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Medicare Wellness Visits

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https://www.readbyqxmd.com/read/29728324/variation-in-downstream-relative-costs-associated-with-incidental-ovarian-cysts-on-ultrasound
#1
Andrew B Rosenkrantz, X Xue, Soterios Gyftopoulos, Danny C Kim, Gregory N Nicola
PURPOSE: To explore variation in downstream relative costs associated with ovarian cysts incidentally detected on ultrasound. METHODS: For 200 consecutive incidental ovarian cysts on ultrasound, ultrasound reports were classified in terms of presence of a radiologist recommendation for additional imaging. All downstream events (imaging, office visits, and surgery) associated with the cysts were identified from the electronic health record. Medical costs associated with these downstream events were estimated using national Medicare rates...
May 2, 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29714994/issues-in-geriatric-care-alzheimer-disease
#2
Kathy Kemle, Richard J Ackermann
Alzheimer disease (AD) occurs in 8.8% of older US adults and is the sixth leading cause of death among older adults. Medicare annual wellness visits require screening for cognitive impairment but do not specify screening methods. Numerous screening instruments are available. If results are positive, evaluation with well-validated assessment tools is needed. If cognitive impairment is confirmed, laboratory tests and imaging studies should be obtained to rule out reversible etiologies. If patients meet diagnostic criteria for AD, clinicians should educate patients and families on the expected course and help them complete advance directives...
May 2018: FP Essentials
https://www.readbyqxmd.com/read/29714992/issues-in-geriatric-care-maintaining-health-and-vigor
#3
Richard J Ackermann
Medicare covers annual wellness visits that are scheduled separately from regular medical appointments. These visits focus on prevention and health maintenance to help patients achieve successful aging, which is defined as living to old age without disability while also maintaining high physical and psychological levels of functioning and social engagement. To achieve these goals, most adults should perform at least 150 min/week of moderate-intensity exercise and maintain an optimal body mass index (ie, 23 to 32 kg/m2 )...
May 2018: FP Essentials
https://www.readbyqxmd.com/read/29668209/the-well-being-of-long-term-cancer-survivors
#4
Jeffrey Sullivan, Julia Thornton Snider, Emma van Eijndhoven, Tony Okoro, Katharine Batt, Thomas DeLeire
OBJECTIVES: To compare the well-being of long-term cancer survivors with that of US residents of similar age and demographic characteristics, patients recently diagnosed with cancer, and individuals with chronic illness. STUDY DESIGN: Retrospective observational study. METHODS: Using the Health and Retirement Study, a survey of US residents older than 50 years, we defined 4 cohorts: long-term cancer survivors (>4 years post diagnosis), individuals recently diagnosed with cancer (≤4 years post diagnosis), individuals with chronic illness, and US residents older than 50 years ("nationally representative cohort")...
April 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29665016/underreporting-of-fall-injuries-of-older-adults-implications-for-wellness-visit-fall-risk-screening
#5
Geoffrey J Hoffman, Jinkyung Ha, Neil B Alexander, Kenneth M Langa, Mary Tinetti, Lillian C Min
OBJECTIVES: To compare the accuracy of and factors affecting the accuracy of self-reported fall-related injuries (SFRIs) with those of administratively obtained FRIs (AFRIs). DESIGN: Retrospective observational study SETTING: United States PARTICIPANTS: Fee-for-service Medicare beneficiaries aged 65 and older (N=47,215). MEASUREMENTS: We used 24-month self-report recall data from 2000-2012 Health and Retirement Study data to identify SFRIs and linked inpatient, outpatient, and ambulatory Medicare data to identify AFRIs...
