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Medicare Wellness Visits

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https://www.readbyqxmd.com/read/29129209/the-medicare-annual-wellness-visit
#1
REVIEW
Jessica L Colburn, Stephanie Nothelle
The Medicare Annual Wellness Visit is an annual preventive health benefit, which was created in 2011 as part of the Patient Protection and Affordable Care Act. The visit provides an opportunity for clinicians to review preventive health recommendations and screen for geriatric syndromes. In this article, the authors review the requirements of the Annual Wellness Visit, discuss ways to use the Annual Wellness Visit to improve the care of geriatric patients, and provide suggestions for how to incorporate this benefit into a busy clinic...
February 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29119824/an-innovative-health-care-delivery-model-for-children-with-medical-complexity
#2
Anne Elizabeth Glassgow, Molly A Martin, Rachel Caskey, Melishia Bansa, Michael Gerges, Mary Johnson, Monika Marko, Kenita Perry-Bell, Heather J Risser, Peter J Smith, Benjamin Van Voorhees
Children with medical complexity (CMC) account for a disproportionate share of pediatric health-care utilization and cost that is largely attributable to long hospitalizations, frequent hospital readmissions, and high use of emergency departments. In response, the Centers for Medicare and Medicaid Services Health Care Innovation Center supports the development and testing of innovative health-care payment and service delivery models. The purpose of this article is to describe the CMS-funded coordinated health care for complex kids (CHECK) program, an innovative system of health-care delivery that provides improved, comprehensive, and well-coordinated services to CMC...
September 2017: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29113636/evaluation-of-interventions-in-clinical-pharmacist-led-annual-medicare-wellness-visits-compared-with-usual-care
#3
Regine C Beliard, Jessica W Merrey
OBJECTIVE: Evaluate and compare the number and types of medication and non-medication-related interventions by clinical pharmacists and nonpharmacists conducting an Annual Medicare Wellness Visit (MWV). DESIGN: Multi-center, retrospective case-control study. SETTING: Two community primary care internal medicine clinics in urban Maryland. PARTICIPANTS: Patients who had a MWV performed January 2014 through October 2015...
November 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29089193/driving-immunization-through-the-medicare-annual-wellness-visit-a-growing-opportunity
#4
Angela K Shen, Rob Warnock, Jeffrey A Kelman
INTRODUCTION: The Annual Wellness Visit (AWV) is a Medicare benefit designed to help prevent disease and disability based on individualized health and risk factors. METHODS: This study analyzes Medicare Part B fee-for-service claims from 2011 to 2016 to assess AWV and seasonal influenza and pneumococcal conjugate vaccinations utilization over time. RESULTS: Utilization of the AWV has increased from 8% of Medicare beneficiaries in 2011 to 19% in 2015...
October 28, 2017: Vaccine
https://www.readbyqxmd.com/read/29083974/patient-satisfaction-with-medicare-annual-wellness-visits-administered-by-a-clinical-pharmacist-practitioner
#5
Christina H Sherrill, Jamie Cavanaugh, Betsy Bryant Shilliday
BACKGROUND: In accordance with the Patient Protection and Affordable Care Act, Medicare provides coverage for annual wellness visits (AWVs) to eligible beneficiaries, which focus on preventative services, furnish personalized preventative health plans, and direct appropriate referrals. These visits may be conducted by a physician or another licensed practitioner working under the direct supervision of a physician. In North Carolina, pharmacists licensed as clinical pharmacist practitioners (CPPs) may perform and bill for AWVs, but there are limited data on patient satisfaction with pharmacists serving in this advanced role...
November 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29082793/the-effectiveness-of-medicare-wellness-visits-in-accessing-preventive-screening
#6
Fabian Camacho, Nengliang Aaron Yao, Roger Anderson
INTRODUCTION: Under the American Affordable Care Act, Medicare insurance beneficiaries receive free Annual Wellness Visits (AWV); there is a need to examine the effectiveness of these visits. The purpose of this study is to examine their impact on subsequent screening rates. METHODS: Using 2011-2014 Medicare FFS (fee-for-service) claims data, seven preventive care services, including vaccinations and cancer screenings were compared among beneficiaries who received and did not receive AWVs...
October 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29057153/testing-new-codes-to-capture-post-operative-care
#7
Courtney A Gidengil, Ateev Mehrotra, Ashley M Kranz, Emily Butcher, Lee H Hilborne, Barbara O Wynn
The Centers for Medicare & Medicaid Services (CMS) uses the resource-based relative value system to determine payment for physicians and nonphysician practitioners for their professional services. For many surgeries and other types of procedures, Medicare payment includes pre- and post-operative visits delivered during a global period of 10 or 90 days. Congress mandated that CMS collect data on the "number and level" of visits in the global period from a representative sample of physicians beginning January 1, 2017...
January 2017: Rand Health Quarterly
https://www.readbyqxmd.com/read/28982749/a-population-based-assessment-of-emergency-department-observation-status-for-older-adults-with-cancer
#8
Allison Lipitz-Snyderman, Adam Klotz, Renee L Gennarelli, Jeffrey Groeger
Background: Hospitals' use of observation status for patients with cancer presenting to the emergency department (ED) is not well understood. This model of care delivery may be a viable alternative to inpatient admission for patients with cancer presenting with certain conditions. Our objective was to assess the use of observation status among Medicare beneficiaries with and without cancer. Methods: Population-based SEER-Medicare data were used to assess differences in the use of observation status between Medicare beneficiaries aged ≥66 years with and without cancer using a matched analysis (n=151,183 per cohort)...
