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https://www.readbyqxmd.com/read/29785787/expanding-systems-thinking-incorporating-tools-from-medical-sociology-into-mft-education-and-research
#1
Joy Heafner, Laura Mauldin
The field of marriage and family therapy has historically focused on dynamics within family systems, and at times the role of social and cultural factors external to the family. To date, however, little scholarship has examined how therapists themselves are embedded within a mental healthcare system. The purpose of this article is to demonstrate how structural components of the mental healthcare system shape the practice of therapy. We draw from the field of medical sociology to illustrate how three dominant structures-managed care, diagnosis, and evidence-based models-are intertwining and mutually reinforcing systems that have significant and long-term implications for systemic therapists and researchers...
May 21, 2018: Journal of Marital and Family Therapy
https://www.readbyqxmd.com/read/29781164/consumer-price-sensitivity-and-health-plan-choice-in-a-regulated-competition-setting
#2
Tamara Bischof, Christian P R Schmid
We estimate premium elasticities in a regulated competition market based on a quasi-exogenous premium increase for young adults in Switzerland. We exploit that individuals born before the turn of the year ("treatment group") face a larger increase in premiums than individuals born after the turn of the year ("control group"). We find that the treatment group is 1.5 times more likely to switch their health plan than the control group. Overall, individuals respond to premium increases by choosing more frequently health plans with managed care features, increasing the deductible, and by switching the insurer...
May 21, 2018: Health Economics
https://www.readbyqxmd.com/read/29775799/exploding-asthma-and-adhd-caseloads-the-role-of-medicaid-managed-care
#3
Anna Chorniy, Janet Currie, Lyudmyla Sonchak
In the U.S., nearly 11% of school-age children have been diagnosed with ADHD, and approximately 10% of children suffer from asthma. In the last decade, the number of children diagnosed with these conditions has inexplicably been on the rise. This increase has been concentrated in the Medicaid caseload nationwide. One of the most striking changes in Medicaid has been the transition from fee-for-service (FFS) reimbursement to Medicaid managed care (MMC), which had taken place in 80% of states by 2016. Using Medicaid claims from South Carolina, we show that this change contributed to the increase in asthma and ADHD caseloads...
May 7, 2018: Journal of Health Economics
https://www.readbyqxmd.com/read/29763411/characteristics-and-health-care-resource-use-of-subjects-with-copd-in-the-year-before-initiating-lama-monotherapy-or-lama-laba-combination-therapy-a-u-s-database-study
#4
Saurabh Nagar, Jeetvan Patel, Richard H Stanford
PURPOSE: To characterize subjects with chronic obstructive pulmonary disease (COPD) newly initiated on long-acting muscarinic antagonists (LAMA) or dual LAMA/long-acting β2-adrenergic agonist (LABA) therapy. DESIGN: This pilot/preliminary analysis was a retrospective crosssectional study of subjects with COPD from the Optum Impact National Managed Care Benchmark Database. METHODOLOGY: Subjects with at least one LAMA prescription in the index period (July 2008-June 2009) were included and stratified by treatment...
May 2018: Managed Care
https://www.readbyqxmd.com/read/29752632/care-management-intervention-to-decrease-psychiatric-and-substance-use-disorder-readmissions-in-medicaid-enrolled-adults
#5
Shari L Hutchison, Jenny V Flanagan, Irina Karpov, Lisa Elliott, Brandi Holsinger, Jamie Edwards, David Loveland
This study examines the generalizability of a successful care management bridging strategy implemented by a behavioral health managed care organization to reduce readmission in psychiatric and substance use disorder (SUD) populations. The sample included 1724 individuals with a psychiatric or SUD hospitalization or detoxification service within 30-days of a prior SUD or inpatient event; 1243 Medicaid-enrolled adults received the intervention plus usual care, and 481 individuals received only usual care. Results included lower readmission to SUD facilities (p = ...
May 11, 2018: Journal of Behavioral Health Services & Research
https://www.readbyqxmd.com/read/29752175/well-child-visits-of-medicaid-insured-children-with-medical-complexity
#6
Igor Shumskiy, Troy Richardson, Sumeet Brar, Matt Hall, Joanne Cox, Charis Crofton, Alon Peltz, Margaret Samuels-Kalow, Elizabeth R Alpern, Mark I Neuman, Jay G Berry
OBJECTIVE: Well-child visits (WCVs) help optimize children's health. We measured annual WCVs for children with medical complexity (CMC) and correlated WCVs with hospitalizations. STUDY DESIGN: This was a retrospective analysis of 93 121 CMC aged 1-18 years continuously enrolled in 10 state Medicaid programs in the Truven MarketScan Database between 2010 and 2014. CMC had a complex chronic condition or 3 or more chronic conditions of any complexity identified from International Classification of Diseases, Ninth Revision codes, and the use of 1 or more chronic medications...