April 17, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29608782/one-year-effect-of-the-medicare-annual-wellness-visit-on-detection-of-cognitive-impairment-a-cohort-study
#6
Nicole R Fowler, Noll L Campbell, Gerhardt M Pohl, Leanne M Munsie, Noam Y Kirson, Urvi Desai, Erich J Trieschman, Mark K Meiselbach, J Scott Andrews, Malaz A Boustani
OBJECTIVES: To examine the effect of the Medicare Annual Wellness Visit (AWV) on the detection of cognitive impairment and on follow-up cognitive care for older adults. DESIGN: Retrospective matched-cohort study. SETTING: United States. PARTICIPANTS: A 5% random sample of fee-for-service Medicare beneficiaries continuously enrolled for 12 months before and after an index ambulatory visit occurring from 2011 to 2013 with no claims evidence of cognitive impairment before index...
April 2, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29535268/atrial-cardiopathy-and-the-risk-of-ischemic-stroke-in-the-chs-cardiovascular-health-study
#7
Hooman Kamel, Traci M Bartz, Mitchell S V Elkind, Peter M Okin, Evan L Thacker, Kristen K Patton, Phyllis K Stein, Christopher R deFilippi, Rebecca F Gottesman, Susan R Heckbert, Richard A Kronmal, Elsayed Z Soliman, W T Longstreth
BACKGROUND AND PURPOSE: Emerging evidence suggests that an underlying atrial cardiopathy may result in thromboembolism before atrial fibrillation (AF) develops. We examined the association between various markers of atrial cardiopathy and the risk of ischemic stroke. METHODS: The CHS (Cardiovascular Health Study) prospectively enrolled community-dwelling adults ≥65 years of age. For this study, we excluded participants diagnosed with stroke or AF before baseline...
April 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29533324/the-effectiveness-of-a-comprehensive-wellness-assessment-on-medication-adherence-in-a-medicare-advantage-plan-diabetic-population
#8
Barbara Guerard, Vincent Omachonu, Blake Perez, Bisakha Sen
The issue of medication nonadherence has generated significant interest because of its complexity from both cost and outcomes perspectives. Of the 3.2 billion prescriptions written annually in the United States, estimates indicate that half are not taken as prescribed, especially among patients with asymptomatic chronic conditions. The objective of this study was to assess whether a comprehensive wellness assessment (CWA) program helps improve medication adherence for oral diabetic medications, statins, and angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (ACE/ARBs) in a Medicare Advantage (MA) plan diabetic population...
March 2018: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/29530652/informing-medicare-s-two-midnight-rule-policy-with-an-analysis-of-hospital-based-long-observation-stays
#9
Brad Wright, Xuan Zhang, Momotazur Rahman, Keith Kocher
STUDY OBJECTIVE: Outpatient observation stays are increasingly substituting for standard inpatient hospitalizations. In 2013, the Centers for Medicare & Medicaid Services adopted the controversial Two-Midnight Rule policy to curb long observation stays and better define the use of hospital-based observation services versus inpatient hospitalizations. We seek to determine the extent to which Medicare beneficiaries exposed to long observation stays (>48 hours) are clinically similar to those with short observation stays (≤48 hours) because this has relevance to the Two-Midnight Rule...
March 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29496293/estimating-potential-for-savings-for-low-risk-endometrial-cancer-using-the-endometrial-cancer-alternative-payment-model-ecap-a-companion-paper-to-the-society-of-gynecologic-oncology-report-on-the-endometrial-cancer-alternative-payment-model
#10
Jason D Wright, Laura J Havrilesky, David E Cohn, Yongmei Huang, Jill Rathbun, Laurel W Rice, Carol L Brown, Ronald D Alvarez, Emily M Ko
OBJECTIVE: To design an endometrial cancer (EC) alternative payment (ECAP) model focused on surgical management of EC, as well as identify drivers of cost in order to develop opportunities for cost-savings while maintaining quality of care. METHODS: National practice patterns and reimbursements were compared between private payers (MarketScan data, years 2009-13) and public payers (Medicare, year 2014) of EC patients who underwent hysterectomy. An episode of care for EC included the hysterectomy, stratified by surgical approach (laparotomy versus robotic versus laparoscopy), and in- and outpatient reimbursements from 30days preoperatively to 60days postoperatively...
