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https://www.readbyqxmd.com/read/27913067/the-financial-impact-of-clinic-no-show-rates-in-an-academic-pediatric-otolaryngology-practice
#1
Zhen Huang, Mariam Ashraf, Heather Gordish-Dressman, Pamela Mudd
PURPOSE: To investigate determinants of no-show rates in an academic pediatric otolaryngology practice including appointment time, age, sex, new patient status, payer mix, and median household income by zip code. MATERIALS AND METHODS: Retrospective chart review of clinic no-show rates and patient demographics in a free standing children's hospital and affiliated outpatient clinics across eight providers in a one-year period. RESULTS: Analysis shows that the overall no-show rate across all providers was 15% with the highest rate of 19% in the zip code with the lowest median income...
November 23, 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27907983/north-korean-refugee-doctors-preliminary-examination-scores
#2
Sung Uk Chae, Jeong Hee Yang, Joon Seop Hyun, June Hee Kim, Seok Hoon Kang
PURPOSE: Although there have been studies emphasizing the re-education of North Korean (NK) doctors for post-unification of the Korean Peninsula, study on the content and scope of such re-education has yet to be conducted. Researchers intended to set the content and scope of re-education by a comparative analysis for the scores of the preliminary examination, which is comparable to the Korean Medical Licensing Examination (KMLE). METHODS: The scores of the first and second preliminary exams were analyzed by subject using the Wilcoxon signed rank test...
December 2016: Korean Journal of Medical Education
https://www.readbyqxmd.com/read/27892907/concierge-medicine-a-viable-business-model-for-some-physicians-of-the-future
#3
David P Paul, Michaeline Skiba
Concierge medicine is a medical management structure that has been in existence since the 1990s. Essentially, a typical concierge medical practice limits its number of patients and provides highly personalized attention that includes comprehensive annual physicals, same-day appointments, preventive and wellness care, and fast, 24/7 response time. Concierge medicine has become popular among both physicians and patients/consumers who are frustrated by the limitations imposed by managed care organizations. From many physicians' perspectives, concierge medicine offers greater autonomy, the opportunity to return to a more manageable patient load, and the chance to improve their incomes that have declined because of increasingly lowered reimbursements for their services...
January 2016: Health Care Manager
https://www.readbyqxmd.com/read/27888945/radiology-as-the-point-of-cancer-patient-and-care%C3%A2-team-engagement-applying-the-4r-model-at%C3%A2-a-patient-s-breast-cancer-care-initiation
#4
Christine B Weldon, Sarah M Friedewald, Swati A Kulkarni, Melissa A Simon, Ruth C Carlos, Jonathan B Strauss, Mikele M Bunce, Art Small, Julia R Trosman
Radiologists aspire to improve patient experience and engagement, as part of the Triple Aim of health reform. Patient engagement requires active partnerships among health providers and patients, and rigorous teamwork provides a mechanism for this. Patient and care team engagement are crucial at the time of cancer diagnosis and care initiation but are complicated by the necessity to orchestrate many interdependent consultations and care events in a short time. Radiology often serves as the patient entry point into the cancer care system, especially for breast cancer...