October 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28964441/cost-utility-of-partially-implantable-active-middle-ear-implants-for-sensorineural-hearing-loss-a-decision-analysis
#9
Melodi Kosaner Kliess, Martina Kluibenschaedl, Ruth Zoehrer, Bettina Schlick, Francesca Scandurra, Michael Urban
BACKGROUND: Partially implantable active middle ear implants (aMEIs) offer a solution for individuals who have mild to severe sensorineural hearing loss and an outer ear medical condition that precludes the use of hearing aids. When otherwise left untreated, individuals report a lower quality of life, which may further decrease with increasing disability. In the lack of cost-effectiveness studies and long-term data, there is a need for decision modeling. OBJECTIVE: To explore individual-level variance in resource utilization patterns following aMEI implantation...
September 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28963260/improved-utilization-of-preventive-services-among-patients-following-team-based-annual-wellness-visits
#10
Shelley L Galvin, Rebecca Grandy, Tasha Woodall, Anna Beth Parlier, Sarah Thach, Suzanne E Landis
BACKGROUND The Annual Wellness Visit was designed to enhance preventive services utilization among Medicare beneficiaries; Annual Wellness Visits are underutilized with sparse documented effectiveness. Patients of 3 community-based and 2 retirement community outpatient clinics in western North Carolina had team-based Annual Wellness Visits over a 20-month program, with the goal of improving the uptake and delivery of the Annual Wellness Visit. A clinical pharmacist saw high-complexity patients (≥5 medications) and a licensed practical nurse saw low-complexity patients...
September 2017: North Carolina Medical Journal
https://www.readbyqxmd.com/read/28941671/outcomes-of-emergency-department-anaphylaxis-visits-from-2005-to-2014
#11
Megan S Motosue, M Fernanda Bellolio, Holly K Van Houten, Nilay D Shah, James T Li, Ronna L Campbell
BACKGROUND: Although the incidence of anaphylaxis appears to be increasing, trends in anaphylaxis-related health care utilization are not well understood. OBJECTIVE: To better understand the potential increasing health care burden, we analyzed the changes in anaphylaxis-related health care utilization, including emergency department (ED) discharges, observation stays, inpatient admissions, intensive care unit admissions, and endotracheal intubations. METHODS: We conducted an observational study examining outcomes of anaphylaxis-related ED visits between January 1, 2005, and December 31, 2014...
September 20, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28925664/preventing-falls-in-older-persons
#12
Lainie Van Voast Moncada, L Glen Mire
The American Geriatrics Society and British Geriatrics Society recommend that all adults older than 65 years be screened annually for a history of falls or balance impairment. The U.S. Preventive Services Task Force and American Academy of Family Physicians recommend exercise or physical therapy and vitamin D supplementation to prevent falls in community-dwelling older adults who are at increased risk of falls. Although the U.S. Preventive Services Task Force and American Academy of Family Physicians do not recommend routine multifactorial intervention to prevent falls in all community-dwelling older adults, they state that it may be appropriate in individual cases...
August 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28910436/integrating-data-collection-into-office-work-flow-and-electronic-health-records-for-clinical-outcomes-research
#13
C Alessandra Colaianni, Patricia A Levesque, Robin W Lindsay
Meticulous collection of clinical outcomes metrics in patients undergoing elective surgery is important to ensure quality care; it is also increasing in importance as the Centers for Medicare & Medicaid Services moves to tie reimbursement to outcomes and insurance approval. This study assesses a systematic method for gathering preoperative and postoperative data on patients with nasal obstruction who undergo functional septorhinoplasty that was developed at the Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts...
December 1, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28872535/the-opportunity-awaits-to-lead-orthopaedic-telehealth-innovation-aoa-critical-issues
#14
Montri D Wongworawat, Gary Capistrant, John M Stephenson
Telehealth is a way to provide health-care services to a patient from a provider who is at another location. The most common methods include a live interactive visit with the patient, interpretation of imaging, and monitoring of patient progress. Principally, telehealth is a way of providing a service rather than a type of service. It is about patient care, not data care.Examples of orthopaedic applications include conducting patient examinations, interpreting imaging studies, and providing postoperative care...
September 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28739479/emergency-department-visits-after-lumbar-spine-surgery-are-associated-with-lower-hcahps-scores
#15
Jay M Levin, Robert D Winkelman, Gabriel A Smith, Joseph E Tanenbaum, Roy Xiao, Thomas E Mroz, Michael P Steinmetz
BACKGROUND: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys are used to assess the quality of the patient experience following an inpatient stay. HCAHPS scores are used to determine reimbursement for hospital systems and incentivize spine surgeons nationwide. There are conflicting data detailing whether early readmission or other post-discharge complications are associated with patient responses on the HCAHPS survey. Currently, the association between post-discharge ED visits and HCAHPS scores following lumbar spine surgery is unknown...
July 21, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28692718/physician-reimbursement-in-medicare-advantage-compared-with-traditional-medicare-and-commercial-health-insurance
#16
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...
September 1, 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
#17
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
#18
MULTICENTER STUDY
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
#19
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
#20
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
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