May 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29492953/food-insecurity-in-older-adults-in-an-integrated-health-care-system
#11
John F Steiner, Sandra H Stenmark, Andrew T Sterrett, Andrea R Paolino, Matthew Stiefel, Wendolyn S Gozansky, Chan Zeng
OBJECTIVES: To estimate food insecurity prevalence and develop a statistical prediction model for food insecurity. DESIGN: Retrospective cohort study. SETTING: Kaiser Permanente Colorado. PARTICIPANTS: Adult members who completed a pre-Medicare Annual Wellness Visit survey. MEASUREMENTS: Food insecurity was assessed using a single screening question. Sociodemographic and clinical characteristics from electronic health records and self-reported characteristics from the survey were used to develop the prediction model...
March 1, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29490365/temporal-trends-in-gender-affirming-surgery-among-transgender-patients-in-the-united-states
#12
Joseph K Canner, Omar Harfouch, Lisa M Kodadek, Danielle Pelaez, Devin Coon, Anaeze C Offodile, Adil H Haider, Brandyn D Lau
Importance: Little is known about the incidence of gender-affirming surgical procedures for transgender patients in the United States. Objectives: To investigate the incidence and trends over time of gender-affirming surgical procedures and to analyze characteristics and payer status of transgender patients seeking these operations. Design, Setting, and Participants: In this descriptive observational study from 2000 to 2014, data were analyzed from the National Inpatient Sample, a representative pool of inpatient visits across the United States...
February 28, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29485947/differences-in-medicaid-antipsychotic-medication-measures-among-children-with-ssi-foster-care-and-income-based-aid
#13
Emily Leckman-Westin, Molly Finnerty, Sarah Hudson Scholle, Riti Pritam, Deborah Layman, Edith Kealey, Sepheen Byron, Emily Morden, Scott Bilder, Sheree Neese-Todd, Sarah Horwitz, Kimberly Hoagwood, Stephen Crystal
BACKGROUND: Concerns about antipsychotic prescribing for children, particularly those enrolled in Medicaid and with Supplemental Security Income (SSI), continue despite recent calls for selective use within established guidelines. OBJECTIVES: To (a) examine the application of 6 quality measures for antipsychotic medication prescribing in children and adolescents receiving Medicaid and (b) understand distinctive patterns across eligibility categories in order to inform ongoing quality management efforts to support judicious antipsychotic use...
March 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29480975/insurance-access-in-adults-with-congenital-heart-disease-in-the-affordable-care-act-era
#14
Chien-Jung Lin, Eric Novak, Michael W Rich, Joseph J Billadello
BACKGROUND: Adults with congenital heart disease (ACHD) have traditionally been viewed as an underinsured population. Whether this is true in the Affordable Care Act era is unknown. We determined insurance patterns in ACHD patients compared to the non-ACHD cardiology population in a contemporary cohort. METHODS: All cardiology outpatient visits between July 2016 and February 2017 to a large referral center in the United States were reviewed. The primary payer was categorized as health maintenance organization (HMO), preferred provider organization (PPO), Medicare, Medicaid, self-pay, or other...
February 26, 2018: Congenital Heart Disease
https://www.readbyqxmd.com/read/29443648/readmission-patterns-after-gi-cancer-hospitalizations-the-medical-versus-surgical-patient
#15
Joanna-Grace M Manzano, Ming Yang, Hui Zhao, Linda S Elting, Marina C George, Ruili Luo, Maria E Suarez-Almazor
PURPOSE: Readmission within 30 days has been used as a metric for quality of care received at hospitals for certain diagnoses. In the era of accountability, value-based care, and increasing cancer costs, policymakers are looking into cancer readmissions as well. It is important to describe the readmission profile of patients with cancer in the most clinically relevant approach to inform policy and health care delivery that can positively impact patient outcomes. PATIENTS AND METHODS: We conducted a retrospective cohort study using linked Texas Cancer Registry and Medicare claims data...
