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https://www.readbyqxmd.com/read/28544288/impact-of-hospital-best-practice-mandates-on-prescription-opioid-dispensing-after-an-emergency-department-visit
#1
Benjamin C Sun, Nicoleta Lupulescu-Mann, Christina J Charlesworth, Hyunjee Kim, Daniel M Hartung, Richard A Deyo, K John McConnell
OBJECTIVE: Washington State mandated seven hospital "best practices" in July 2012, several of which may affect ED opioid prescribing and provide a policy template for addressing the opioid prescription epidemic. We tested the hypothesis that the mandates would reduce opioid dispensing after an ED visit. We further assessed for a selective effect in patients with prior risky or chronic opioid use. METHODS: We performed a retrospective, observational analysis of ED visits by Medicaid fee-for service beneficiaries in Washington State, between July 1, 2011 to June 30, 2013...
May 23, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28542870/the-breast-and-cervical-cancer-early-detection-program-medicaid-and-breast-cancer-outcomes-among-ohio-s-underserved-women
#2
Siran M Koroukian, Paul M Bakaki, Phyo Than Htoo, Xiaozhen Han, Mark Schluchter, Cynthia Owusu, Gregory S Cooper, Johnie Rose, Susan A Flocke
BACKGROUND: As an organized screening program, the national Breast and Cervical Cancer Early Detection Program (BCCEDP) was launched in the early 1990s to improve breast cancer outcomes among underserved women. To analyze the impact of the BCCEDP on breast cancer outcomes in Ohio, this study compared cancer stages and mortality across BCCEDP participants, Medicaid beneficiaries, and "all others." METHODS: This study linked data across the Ohio Cancer Incidence Surveillance System, Medicaid, the BCCEDP database, death certificates, and the US Census and identified 26,426 women aged 40 to 64 years who had been diagnosed with incident invasive breast cancer during the years 2002-2008 (deaths through 2010)...
May 23, 2017: Cancer
https://www.readbyqxmd.com/read/28542637/smoking-prevalence-in-medicaid-has-been-declining-at-a-negligible-rate
#3
Shu-Hong Zhu, Christopher M Anderson, Yue-Lin Zhuang, Anthony C Gamst, Neal D Kohatsu
BACKGROUND: In recent decades the overall smoking prevalence in the US has fallen steadily. This study examines whether the same trend is seen in the Medicaid population. METHODS AND FINDINGS: National Health Interview Survey (NHIS) data from 17 consecutive annual surveys from 1997 to 2013 (combined N = 514,043) were used to compare smoking trends for 4 insurance groups: Medicaid, the Uninsured, Private Insurance, and Other Coverage. Rates of chronic disease and psychological distress were also compared...
2017: PloS One
https://www.readbyqxmd.com/read/28541869/teaming-up-for-asthma-control-epr-3-compliant-school-program-in-missouri-is-effective-and-cost-efficient
#4
Benjamin Francisco, Tammy Rood, Rebekah Nevel, Paul Foreman, Sherri Homan
INTRODUCTION: Teaming Up for Asthma Control (TUAC) is a work force development intervention to improve asthma control among children by increasing the competency of school nurses and delivering guideline-based education. We hypothesized that the knowledge and skills of participating school nurses would improve and that this change would positively affect students' asthma health and reduce health care utilization cost. METHODS: Asthma education for school nurses was provided online in a pretest/posttest format or in instructor-led groups...
May 25, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28541710/planned-parenthood-is-health-care-and-health-care-must-defend-it-a-call-to-action
#5
Diana Silver, Farzana Kapadia
Emboldened by the hostile rhetoric of the current presidential administration, federal and state legislators are intent on enacting legislation further curtailing, if not eliminating, Title X funding and Medicaid reimbursement to sexual and reproductive health care services providers-which are predominantly Planned Parenthood health centers. Defunding Planned Parenthood health centers would result in the loss of reproductive health and primary health care services that cannot be immediately replaced by community health clinics (CHCs) or other providers in underresourced counties...
May 25, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28539384/trump-proposes-slashing-funding-for-medicaid-poverty-programs-and-medical-research
#6
Michael McCarthy
No abstract text is available yet for this article.
May 24, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28539004/building-better-medicaid-care
#7
Joey Berlin
The trend away from fee-for-service and toward value-based payment models in the Texas Medicaid program shows some early promise.
