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Medicare Wellness Visits

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https://www.readbyqxmd.com/read/28692718/physician-reimbursement-in-medicare-advantage-compared-with-traditional-medicare-and-commercial-health-insurance
#1
Erin Trish, Paul Ginsburg, Laura Gascue, Geoffrey Joyce
Importance: Nearly one-third of Medicare beneficiaries are enrolled in a Medicare Advantage (MA) plan, yet little is known about the prices that MA plans pay for physician services. Medicare Advantage insurers typically also sell commercial plans, and the extent to which MA physician reimbursement reflects traditional Medicare (TM) rates vs negotiated commercial prices is unclear. Objective: To compare prices paid for physician and other health care services in MA, traditional Medicare, and commercial plans...
July 10, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28685852/the-relationship-between-rural-health-clinic-use-and-potentially-preventable-hospitalizations-and-emergency-department-visits-among-medicare-beneficiaries
#2
Brad Wright, Andrew J Potter, Amal N Trivedi, Keith J Mueller
PURPOSE: High rates of potentially preventable hospitalizations and emergency department (ED) visits indicate limited primary care access. Rural Health Clinics (RHCs) are intended to increase access to primary care. The goal of this study was to evaluate the role of RHCs and their impact on potentially preventable hospitalizations and ED visits among Medicare beneficiaries based on actual individual-level utilization patterns. METHODS: With Medicare Part A and Part B claims data from 2007 to 2010, we constructed a series of individual-level negative binomial regression models to examine the relationship between RHC use and the number of potentially preventable hospitalizations and ED visits...
July 7, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28632589/emergency-department-visits-following-elective-total-hip-and-knee-replacement-surgery-identifying-gaps-in-continuity-of-care
#3
Micaela A Finnegan, Robyn Shaffer, Austin Remington, Jereen Kwong, Catherine Curtin, Tina Hernandez-Boussard
BACKGROUND: Major joint replacement surgical procedures are common, elective procedures with a care episode that includes both inpatient readmissions and postoperative emergency department (ED) visits. Inpatient readmissions are well studied; however, to our knowledge, little is known about ED visits following these procedures. We sought to characterize 30-day ED visits following a major joint replacement surgical procedure. METHODS: We used administrative records from California, Florida, and New York, from 2010 through 2012, to identify adults undergoing total knee and hip arthroplasty...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28611897/feasibility-of-an-ed-to-home-intervention-to-engage-patients-a-mixed-methods-investigation
#4
Jessica R Schumacher, Barbara J Lutz, Allyson G Hall, Jesse M Pines, Andrea L Jones, Phyllis Hendry, Colleen Kalynych, Donna L Carden
INTRODUCTION: Older, chronically ill patients with limited health literacy are often under-engaged in managing their health and turn to the emergency department (ED) for healthcare needs. We tested the impact of an ED-initiated coaching intervention on patient engagement and follow-up doctor visits in this high-risk population. We also explored patients' care-seeking decisions. METHODS: We conducted a mixed-methods study including a randomized controlled trial and in-depth interviews in two EDs in northern Florida...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28566133/variation-in-screening-mammography-rates-among-medicare-advantage-plans
#5
Andrew B Rosenkrantz, Margaret Fleming, Richard Duszak
PURPOSE: Prior studies have shown higher screening mammography rates for beneficiaries in capitated managed care Medicare Advantage (MA) plans compared with traditional fee-for-service Medicare. The aim of this study was to explore variation in screening mammography rates at the level of MA managed care plans. METHODS: Using the 2016 MA Healthcare Effectiveness Data and Information Set Public Use File, screening mammography rates were identified for all 385 reporting MA plans...
May 27, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28498938/healthcare-resource-utilization-and-patient-reported-outcomes-following-elective-surgery-for-intradural-extramedullary-spinal-tumors
#6
Silky Chotai, Scott L Zuckerman, Scott L Parker, Joseph B Wick, David P Stonko, Andrew T Hale, Matthew J McGirt, Joseph S Cheng, Clinton J Devin
BACKGROUND: Healthcare resource utilization and patient-reported outcomes (PROs) for intradural extramedullary (IDEM) spine tumors are not well reported. OBJECTIVE: To analyze the PROs, costs, and resource utilization 1 year following surgical resection of IDEM tumors. METHODS: Patients undergoing elective spine surgery for IDEM tumors and enrolled in a single-center, prospective, longitudinal registry were analyzed. Baseline and postoperative 1-year PROs were recorded...