March 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29438483/statin-use-and-risks-of-influenza-related-outcomes-among-older-adults-receiving-standard-dose-or-high-dose-influenza-vaccines-through-medicare-during-2010-2015
#16
Hector S Izurieta, Yoganand Chillarige, Jeffrey A Kelman, Richard Forshee, Yandong Qiang, Michael Wernecke, Jill M Ferdinands, Yun Lu, Yuqin Wei, Wenjie Xu, Michael Lu, Alicia Fry, Douglas Pratt, David K Shay
Background: Statins are used to reduce cardiovascular disease risk. Recent studies suggest that statin use may be associated with an increased influenza risk among influenza vaccinees. We used Medicare data to evaluate associations between statins and risks of influenza-related encounters among vaccinees. Methods: In this retrospective cohort study, we identified Medicare beneficiaries aged >65 years who received high-dose (HD) or standard-dose (SD) influenza vaccines at pharmacies from 2010-11 through 2014-15...
February 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29401035/practices-caring-for-the-underserved-are-less-likely-to-adopt-medicare-s-annual-wellness-visit
#17
Ishani Ganguli, Jeffrey Souza, J Michael McWilliams, Ateev Mehrotra
In 2011 Medicare introduced the annual wellness visit to help address the health risks of aging adults. The visit also offers primary care practices an opportunity to generate revenue, and may allow practices in accountable care organizations to attract healthier patients while stabilizing patient-practitioner assignments. However, uptake of the visit has been uneven. Using national Medicare data for the period 2008-15, we assessed practices' ability and motivation to adopt the visit. In 2015, 51.2 percent of practices provided no annual wellness visits (nonadopters), while 23...
February 2018: Health Affairs
https://www.readbyqxmd.com/read/29401019/diffusion-of-innovation
#18
(no author information available yet)
Health care providers are in the midst of a massive effort to diffuse innovative approaches to patient care. While most innovations fail, a few diffuse successfully and are sustained. This month's DataGraphic describes the spread or outcomes of four important health care delivery innovations adopted by hospitals or primary care clinicians: hospital palliative care, electronic consults for preoperative anesthesiology assessment, Medicare's free annual wellness visit, and a primary care improvement network.
February 2018: Health Affairs
https://www.readbyqxmd.com/read/29300215/the-case-for-utilizing-rns-in-medicare-annual-wellness-visits
#19
Heather Bogrett, Maura Carriel
RNs in ambulatory practice must expand their role to assist primary care physicians meet the growing demands of the aging American population. This article explores the benefits of RNs performing annual wellness visits (AWVs) for Medicare patients. Having RNs conduct AWVs can decrease the workload of primary care providers, improve patient outcomes, contribute to the revenue of the practice, and elevate nursing standards in the ambulatory setting.
February 2018: Journal of Nursing Administration
https://www.readbyqxmd.com/read/29290177/health-care-resource-utilization-and-costs-among-newly-diagnosed-and-oral-anticoagulant-naive-nonvalvular-atrial-fibrillation-patients-treated-with-dabigatran-or-warfarin-in-the-united-states
#20
Rahul Jain, An-Chen Fu, Jonathan Lim, Cheng Wang, Jessica Elder, Stephen D Sander, Hiangkiat Tan
BACKGROUND: Warfarin has a long history of use to reduce the risk of stroke in patients with atrial fibrillation (AF), but it requires frequent laboratory monitoring to maintain international normalized ratio levels in the therapeutic range. Dabigatran, a novel oral anticoagulant (OAC), has demonstrated efficacy in reducing the risk of stroke and systemic embolism and does not require laboratory monitoring. OBJECTIVE: To compare health care resource utilization (HCRU) and costs of OAC-naive patients newly diagnosed with nonvalvular atrial fibrillation (NVAF), using dabigatran or warfarin...
January 2018: Journal of Managed Care & Specialty Pharmacy
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