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https://www.readbyqxmd.com/read/29176511/payer-policy-behavior-towards-opioid-pharmacotherapy-treatment-in-ohio
#1
Todd Molfenter, Carol Sherbeck, Sandy Starr, Jee-Seon Kim, Mark Zehner, Andrew Quanbeck, Nora Jacobson, Dennis McCarty
OBJECTIVE: Few studies examine how payers address the need for improved access to pharmacotherapy for opioid use disorders and the influence of environmental variables on access to opioid agonist and antagonist medications. METHOD: The 52 Ohio Addiction Drug Abuse and Mental Health Services (ADAMHS) Boards that disburse funds for treatment services for the uninsured and underinsured were surveyed to assess coverage for opioid agonist and antagonist treatment medications...
November 15, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/29155612/health-reform-and-utilization-of-high-volume-hospitals-for-complex-cancer-operations
#2
Andrew P Loehrer, David C Chang, Zirui Song, George J Chang
PURPOSE: Underinsured patients are less likely to receive complex cancer operations at hospitals with high surgical volumes (high-volume hospitals, or HVHs), which contributes to disparities in care. To date, the impact of insurance coverage expansion on site of complex cancer surgery remains unknown. METHODS: Using the 2006 Massachusetts coverage expansion as a natural experiment, we searched the Hospital Cost and Utilization Project state inpatient databases for Massachusetts and control states (New York, New Jersey, and Florida) between 2001 and 2011 to evaluate changes in the utilization of HVHs for resections of bladder, esophageal, stomach, pancreatic, rectal, or lung cancer after the expansion of insurance coverage...
November 20, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29151365/effectiveness-of-direct-acting-antiviral-therapy-for-hepatitis-c-in-difficult-to-treat-patients-in-a-safety-net-health-system-a-retrospective-cohort-study
#3
Christina Yek, Carolina de la Flor, John Marshall, Cindy Zoellner, Grace Thompson, Lisa Quirk, Christian Mayorga, Barbara J Turner, Amit G Singal, Mamta K Jain
BACKGROUND: Direct-acting antivirals (DAAs) have revolutionized chronic hepatitis C (HCV) treatment, but real-world effectiveness among vulnerable populations, including uninsured patients, is lacking. This study was conducted to characterize the effectiveness of DAAs in a socioeconomically disadvantaged and underinsured patient cohort. METHODS: This retrospective observational study included all patients undergoing HCV treatment with DAA-based therapy between April 2014 and June 2016 at a large urban safety-net health system (Parkland Health and Hospital System, Dallas, TX, USA)...
November 20, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29150748/an-evaluation-of-a-rural-community-based-breast-education-and-navigation-program-highlights-and-lessons-learned
#4
Essie Torres, Alice R Richman, Ann M Schreier, Nasreen Vohra, Kathryn Verbanac
Cancer has become the leading cause of death in North Carolina (NC) (North Carolina DHHS, State Center for Health Statistics 2015) and the eastern region of North Carolina (ENC) has experienced greater cancer mortality than the remainder of the state. The Pitt County Breast Wellness Initiative-Education (PCBWI-E) provides culturally tailored breast cancer education and navigation to screening services for uninsured/underinsured women in Pitt and Edgecombe Counties in ENC. PCBWI-E created a network of 23 lay breast health educators, and has educated 735 women on breast health and breast cancer screening guidelines...
November 17, 2017: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/29102459/health-insurance-status-and-clinical-cancer-screenings-among-u-s-adults
#5
Guixiang Zhao, Catherine A Okoro, Jun Li, Machell Town
INTRODUCTION: Health insurance coverage is linked to clinical preventive service use. This study examined cancer screenings among U.S. adults by health insurance status. METHODS: The Behavioral Risk Factor Surveillance System collected data on healthcare access and cancer screenings from 42 states and the District of Columbia in 2014. Data analyses were conducted in 2016. Participants' health insurance status during the preceding 12 months was categorized as adequately insured, underinsured, or never insured...
November 1, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28886800/temporal-image-comparison-serial-imaging-in-assessing-pigmented-lesions
#6
REVIEW
Rhett J Drugge, Elizabeth D Drugge
The large-scale deployment of low-cost, noninvasive mechanisms of early detection are needed to reduce the melanoma burden. A serial 2-step system could power mass screening efforts serving the uninsured and underinsured as well as the rural and remote US counties where melanoma mortality is doubled for lack of access to dermatologists. Furthermore, serial melanoma screening strategies, serial total body photography and serial digital dermatoscopy imaging may be performed as a telehealth service, and thus would be available in any location that can support activity compliant with the Health Insurance Portability and Accountability Act and has appropriate bandwidth...