May 1, 2017: Texas Medicine
https://www.readbyqxmd.com/read/28538626/the-capacity-of-icd-10-cm-pcs-to-characterize-surgical-care
#8
Garth H Utter, Kevin M Schuster, Preston R Miller, Nathan T Mowery, Suresh K Agarwal, Robert J Winchell, Marie L Crandall
The International Classification of Diseases, 10th edition, Clinical Modification and Procedure Coding System (ICD-10-CM/PCS) have been in effect since October 1, 2015 and offer much greater capacity than previous classifications to characterize the nature and treatment of surgical conditions. However, the diagnosis codes of ICD-10-CM are unevenly specific across the spectrum of surgical conditions and currently do not adequately allow description of important distinctions in disease severity for many common surgical conditions...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538031/association-between-surgeon-specific-features-and-number-of-stages-flaps-and-grafts-in-mohs-micrographic-surgery-a-retrospective-observational-study-of-59-early-mid-and-advanced-career-mohs-surgeons
#9
Marwan Alhaddad, John Zade, Adam Nabatian, David Kriegel, Hooman Khorasani
BACKGROUND: There is limited data available to correlate Mohs surgeons' behavior and years of experience. Moreover, the recent standardization of Mohs surgery training programs may allow for the prediction of future trends in Mohs micrographic surgery surgery based on the current behavior of recently trained Mohs surgeons. OBJECTIVE: To better understand the relationship between surgeon-specific characteristics and the number of Mohs micrographic surgery total cases, stages per case, number of grafts, and number of flaps performed by each surgeon...
May 22, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28537963/out-of-pocket-spending-under-the-affordable-care-act-for-patients-with-cancer
#10
Matthew S Dixon, Ashley L Cole, Stacie B Dusetzina
The Patient Protection and Affordable Care Act (ACA) included several key provisions aimed at lowering the out-of-pocket cost burden for patients. In this review, we summarize the effect of 3 provisions under Medicaid, Medicare, and commercial insurance, respectively: expansion of Medicaid eligibility, closing the doughnut hole for Medicare Part D beneficiaries, and requiring an annual limit on out-of-pocket spending for commercially insured patients. Through this review, we find early evidence that these 3 ACA provisions have reduced the out-of-pocket burden or increased access to health insurance for many patients...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28537962/effects-of-affordable-care-act-marketplaces-and-medicaid-eligibility-expansion-on-access-to-cancer-care
#11
John A Graves, Katherine Swartz
PURPOSE: The aim of this study was to inform oncologists about how repealing the Affordable Care Act (ACA) may affect their ability to provide cancer therapies for people with cancer enrolled in ACA health plans and why proposals to change Medicaid funding may make it even more difficult for Medicaid beneficiaries to access cancer treatments. METHODS: We examined the regulations and provisions of the ACA related to how health insurance impacts access to diagnostic testing and treatments for people with cancer, including access to clinical trials...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28537961/the-affordable-care-act-and-cancer-care-delivery
#12
Gabriel A Brooks, J Russell Hoverman, Carrie H Colla
The Affordable Care Act (ACA) has reformed US health care delivery through insurance coverage expansion, experiments in payment design, and funding for patient-centered clinical and health care delivery research. The impact on cancer care specifically has been far reaching, with new ACA-related programs that encourage coordinated, patient-centered, cost-effective care. Insurance expansions through private exchanges and Medicaid, along with preexisting condition clauses, have helped more than 20 million Americans gain health care coverage...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28537936/zidovudine-use-in-pregnancy-and-congenital-malformations-meta-analysis-and-bayesian-incorporation-of-medicaid-data
#13
Kathryn Rough, Jenny W Sun, George R Seage, Paige L Williams, Krista F Huybrechts, Brian T Bateman, Sonia Hernandez-Diaz
OBJECTIVE: There is inconsistent evidence that zidovudine use during pregnancy increases overall, cardiac, and male genital malformations. DESIGN: We conducted a systematic review and meta-analysis of zidovudine use and malformations and, using Bayesian methods, combined it with data from a cohort study of mother-infant pairs in the nationwide Medicaid Analytic eXtract (MAX). METHODS: Using MAX data (2000-2010), we identified pregnant women with HIV treated with antiretroviral therapy (ART)...
May 23, 2017: AIDS
https://www.readbyqxmd.com/read/28537346/does-length-of-stay-influence-how-patients-rate-their-hospitalization-after-total-hip-arthroplasty
#14
Ronald E Delanois, Chukwuweike Gwam, Jaydev B Mistry, Anton Khlopas, Morad Chughtai, Prem Ramkumar, Nicolas Piuzzi, Ryan Berger, Peter M Bonutti, Arthur L Malkani, Michael A Mont
BACKGROUND: The reimbursement for medical services by Medicare and Medicaid (CMS) has recently changed from fee-for-service to quality-based payments. This is being implemented through the use of patient administered surveys, most commonly Press Ganey. With a recent strive for fast-track total hip arthroplasty (THA), it is important to ascertain whether length-of-stay (LOS) in post-THA patients influences the Press Ganey scores and overall hospital ratings. Therefore, we looked at: 1) Which Press Ganey survey factors affect overall hospital rating in patients who have a short (=2) or longer (>2) length of stay; and 2) whether hospital satisfaction is different between patients who have varied lengths of stay...