May 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28486935/emergency-department-use-and-barriers-to-wellness-a-survey-of-emergency-department-frequent-users
#7
Lauren E Birmingham, Thaddeus Cochran, Jennifer A Frey, Kirk A Stiffler, Scott T Wilber
BACKGROUND: There is no common understanding of how needs of emergency department (ED) frequent users differ from other patients. This study sought to examine how to best serve this population. Examinations of why ED frequent users present to the ED, what barriers to care exist, and what service offerings may help these patients achieve an optimal level of health were conducted. METHODS: We performed a prospective study of frequent ED users in an adult only, level 1 trauma center with approximately 90,000 visits per year...
May 10, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28461355/bending-the-spending-curve-by-altering-care-delivery-patterns-the-role-of-care-management-within-a-pioneer-aco
#8
John Hsu, Mary Price, Christine Vogeli, Richard Brand, Michael E Chernew, Sreekanth K Chaguturu, Eric Weil, Timothy G Ferris
Accountable care organizations (ACOs) appear to lower medical spending, but there is little information on how they do so. We examined the impact of patient participation in a Pioneer ACO and its care management program on rates of emergency department (ED) visits and hospitalizations and on Medicare spending. We used data for the period 2009-14, exploiting naturally staggered program entry to create concurrent controls to help isolate the program effects. The care management program (the ACO's primary intervention) targeted beneficiaries with elevated but modifiable risks for future spending...
May 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28437320/development-of-a-claims-based-frailty-indicator-anchored-to-a-well-established-frailty-phenotype
#9
Jodi B Segal, Hsien-Yen Chang, Yu Du, Jeremy D Walston, Michelle C Carlson, Ravi Varadhan
BACKGROUND: Fried and colleagues described a frailty phenotype measured in the Cardiovascular Health Study (CHS). This phenotype is manifest when ≥3 of the following are present: low grip strength, low energy, slowed waking speed, low physical activity, or unintentional weight loss. We sought to approximate frailty phenotype using only administrative claims data to enable frailty to be assessed without physical performance measures. STUDY DESIGN: We used the CHS cohort data linked to participants Medicare claims...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28423397/trends-in-use-of-the-us-medicare-annual-wellness-visit-2011-2014
#10
Ishani Ganguli, Jeffrey Souza, J Michael McWilliams, Ateev Mehrotra
No abstract text is available yet for this article.
June 6, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28400254/community-pharmacist-delivered-medicare-annual-wellness-visits-within-a-family-medicine-practice
#11
Taylor A Evans, Patricia H Fabel, Bryan Ziegler
OBJECTIVE: To identify the steps to implement a community pharmacist into a family medicine practice to deliver Medicare Annual Wellness Visits (AWVs). SETTING: Medicine Mart Pharmacy is a locally owned and operated pharmacy that has served the West Columbia, South Carolina, area for over 30 years. The services offered by the pharmacy have expanded over the past 3 years through the addition of a community pharmacy resident. PRACTICE INNOVATION: A stepwise approach was developed for a community pharmacist to identify, market, and establish an AWV service through a collaborative practice agreement with a local family medicine practice...
April 8, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28379822/improving-patient-clinician-conversations-during-annual-wellness-visits
#12
Zsolt J Nagykaldi, Ami Dave, Connor J Kristof, Tanya N Watts, Sravanthi Utpala, Elizabeth Wickersham
BACKGROUND: Health risk assessments (HRAs) have been implemented and studied for decades in various settings, but little is known about the effect of introducing HRAs on the dynamics and content of patient-clinician conversations during Medicare Annual Wellness Visits (AWVs) and whether the effective use of HRAs requires additional training and resources. METHODS: We used Conversation Analysis techniques to analyze 40 AWVs conducted in an academic family medicine residency practice...
March 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28319581/can-claims-data-algorithms-identify-the-physician-of-record
#13
Eva H DuGoff, Emily Walden, Katie Ronk, Mari Palta, Maureen Smith
BACKGROUND: Claims-based algorithms based on administrative claims data are frequently used to identify an individual's primary care physician (PCP). The validity of these algorithms in the US Medicare population has not been assessed. OBJECTIVE: To determine the agreement of the PCP identified by claims algorithms with the PCP of record in electronic health record data. DATA: Electronic health record and Medicare claims data from older adults with diabetes...
March 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28295145/variation-in-hospice-services-by-location-of-care-nursing-home-versus-assisted-living-facility-versus-home
#14
Kathleen T Unroe, Brittany Bernard, Timothy E Stump, Wanzhu Tu, Christopher M Callahan
OBJECTIVES: To describe differences in hospice services for patients living at home, in nursing homes or in assisted living facilities, including the overall number and duration of visits by different hospice care providers across varying lengths of stay. DESIGN: Retrospective cohort study using hospice patient electronic medical record data. SETTING: Large, national hospice provider. PARTICIPANTS: Data from 32,605 hospice patients who received routine hospice care from 2009 to 2014 were analyzed...