October 2017: Dermatologic Clinics
https://www.readbyqxmd.com/read/28881902/frequency-of-endoscopic-surveillance-for-barrett-s-esophagus-is-influenced-by-health-insurance-status-results-from-a-population-based-analysis
#7
A Faqih, K K Broman, L-C Huang, S E Phillips, M D Holzman, R A Pierce, B K Poulose, P S Yachimski
Factors that influence the frequency of surveillance endoscopy for nondysplastic Barrett's esophagus are not well understood. The objective of this study is to assess factors which influence the frequency of endoscopic surveillance for Barrett's esophagus, including health insurance/third-party payer status. Cases of nondysplastic Barrett's esophagus undergoing esophagogastroduodenoscopy with biopsy were identified using longitudinal data from the Healthcare Utilization Project database in 2005-2006 and followed through 2011...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28869210/the-affordable-care-act-s-dependent-care-coverage-expansion-and-behavioral-health-care
#8
Chandler B McClellan
BACKGROUND: In September 2010, the Affordable Care Act (ACA) extended dependent care coverage to individuals under the age of 26, allowing young adults to remain on their parent's private insurance. AIMS OF THE STUDY: This policy offers a natural experiment to examine the impact of expanded insurance coverage on mental health and substance use treatment utilization and payment composition. METHODS: Using National Survey on Drug Use and Health (NSDUH) and Medical Expenditure Panel Survey (MEPS) data between 2005 and 2014, this study employs a difference-in-differences approach with 23-25 year olds as the treatment group and 27-30 year olds as the control group to examine the impact of the expansion on insurance coverage, behavioral health treatment utilization, and treatment payment source...
September 1, 2017: Journal of Mental Health Policy and Economics
https://www.readbyqxmd.com/read/28861676/machete-injuries-to-the-upper-extremity
#9
Chester J Donnally, William Hannay, Derek A Rapp, Nikola Lekic, Seth D Dodds
PURPOSE: We intend to describe and analyze the spectrum of upper extremity injuries that arises from both accidental and intentional machete injuries with a focus on associated complications and comorbidities. This review is the first from a United States institution, and the only from a designated level 1 trauma center. METHODS: A retrospective review of machete related upper extremity injuries admitted to a level 1 trauma center from 2008 to 2016. The following data was collected on admitted patients: demographics, mechanism of injury, surgical management, and complications...
August 31, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28831638/health-insurance-status-and-eligibility-among-patients-who-seek-healthcare-at-a-free-clinic-in-the-affordable-care-act-era
#10
Kristen Sessions, Amal Hassan, Thomas G McLeod, Mark L Wieland
Free clinics provide care to over 1.8 million people in the United States every year and are a valuable safety net for uninsured and underinsured patients. The Affordable Care Act has resulted in millions of newly insured Americans, yet there is continued demand for healthcare at free clinics. In this study, we assessed health insurance status and eligibility among 489 patients who visited a free clinic in 2016. Eighty-seven percent of patients seen were uninsured, 53.1% of whom were eligible for health insurance (Medicaid or subsidized insurance premiums)...
August 22, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28817791/using-practice-facilitation-to-increase-rates-of-colorectal-cancer-screening-in-community-health-centers-north-carolina-2012-2013-feasibility-facilitators-and-barriers
#11
Bryan J Weiner, Catherine L Rohweder, Jennifer E Scott, Randall Teal, Alecia Slade, Allison M Deal, Naima Jihad, Marti Wolf
INTRODUCTION: Practice facilitation involves trained individuals working with practice staff to conduct quality improvement activities and support delivery of evidence-based clinical services. We examined the feasibility of using practice facilitation to assist federally qualified health centers (FQHCs) to increase colorectal cancer screening rates in North Carolina. METHODS: The intervention consisted of 12 months of facilitation in 3 FQHCs. We conducted chart audits to obtain data on changes in documented recommendation for colorectal cancer screening and completed screening...
August 17, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28797422/in-hospital-outcomes-of-percutaneous%C3%A2-coronary-intervention-in%C3%A2-america-s-safety%C3%A2-net-insights-from-the-ncdr-cath-pci-registry
#12
Tushar Acharya, Adam C Salisbury, John A Spertus, Kevin F Kennedy, Amarbir Bhullar, H Kiran K Reddy, Bipin K Joshi, John A Ambrose
OBJECTIVES: This study compared risk-adjusted percutaneous coronary intervention (PCI) outcomes of safety-net hospitals (SNHs) and non-SNHs. BACKGROUND: Although risk adjustment is used to compare hospitals, SNHs treat a disproportionate share of uninsured and underinsured patients, who may have unmeasured risk factors, limited health care access, and poorer outcomes than patients treated at non-SNHs. METHODS: Using the National Cardiovascular Data Registry CathPCI Registry from 2009 to 2015, we analyzed 3,746,961 patients who underwent PCI at 282 SNHs (hospitals where ≥10% of PCI patients were uninsured) and 1,134 non-SNHs...
August 14, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28796862/out-of-pocket-costs-financial-distress-and-underinsurance-in-cancer-care
#13
Fumiko Chino, Jeffrey M Peppercorn, Christel Rushing, Arif H Kamal, Ivy Altomare, Greg Samsa, S Yousuf Zafar
No abstract text is available yet for this article.
