threshold for any of the criteria. Given this implicit review process, it is of interest to understand which factors appear to carry the most weight in pCODR recommendations using a revealed preferences approach...
January 20, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29349522/team-based-care-with-pharmacists-to-improve-blood-pressure-a-review-of-recent-literature
#14
REVIEW
Korey A Kennelty, Linnea A Polgreen, Barry L Carter
PURPOSE OF REVIEW: We review studies published since 2014 that examined team-based care strategies and involved pharmacists to improve blood pressure (BP). We then discuss opportunities and challenges to sustainment of team-based care models in primary care clinics. RECENT FINDINGS: Multiple studies presented in this review have demonstrated that team-based care including pharmacists can improve BP management. Studies highlighted the cost-effectiveness of a team-based pharmacy intervention for BP control in primary care clinics...
January 18, 2018: Current Hypertension Reports
https://www.readbyqxmd.com/read/29346136/interdisciplinary-team-evaluation-an-effective-method-for-the-diagnostic-assessment-of-autism-spectrum-disorder
#15
Jennifer Gerdts, James Mancini, Emily Fox, Candace Rhoads, Tracey Ward, Erin Easley, Raphael A Bernier
OBJECTIVE: The objective of this research is to assess the feasibility of an interdisciplinary team diagnostic assessment model for autism spectrum disorder (ASD). METHOD: Medical records from 366 patients evaluated for ASD at the Seattle Children's Autism Center (SCAC) were reviewed. ASD diagnostic outcomes, provider satisfaction, engagement in follow-up care, billed time, and reimbursement amounts were compared in patients evaluated through an interdisciplinary team approach (n = 91) with those seen in multidisciplinary evaluations led by either a psychologist (n = 165) or a physician (n = 110)...
January 12, 2018: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/29331280/-jurisdictions-on-the-reimbursement-of-new-medical-technologies-by-public-health-insurance-a-systematic-review
#16
REVIEW
Patricia Ex, Susanne Felgner, Cornelia Henschke
BACKGROUND: In Germany reimbursement for new medical technologies is often enforced before a social court. It is likely that these judicial decisions also affect the sickness funds' decisions on requests for reimbursement and thus patient access to new technologies in general. OBJECTIVES: The aim of this study was to identify the technologies that have repeatedly generated court actions and whether these actions have been successful. The focus was on differences between sectors, technology groups and indications...
January 10, 2018: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/29331254/technology-alignment-in-the-presence-of-regulatory-changes-the-case-of-meaningful-use-of-information-technology-in-healthcare
#17
Anand Nair, David Dreyfus
OBJECTIVES: Using the context of the healthcare sector, this study examines the impact of regulatory change on technology implementation and use. Hospitals are now federally mandated to showcase meaningful use of information technology (IT). We theorize that IT plan scope structured prior to a regulatory change by means of a long-term planning horizon, top management involvement, and steering committee engagement impacts organizations' ability to fulfill meaningful use requirements three to five years later...
February 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29324861/cost-of-treatment-for-head-and-neck-cancer-in-india
#18
Akashdeep Singh Chauhan, Shankar Prinja, Sushmita Ghoshal, Roshan Verma, Arun S Oinam
There are no published data on the cost of cancer treatment for guiding reimbursement decisions in India. The present study was designed to estimate the cost of treating head and neck cancer (HNC) with the aim of determining package rates. The present study was undertaken in the Departments of Radiotherapy and Otolaryngology of a large tertiary care hospital in North India. Economic health system costs incurred were assessed using a bottom-up methodology. Data on all resources-capital or recurrent, incurred on the delivery of HNC treatment were collected from April 2014 to March 2015...
2018: PloS One
https://www.readbyqxmd.com/read/29318082/a-review-of-a-workers-compensation-database-2003-to-2013-patient-factors-influencing-return-to-work-and-cumulative-financial-claims-after-rotator-cuff-repair-in-geriatric-workers-compensation-cases
#19
Edward Shields, Caroline Thirukumaran, Katia Noyes, Ilya Voloshin
Background: Workers' compensation status is associated with poor outcomes after rotator cuff repair surgery. The purpose of this study was to analyze a database of geriatric workers' compensation patients after surgical repair of the rotator cuff and identify both medical and nonmedical patient factors that influence the time it takes for them to return to work at full duty, including a comparison of arthroscopic and open techniques. Methods: An all workers' compensation database was queried for rotator cuff claims that were surgically managed using arthroscopic, open, or both approaches from 2003 to 2013 in patients aged ≥60...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29316449/integrating-physical-health-what-were-the-costs-to-behavioral-health-care-clinics
#20
Kathryn L Connor, Joshua Breslau, Molly T Finnerty, Emily Leckman-Westin, Riti Pritam, Hao Yu
OBJECTIVE: To inform providers and policy-makers about the potential costs of providing physical health care in mental health clinics. METHODS: Cost data were collected through interviews with 22 behavioral health clinics participating in New York State Office of Mental Health's health monitoring and health physicals programs. The interview data was combined with financial reporting data provided to the state to identify per interaction costs for two levels of physical health services: health monitoring and health monitoring plus health physicals...
December 20, 2017: General Hospital Psychiatry
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