May 8, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29749302/integrated-accountable-care-for-medicaid-expansion-enrollees-a-comparative-evaluation-of-hennepin-health
#7
Katherine D Vickery, Nathan D Shippee, Jeremiah Menk, Ross Owen, David M Vock, Peter Bodurtha, Dana Soderlund, Rodney A Hayward, Matthew M Davis, John Connett, Mark Linzer
Hennepin Health, a Medicaid accountable care organization, began serving early expansion enrollees (very low-income childless adults) in 2012. It uses an integrated care model to address social and behavioral needs. We compared health care utilization in Hennepin Health with other Medicaid managed care in the same area from 2012 to 2014, controlling for demographics, chronic conditions, and enrollment patterns. Homelessness and substance use were higher in Hennepin Health. Overall adjusted results showed Hennepin Health had 52% more emergency department visits and 11% more primary care visits than comparators...
May 1, 2018: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29742653/what-obstetrician-gynecologists-should-know-about-population-health
#8
Denise J Jamieson, Lisa B Haddad
Although there is much discussion about population health in academic medical centers, managed care organizations, and a variety of disciplines, it is not always clear what this term means. Population health describes the health outcomes of a group of individuals including health disparities, social determinants of health, and policies and interventions that link health outcomes with and patterns of health determinants. We describe some of the successes and challenges to addressing reproductive health issues in Georgia from a population health perspective, focusing on efforts to reduce teenage pregnancy and improve maternal health...
May 7, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29740816/the-impact-of-the-hospital-readmissions-reduction-program-across-insurance-types-in-california
#9
David S Zingmond, Li-Jung Liang, Punam Parikh, José J Escarce
OBJECTIVE: Examine 30-day readmission rates for indicator conditions before and after adoption of the Hospital Readmissions Reduction Program (HRRP). DATA: California hospital discharge data, 2005 to 2014. STUDY DESIGN: Estimated difference between pre-HRRP trends and post-HRRP rates of hospital readmissions after hospitalization for indicator conditions targeted by the HRRP (heart attack, heart failure, and pneumonia) by payer among insured adults...
May 8, 2018: Health Services Research
https://www.readbyqxmd.com/read/29733229/healthcare-resource-utilization-costs-of-care-and-treatment-of-mycosis-fungoides-cutaneous-t-cell-lymphoma-patterns-in-a-large-managed-care-population-a-retrospective-us-claims-based-analysis
#10
Yuen Tsang, Tao Gu, Gaurav Sharma, Susan Raspa, Bill Drake, Hiangkiat Tan
PURPOSE: To evaluate health care utilization, treatment patterns and costs among patients with mycosis fungoides-cutaneous T-cell lymphoma (MF-CTCL). METHODS: This retrospective cohort study queried the HealthCore Integrated Research Database to identify patients ≥18 years with ≥2 diagnoses of MF-CTCL (ICD-9-CM code 202.1x, 202.2x) between 07 January 2006 and 07 January 2013. Index date was defined as first MF-CTCL diagnosis. Patients were continuously enrolled ≥6 months before and ≥12 months after index date...
May 7, 2018: Journal of Dermatological Treatment
https://www.readbyqxmd.com/read/29726928/effects-of-long-term-services-and-supports-on-survival-of-poor-highly-vulnerable-older-adults
#11
Raven H Weaver, Karen A Roberto
Background and Objectives: We explore how an understudied population of older individuals addresses their ongoing care needs when ineligible for Medicaid waiver services. Research Design and Methods: Using regression techniques, we identified factors associated with service use and health outcomes among 1,008 older adults (60+) who applied for Medicaid waiver assistance. Exploratory follow-up interviews with eight waiver-ineligible rural-dwelling individuals identified strategies used for managing their care needs...
May 3, 2018: Gerontologist
https://www.readbyqxmd.com/read/29726303/breast-and-cervical-cancer-screening-among-medicaid-beneficiaries-the-role-of-physician-payment-and-managed-care
#12
Lindsay M Sabik, Bassam Dahman, Anushree Vichare, Cathy J Bradley
Medicaid-insured women have low rates of cancer screening. There are multiple policy levers that may influence access to preventive services such as screening, including physician payment and managed care. We examine the relationship between each of these factors and breast and cervical cancer screening among nonelderly nondisabled adult Medicaid enrollees. We combine individual-level data on Medicaid enrollment, demographics, and use of screening services from the Medicaid Analytic eXtract files with data on states' Medicaid-to-Medicare fee ratios and estimate their impact on screening services...