November 1, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28708447/coverage-for-gender-affirming-care-making-health-insurance-work-for-transgender-americans
#14
William V Padula, Kellan Baker
Many transgender Americans continue to remain uninsured or are underinsured because of payers' refusal to cover medically necessary, gender-affirming healthcare services-such as hormone therapy, mental health counseling, and reconstructive surgeries. Coverage refusal results in higher costs and poor health outcomes among transgender people who cannot access gender-affirming care. Research into the value of health insurance coverage for gender-affirming care for transgender individuals shows that the health benefits far outweigh the costs of insuring transition procedures...
August 2017: LGBT Health
https://www.readbyqxmd.com/read/28550905/socioeconomic-factors-and-mortality-in-emergency-general-surgery-trends-over-a-20-year-period
#15
Sarah J Armenia, Sri Ram Pentakota, Aziz M Merchant
BACKGROUND: Socioeconomic factors such as race, insurance, and income quartiles have been identified as independent risk factors in emergency general surgery (EGS), but this impact has not been studied over time. We sought to identify trends in disparities in EGS-related operative mortality over a 20-y period. METHODS: The National Inpatient Sample was used to identify patient encounters coded for EGS in 1993, 2003, and 2013. Logistic regression models were used to examine the adjusted relationship between race, primary payer status, and median income quartiles and in-hospital mortality after adjusting for patients' age, gender, Elixhauser comorbidity score, and hospital region, size, and location-cum-teaching status...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28534189/national-trends-in-bariatric-surgery-2012-2015-demographics-procedure-selection-readmissions-and-cost
#16
Scott Kizy, Cyrus Jahansouz, Michael C Downey, Nathanael Hevelone, Sayeed Ikramuddin, Daniel Leslie
BACKGROUND: Bariatric surgery is widely accepted as the best treatment for obesity and type 2 diabetes mellitus (T2DM). The Roux-en-Y gastric bypass (RYGB) and the sleeve gastrectomy (SG) have become the predominant bariatric procedures in the USA over the last several years, although the most recent trends in selection are unknown. OBJECTIVE: The objective of this study is to assess selection trends, readmission rates, and cost of bariatric procedures in the USA from 2012 to 2015...
November 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28511946/national-incidence-of-patient-safety-indicators-in-the-total-hip-arthroplasty-population
#17
Joseph E Tanenbaum, Derrick M Knapik, Glenn D Wera, Steven J Fitzgerald
BACKGROUND: The Centers for Medicare & Medicaid Services use the incidence of patient safety indicators (PSIs) to determine health care value and hospital reimbursement. The national incidence of PSI has not been quantified in the total hip arthroplasty (THA) population, and it is unknown if patient insurance status is associated with PSI incidence after THA. METHODS: All patients in the Nationwide Inpatient Sample (NIS) who underwent THA in 2013 were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification codes...
September 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28346590/implementation-and-evaluation-of-a-large-scale-teleretinal-diabetic-retinopathy-screening-program-in-the-los-angeles-county-department-of-health-services
#18
Lauren P Daskivich, Carolina Vasquez, Carlos Martinez, Chi-Hong Tseng, Carol M Mangione
Importance: Diabetic retinopathy (DR) is the leading cause of blindness in adults of working age in the United States. In the Los Angeles County safety net, a nonvertically integrated system serving underinsured and uninsured patients, the prevalence of DR is approximately 50%, and owing to limited specialty care resources, the average wait times for screening for DR have been 8 months or more. Objective: To determine whether a primary care-based teleretinal DR screening (TDRS) program reduces wait times for screening and improves timeliness of needed care in the Los Angeles County safety net...
May 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28241907/physicians-perceptions-of-volunteer-service-at-safety-net-clinics
#19
Laura Mcgeehan, Michael A Takehara, Ellen Daroszewski
BACKGROUND: Volunteer physicians are crucial for the operation of safety-net clinics, which provide medical care for uninsured and underinsured populations. Thus, identifying ways to maximize the number of physicians volunteering at such clinics is an important goal. OBJECTIVE: To investigate the perceptions, motivations, functions, and barriers associated with physician volunteering in four safety-net clinics in San Bernardino County, Southern California, a location of great medical need with many barriers to care...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28231239/surveillance-for-health-care-access-and-health-services-use-adults-aged-18-64-years-behavioral-risk-factor-surveillance-system-united-states-2014
#20
Catherine A Okoro, Guixiang Zhao, Jared B Fox, Paul I Eke, Kurt J Greenlund, Machell Town
PROBLEM/CONDITION: As a result of the 2010 Patient Protection and Affordable Care Act, millions of U.S. adults attained health insurance coverage. However, millions of adults remain uninsured or underinsured. Compared with adults without barriers to health care, adults who lack health insurance coverage, have coverage gaps, or skip or delay care because of limited personal finances might face increased risk for poor physical and mental health and premature mortality. PERIOD COVERED: 2014...
February 24, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
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