December 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27882841/association-of-a-controlled-substance-scoring-algorithm-with-health-care-costs-and-hospitalizations-a-cohort-study
#5
Catherine I Starner, Yang Qiu, Pinar Karaca-Mandic, Patrick P Gleason
BACKGROUND: Patients often misuse a combination of prescription drugs including opioids; however, the relationship between a controlled substance (CS) score and health outcomes is unknown. OBJECTIVE: To examine the association between a CS scoring algorithm and health care use, specifically total cost of care, hospitalizations, and emergency room (ER) visits. METHODS: This analysis was a retrospective cohort study using administrative claims data from a large U...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27882834/amcp-partnership-forum-navigating-innovations-in-diabetes-care
#6
(no author information available yet)
: New developments that provide opportunities to enhance cost-effective diabetes care include advances in the pharmacologic treatment of diabetes, new drug delivery devices, innovations in patient management strategies, contracting strategies that incentivize effective interventions, and mobile health technologies. Payers must carefully consider the utility of these advances when making coverage decisions and designing benefits. To engage national stakeholders in a discussion about how to utilize innovations in diabetes care to optimize patient outcomes, the Academy of Managed Care Pharmacy organized the Partnership Forum on Navigating Innovations in Diabetes Care in Arlington, Virginia, on July 19-20, 2016...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27882833/evaluation-of-real-world-experience-with-tofacitinib-compared-with-adalimumab-etanercept-and-abatacept-in-ra-patients-with-1-previous-biologic-dmard-data-from-a-u-s-administrative-claims-database
#7
James Harnett, Robert Gerber, David Gruben, Andrew S Koenig, Connie Chen
BACKGROUND: Real-world data comparing tofacitinib with biologic disease-modifying antirheumatic drugs (bDMARDs) are limited. OBJECTIVE: To compare characteristics, treatment patterns, and costs of patients with rheumatoid arthritis (RA) receiving tofacitinib versus the most common bDMARDs (adalimumab [ADA], etanercept [ETN], and abatacept [ABA]) following a single bDMARD in a U.S. administrative claims database. METHODS: This study was a retrospective cohort analysis of patients aged ≥ 18 years with an RA diagnosis (ICD-9-CM codes 714...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27882832/geographic-variation-in-the-quality-and-cost-of-care-for-patients-with-rheumatoid-arthritis
#8
Jason Shafrin, Arijit Ganguli, Yuri Sanchez Gonzalez, Jin Joo Shim, Seth A Seabury
BACKGROUND: There is considerable push to improve value in health care by simultaneously increasing quality while lowering or containing costs. However, for diseases that are best treated with comparatively expensive treatments, such as rheumatoid arthritis (RA), there could be tension between these aims. In this study, we measured geographic variation in quality, access, and cost for patients with RA, a disease with effective but costly specialty treatments. OBJECTIVE: To assess the geographic differences in the quality, access, and cost of care for patients with RA...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27860158/a-real-world-study-of-treatment-patterns-and-outcomes-in-us-managed-care-patients-with-type-2-diabetes-initiating-injectable-therapies
#9
W Wei, E Buysman, M Grabner, L Xie, L Brekke, X Ke, J W Chu, P A Levin
AIMS: Examine real-world outcomes in patients with type 2 diabetes mellitus (T2DM) initiating injectable therapy as part of the Initiation of New Injectable Treatment Introduced after Anti-diabetic Therapy with Oral-only Regimens (INITIATOR) study. MATERIALS AND METHODS: Linked insurance claims and medical record data were collected from two large US health insurers (1 April 2010 - 31 March 2012) of T2D adults initiating glargine (GLA) or liraglutide (LIRA). Baseline characteristics were examined and changes in 12-months' follow-up outcomes were described for both treatment groups: HbA1c, weight change, hypoglycaemia, persistence, healthcare utilisation and costs...
November 17, 2016: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/27859056/mandatory-statewide-medicaid-managed-care-in-florida-and-hospitalizations-for-ambulatory-care-sensitive-conditions
#10
Tianyan Hu, Karoline Mortensen
OBJECTIVE: To investigate the impact of implementation of the Statewide Medicaid Managed Care (SMMC) program in Florida on access to and quality of primary care for Medicaid enrollees, measured by hospitalizations for ambulatory care sensitive conditions (ACSCs). DATA SOURCES: We examine inpatient data obtained from the Agency for Health Care Administration for 285 hospitals in Florida from January 2010 to June 2015. The analysis includes 3,645,515 discharges for Florida residents between the ages 18 and 64 with a primary payer of Medicaid or private insurance...