May 24, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28536176/cost-of-alteplase-has-more-than-doubled-over-the-past-decade
#15
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/28535101/design-challenges-of-an-episode-based-payment-model-in-oncology-the-centers-for-medicare-medicaid-services-oncology-care-model
#16
Ronald M Kline, L Daniel Muldoon, Heidi K Schumacher, Larisa M Strawbridge, Andrew W York, Laura K Mortimer, Alison F Falb, Katherine J Cox, Carol Bazell, Ellen W Lukens, Mary C Kapp, Rahul Rajkumar, Amy Bassano, Patrick H Conway
The Centers for Medicare & Medicaid Services developed the Oncology Care Model as an episode-based payment model to encourage participating practitioners to provide higher-quality, better-coordinated care at a lower cost to the nearly three-quarter million fee-for-service Medicare beneficiaries with cancer who receive chemotherapy each year. Episode payment models can be complex. They combine into a single benchmark price all payments for services during an episode of illness, many of which may be delivered at different times by different providers in different locations...
May 23, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28534667/commentary-on-the-use-of-96119-in-billing-for-neuropsychological-services
#17
Leslie D Rosenstein
OBJECTIVE: This commentary seeks to outline the problematic issues with the use of 96119 in billing for neuropsychological evaluations. Issues covered include billing for the provider's time when using technicians as well as the use of trainees when billing Medicare. METHOD: Resources from the Centers for Medicare and Medicaid Services (CMS) were reviewed along with a search of available documentation from regional carriers and the general literature. CONCLUSIONS: There has been much confusion in the professional community regarding billing for neuropsychological evaluation services when utilizing technicians and/or trainees...
May 23, 2017: Clinical Neuropsychologist
https://www.readbyqxmd.com/read/28533698/use-of-the-medicare-database-in-epidemiologic-and-health-services-research-a-valuable-source-of-real-world-evidence-on-the-older-and-disabled-populations-in-the-us
#18
REVIEW
Katherine E Mues, Alexander Liede, Jiannong Liu, James B Wetmore, Rebecca Zaha, Brian D Bradbury, Allan J Collins, David T Gilbertson
Medicare is the federal health insurance program for individuals in the US who are aged ≥65 years, select individuals with disabilities aged <65 years, and individuals with end-stage renal disease. The Centers for Medicare and Medicaid Services grants researchers access to Medicare administrative claims databases for epidemiologic and health outcomes research. The data cover beneficiaries' encounters with the health care system and receipt of therapeutic interventions, including medications, procedures, and services...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28530523/cost-effectiveness-of-peginterferon-beta-1a-and-alemtuzumab-in-relapsing-remitting-multiple-sclerosis
#19
Ankur A Dashputre, Khalid M Kamal, Gauri Pawar
BACKGROUND: Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system, affecting 2.5 million people globally and 400,000 people in the United States. While no cure exists for MS, the goal is to manage the disease using disease-modifying therapies (DMTs), which have been shown to slow disease progression and prevent relapses. Relapsing-remitting MS (RRMS) is the most common form of MS at the time of diagnosis. Peginterferon beta-1a (PEG) and alemtuzumab (ALT) were recently approved and have demonstrated good clinical outcomes, including reduced relapse rates in clinical trials...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530522/factors-associated-with-adherence-to-and-treatment-duration-of-erlotinib-among-patients-with-non-small-cell-lung-cancer
#20
Lisa M Hess, Anthony Louder, Katherine Winfree, Yajun E Zhu, Ana B Oton, Radhika Nair
BACKGROUND: In lung cancer, there is an increasing number of oral agents available for patients; however, little is known about the factors associated with adherence to and treatment duration on oral medications in non-small cell lung cancer (NSCLC). OBJECTIVE: To evaluate the clinical and demographic factors associated with adherence and treatment discontinuation, respectively, to oral oncolytics among patients with NSCLC. METHODS: A retrospective, claims-based analysis of the Humana Research Database supplemented with medical chart review was conducted among patients with NSCLC who started an oral oncolytic between January 1, 2008, and June 30, 2013...
June 2017: Journal of Managed Care & Specialty Pharmacy
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