July 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28291306/medicare-annual-wellness-visits-how-to-get-patients-and-physicians-on-board
#15
Daniel Bluestein, Ryan Diduk-Smith, Laura Jordan, Kelsie Persaud, Travonia Hughes
No abstract text is available yet for this article.
March 2017: Family Practice Management
https://www.readbyqxmd.com/read/28256998/ambulatory-surgery-data-from-hospitals-and-ambulatory-surgery-centers-united-states-2010
#16
Margaret J Hall, Alexander Schwartzman, Jin Zhang, Xiang Liu
Objectives-This report presents national estimates of surgical and nonsurgical ambulatory procedures performed in hospitals and ambulatory surgery centers (ASCs) in the United States during 2010. Patient characteristics, including age, sex, expected payment source, duration of surgery, and discharge disposition are presented, as well as the number and types of procedures performed in these settings. Methods-Estimates in this report are based on ambulatory surgery data collected in the 2010 National Hospital Ambulatory Medical Care Survey (NHAMCS)...
February 2017: National Health Statistics Reports
https://www.readbyqxmd.com/read/28230421/medicare-expenditure-correlates-of-atrophy-and-cerebrovascular-disease-in-older-adults
#17
Briana S Last, Maria-José García Rubio, Carolyn W Zhu, Stephanie Cosentino, Jennifer J Manly, Charles DeCarli, Yaakov Stern, Adam M Brickman
Background/Study Context: Magnetic resonance imaging (MRI) markers of cerebrovascular disease and atrophy are common in older adults and are associated with cognitive and medical burden. However, the extent to which they are related to health care expenditures has not been examined. We studied whether increased Medicare expenditures were associated with brain markers of atrophy and cerebrovascular disease in older adults. METHODS: A subset of participants (n = 592; mean age = 80 years; 66% women) from the Washington Heights Inwood Columbia Aging Project (WHICAP), a community-based observational study of aging in upper Manhattan, received high-resolution MRI and had Medicare expenditure data on file...
March 2017: Experimental Aging Research
https://www.readbyqxmd.com/read/28182472/integrating-health-care-for-high-need-medicaid-beneficiaries-with-serious-mental-illness-and-chronic-physical-health-conditions-at-managed-care-provider-and-consumer-levels
#18
Jung Y Kim, Tricia Collins Higgins, Dominick Esposito, Allison Hamblin
OBJECTIVE: Policies supporting value-based care and alternative payment models, notably in the Affordable Care Act and the Medicare Access & CHIP Reauthorization Act of 2015, offer hope to advance care integration for individuals with behavioral and chronic physical health conditions. The potential for integration to improve quality while managing costs for individuals with high needs, coupled with the remaining financial, operational, and policy challenges, underscores a need for continued discussion of integration programs' preliminary outcomes and lessons...
June 2017: Psychiatric Rehabilitation Journal
https://www.readbyqxmd.com/read/28179248/provision-of-annual-wellness-visits-with-comprehensive-medication-management-by-a-clinical-pharmacist-practitioner
#19
Tasha Woodall, Suzanne E Landis, Shelley L Galvin, Tim Plaut, Mary T Roth McClurg
PURPOSE: The effectiveness and financial benefit of pharmacist-led annual wellness visits (AWVs) in conjunction with comprehensive medication management (CMM) for older, high-risk patients were examined. METHODS: Eligible patients were 65 years of age or older with three or more chronic medical conditions, taking five or more long-term prescription or nonprescription medications and receiving primary care in a retirement community clinic. The intervention involved two components, an AWV and CMM...
February 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28046001/the-diagnosis-and-management-of-patients-with-renal-colic-across-a-sample-of-us-hospitals-high-ct-utilization-despite-low-rates-of-admission-and-inpatient-urologic-intervention
#20
Elizabeth M Schoenfeld, Penelope S Pekow, Meng-Shiou Shieh, Charles D Scales, Tara Lagu, Peter K Lindenauer
OBJECTIVES: Symptomatic ureterolithiasis (renal colic) is a common Emergency Department (ED) complaint. Variation in practice surrounding the diagnosis and management of suspected renal colic could have substantial implications for both quality and cost of care as well as patient radiation burden. Previous literature has suggested that CT scanning has increased with no improvements in outcome, owing at least partially to the spontaneous passage of kidney stones in the majority of patients...
2017: PloS One
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