November 17, 2016: Health Services Research
https://www.readbyqxmd.com/read/27849350/maternal-mental-health-and-infant-mortality-for-healthy-weight-infants
#11
Susan E White, Robert W Gladden
OBJECTIVES: The objective of this study was to determine if severe mental illness and/or a history of substance use in mothers of babies of a healthy weight was associated with infant mortality. STUDY DESIGN: This was a cross-sectional observational study using CareSource historical billed Medicaid Managed Care plan (MMC) claims in Ohio. METHODS: CareSource is Ohio's largest MMCP, serving approximately 1.2 million Medicaid consumers. Claims from 89,159 babies of a healthy weight (≥ 2500 grams) and their mothers were selected from the CareSource Ohio MMCP population from January 2011 through December 2014...
November 1, 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27846640/cardiac-stress-test-trends-among-us-patients-younger-than-65-years-2005-2012
#12
Vinay Kini, Fenton H McCarthy, Elias Dayoub, Steven M Bradley, Frederick A Masoudi, P Michael Ho, Peter W Groeneveld
Importance: After a period of rapid growth, use of cardiac stress testing has recently decreased among Medicare beneficiaries and in a large integrated health system. However, it is not known whether declines in cardiac stress testing are universal or are confined to certain populations. Objective: To determine trends in rates of cardiac stress testing among a large and diverse cohort of commercially insured patients. Design, Setting, and Participants: A serial cross-sectional study with time trends was conducted using administrative claims from all members aged 25 to 64 years belonging to a large, national managed care company from January 1, 2005, to December 31, 2012...
November 15, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27822405/job-satisfaction-among-doctors-of-a-government-medical-college-and-hospital-of-eastern-india
#13
Sharmistha Bhattacherjee, Kuntala Ray, Jayanta Kumar Roy, Abhijit Mukherjee, Hironmoy Roy, Saikat Datta
BACKGROUND: Job satisfaction expresses the extent of congruence between an individual’s expectation of the job and the reward that the job provides.Job satisfaction among doctors is an issue that is of utmost importance because offactors like patient relationships and time pressures associated with managed care. The current study was done to determine the level of job satisfaction in doctors posted in a tertiary care hospital of eastern India and to find out the factors associated with it...
October 2016: Nepal journal of epidemiology
https://www.readbyqxmd.com/read/27819160/comparison-of-health-utility-weights-among-elderly-patients-receiving-breast-conserving-surgery-plus-hormonal-therapy-with-or-without-radiotherapy
#14
Askal Ayalew Ali, Hong Xiao, Rima Tawk, Ellen Campbell, Anastasia Semykina, Alberto J Montero, Vakaramoko Diaby
BACKGROUND: The selection of the most appropriate treatment combinations requires the balancing of benefits and harms of these treatment options as well as the patients' preferences for the resulting outcomes. OBJECTIVE: This research aimed at estimating and comparing the utility weights between elderly women with early-stage hormone receptor positive (HR+) breast cancer, receiving a combination of radiotherapy and hormonal therapy after BCS, and those receiving a combination of BCS and hormonal therapy...
November 5, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27818441/seniors-and-people-with-disabilities-experiences-with-mandatory-medicaid-managed-care-in-california-populations-to-target-for-additional-support-during-transitions
#15
Carrie L Graham, Diana D McDonnell
With more states moving people with disabilities and complex care needs into managed care, it is important to target beneficiaries for additional anticipated support before specific needs arise. In a survey of 1,521 seniors and people with disabilities in California who moved into Medicaid managed care six-16 months previously, the majority reported neutral or positive experiences with managed care continuity, access, and quality, compared with fee-for-service. Beneficiaries most likely to have negative experiences included those with poor self-rated health, functional impairment, cognitive impairment, frequent ED visits, and claims for back / osteoarthritis and cancer...