May 1, 2018: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29720034/peptidoglycan-and-lipoteichoic-acid-induces-differential-mrna-response-of-immune-related-genes-in-pbmc-of-crossbred-tharparkar-cattle-and-murrah-buffalo
#13
Sourabh Sulabh, Manjit Panigrahi, Sheikh Firdous Ahmad, Rajat Varshney, Ankita Verma, Naseer Ahmad Baba, Satish Kumar, Soni Kumari, Anuj Chauhan, Pushpendra Kumar, Bharat Bhushan
Subclinical mastitis, generally caused by Staphylococcus aureus, has a global economic impact all over the world. Hence, it needs to be resolved on higher priority which may be attained via. selection of mastitis resistant animals or inclusion of mastitis resistant trait into herd apart from management care. Diverse hosts with various genetic make-ups encounter pathogens in a diverse manner which in turn leads to contradicting outcome of the disease. Identification of species-wise or breed-wise differential expressed genes in response to S...
May 2, 2018: Animal Biotechnology
https://www.readbyqxmd.com/read/29702080/continuation-of-long-acting-reversible-contraceptives-among-medicaid-patients
#14
Max J Romano, Patryce Toye, Loral Patchen
OBJECTIVE: Our objective was to compare continuation and complication rates of subdermal etonogestrel implants and intrauterine devices (IUDs) using Medicaid insurance claims. STUDY DESIGN: We performed a retrospective cohort study using insurance claims data for 15- to 44-year-old subjects receiving implants or IUDs from 2012 to 2015 in a Medicaid managed care organization in Washington, DC, and Maryland. We performed a planned Kaplan-Meier survival analysis for long-acting reversible contraceptive (LARC) continuation, defined as the absence of a claim for LARC removal, during periods of continuous insurance plan enrollment...
April 24, 2018: Contraception
https://www.readbyqxmd.com/read/29701584/ending-medicaid-as-we-ve-known-it
#15
Robert Calandra
CMS is granting waivers that impose work and other new requirements on some Medicaid beneficiaries. Medicaid managed care plans are wary of the added administrative complexity-and possibly a change in the Medicaid population's risk profile.
April 2018: Managed Care
https://www.readbyqxmd.com/read/29701582/social-determinants-of-health-stretching-health-care-s-job-description
#16
Lola Butcher
Providers and payers are being asked to tackle the 'upstream' causes of poor health. Medicaid managed care organizations are being asked to screen enrollees for social needs. Some targeted efforts have translated into cost savings and make sense in value-based arrangements. But are we asking the health sector to take on too much?
April 2018: Managed Care
https://www.readbyqxmd.com/read/29701578/why-medicaid-managed-care-is-looking-outside-the-traditional-coverage-box
#17
Richard Mark Kirkner
Social determinants of health come into focus to keep beneficiaries out of the hospital.
April 2018: Managed Care
https://www.readbyqxmd.com/read/29694293/development-of-a-pharmacoeconomic-model-to-demonstrate-the-effect-of-clinical-pharmacist-involvement-in-diabetes-management
#18
Heather Ourth, Jordan Nelson, Patrick Spoutz, Anthony P Morreale
BACKGROUND: A data collection tool was developed and nationally deployed to clinical pharmacists (CPs) working in advanced practice provider roles within the Department of Veterans Affairs to document interventions and associated clinical outcomes. Intervention and short-term clinical outcome data derived from the tool were used to populate a validated clinical outcomes modeling program to predict long-term clinical and economic effects. OBJECTIVE: To predict the long-term effect of CP-provided pharmacotherapy management on outcomes and costs for patients with type 2 diabetes...
May 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29694285/real-world-health-care-costs-based-on-medication-adherence-and-risk-of-stroke-and-bleeding-in-patients-treated-with-novel-anticoagulant-therapy
#19
Chinmay G Deshpande, Stephen Kogut, Cynthia Willey
BACKGROUND: With the lack of real-world evidence, the challenge for drug reimbursement policy decision makers is to understand medication adherence behavior among users of novel oral anticoagulants (NOACs) and its effect on overall cost savings. No study has examined and quantified the burden of cost in high-risk patients taking NOAC therapy. OBJECTIVE: To examine the association of cost with adherence, comorbidity, and risk of stroke and bleeding in patients taking NOACs (rivaroxaban and dabigatran)...
May 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29693363/edaravone-in-the-treatment-of-amyotrophic-lateral-sclerosis-efficacy-and-access-to-therapy-a-roundtable-discussion
#20
Benjamin Rix Brooks, James A Jorgenson, Barbara J Newhouse, Jeremy M Shefner, Wendy Agnese
Amyotrophic lateral sclerosis (ALS) is a progressive and fatal neuromuscular disease affecting approximately 5 out of every 100,000 individuals living in the United States. ALS is associated with 50% mortality within 30 months of initial symptom onset. The rarity of the disease, along with the significant inter- and intra-patient variability in clinical course and a lack of reliable biomarkers, have rendered the development of effective agents to treat ALS a challenge. Because oxidative stress is considered a contributing factor to ALS onset and progression, drugs that eliminate free radicals may protect motor neurons from damage potentially caused by free-radical and oxidative stress...
April 2018: American Journal of Managed Care
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