2016: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/27813042/red-blood-cell-distribution-width-is-an-independent-predictor-of-outcome-in-patients-undergoing-thrombolysis-for-ischemic-stroke
#16
Gianni Turcato, Manuel Cappellari, Luca Follador, Alice Dilda, Antonio Bonora, Massimo Zannoni, Chiara Bovo, Giorgio Ricci, Paolo Bovi, Giuseppe Lippi
An appropriate and timely management, including early diagnosis and accurate prognostication, is the mainstay for managed care of patients with acute ischemic stroke. Since red blood cell distribution width (RDW) was found to be an independent predictor of clinical outcomes in patients with thrombotic disorders, we designed a retrospective observational study to investigate whether the RDW value may also retain predictive significance in stoke patients undergoing thrombolytic therapy. This retrospective study was based on all patients admitted to the Emergency Department (ED) of the University Hospital of Verona (Italy) with a diagnosis of ischemic stroke, who underwent systemic thrombolysis between January 2013 and June 2015...
November 3, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27798809/a-review-of-us-drug-costs-relevant-to-medicare-medicaid-and-commercial-insurers-post-affordable-care-act-enactment-2010-2016
#17
REVIEW
Jacquelyn McRae, F Randy Vogenberg, Silky Webb Beaty, Elizabeth Mearns, Stefan Varga, Laura Pizzi
Since passage of the Affordable Care Act (ACA) in 2010, US stakeholders are increasingly being held accountable for the value of healthcare services and drugs administered to patients. Pharmacoeconomic analyses offer one method of demonstrating a product's value, yet there is a lack of resources specific to US drug costs relevant to each stakeholder. The aim of this study was to review current US drug costs (post-ACA). A literature review aimed at finding evidence on outpatient prescription drug costs was performed using the following sources: PubMed, governmental agencies, news websites, the Academy of Managed Care Pharmacy (AMCP) website, and Google Scholar...
October 31, 2016: PharmacoEconomics
https://www.readbyqxmd.com/read/27783556/adherence-to-rivaroxaban-dabigatran-and-apixaban-for-stroke-prevention-in-incident-treatment-na%C3%A3-ve-nonvalvular-atrial-fibrillation
#18
Joshua D Brown, Anand R Shewale, Jeffery C Talbert
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) are widely used for prevention of stroke secondary to nonvalvular atrial fibrillation (NVAF). Increased use of NOACs is partially a result of simplified regimens compared with warfarin, which has been associated with poor adherence and persistence to therapy. Few studies have assessed adherence to NOACs, especially using contemporary data now that multiple NOACs are available. OBJECTIVE: To evaluate adherence to NOACs in a cohort of newly diagnosed NVAF patients who are commercially insured...
November 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27783550/impact-of-a-combined-value-based-insurance-design-and-medication-therapy-management-program-on-diabetes-medication-adherence
#19
Alex Peaslee, Marleen Wickizer, Julie Olson, Robert Topp
BACKGROUND: Value-based insurance design (VBID) waives or reduces prescription copayments in order to decrease member cost barriers to refilling medications. Medication therapy management (MTM) is a member clinical intervention designed to reinforce members' knowledge of their medications, which addresses barriers to medication adherence. Both methods have been shown to increase adherence in members, particularly when used in combination. To date, studies of such combined programs have often been completed within integrated health systems but have rarely included control populations...
November 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27783549/impact-of-out-of-pocket-pharmacy-costs-on-branded-medication-adherence-among-patients-with-type-2-diabetes
#20
Wendy S Bibeau, Haoda Fu, April D Taylor, Anita Y M Kwan
BACKGROUND: Medication adherence is pivotal for the successful treatment of diabetes. However, medication adherence remains a major concern, as nonadherence is associated with poor health outcomes. Studies have indicated that increasing patients' share of medication costs significantly reduces adherence. Little is known about a potential out-of-pocket (OOP) cost threshold where substantial reduction in adherence may occur. OBJECTIVE: To examine the impact of diabetes OOP pharmacy costs on antihyperglycemic medication adherence and identify the potential threshold at which significant reduction in adherence may occur among patients with type 2 diabetes mellitus (T2DM)...
November 2016: Journal of Managed Care & Specialty Pharmacy
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