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Medicare Wellness Visits

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https://www.readbyqxmd.com/read/28498938/healthcare-resource-utilization-and-patient-reported-outcomes-following-elective-surgery-for-intradural-extramedullary-spinal-tumors
#1
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
#2
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
#3
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
#4
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...
May 16, 2017: Medical Care
https://www.readbyqxmd.com/read/28423397/trends-in-use-of-the-us-medicare-annual-wellness-visit-2011-2014
#5
Ishani Ganguli, Jeffrey Souza, J Michael McWilliams, Ateev Mehrotra
No abstract text is available yet for this article.
April 19, 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
#6
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
#7
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
#8
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
#9
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...
March 14, 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
#10
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
#11
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
#12
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
#13
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...
February 9, 2017: Psychiatric Rehabilitation Journal
https://www.readbyqxmd.com/read/28179248/provision-of-annual-wellness-visits-with-comprehensive-medication-management-by-a-clinical-pharmacist-practitioner
#14
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
#15
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
https://www.readbyqxmd.com/read/27882836/comparison-of-pharmacist-and-physician-managed-annual-medicare-wellness-services
#16
COMPARATIVE STUDY
Mary Jean Sewell, Daniel M Riche, Joshua W Fleming, Scott S Malinowski, R Terry Jackson
BACKGROUND: Medicare Annual Wellness Visits (AWV) are a benefit provided for Medicare beneficiaries to increase focus on wellness and preventive measures. Pharmacists can conduct AWVs, which offers a potential avenue for outpatient revenue generation. PROGRAM DESCRIPTION: To compare a composite of interventions and screenings and revenue generated by a pharmacist with those made by a physician during a subsequent AWV. A report generated through the electronic health record was used to determine AWVs conducted by a pharmacist or 3 participating physicians from December 2013 to March 2016, including revenue generated...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27856783/analysis-of-actual-versus-projected-medical-claims-under-the-first-year-of-aca-mandated-coverage
#17
Michael J McCue, Jennifer R Palazzolo
For the individual market, 2014 was the first year Affordable Care Act medical claims experience data were available to set 2016 rates. Accessing Centers for Medicare and Medicaid Services rate data for 175 state insurers, this study compares projected medical claims with actual medical claims of 2014, as well as the cost and utilization of benefit categories for inpatient, outpatient, professional, and prescription drug spending. Actual costs per member per month (pmpm) were greater than projected in 2014 for inpatient, outpatient, and prescription spending but not for professional care...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27769219/advanced-practice-pharmacists-a-retrospective-evaluation-of-the-efficacy-and-cost-of-clinical-pharmacist-practitioners-managing-ambulatory-medicare-patients-in-north-carolina-apple-nc
#18
Michèle M Kislan, Adam T Bernstein, Loretta R Fearrington, Timothy J Ives
BACKGROUND: Clinical Pharmacist Practitioners are advanced practicing pharmacists in North Carolina that provide disease-specific management. The purpose of this retrospective cohort study was to compare the efficacy and charges from referrals to a Clinical Pharmacist Practitioner by the primary care provider, to those managed by a primary care provider alone. METHODS: Patients were separated into cohorts depending if they had at least two appointments with a Clinical Pharmacist Practitioner from November 2008 to November 2011...
October 21, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27763962/the-role-of-radiographs-and-office-visits-in-the-follow-up-of-healed-intertrochanteric-hip-fractures-an-economic-analysis
#19
Harish Kempegowda, Raveesh Richard, Amrut Borade, Akhil Tawari, Abby M Howenstein, Erik N Kubiak, Michael Suk, Daniel S Horwitz
OBJECTIVES: The purpose of this study was to evaluate the role and the necessity of radiographs and office visits obtained during follow-up of intertrochanteric hip injuries. DESIGN: Retrospective study. SETTING: Two level I trauma centers. PATIENTS: Four hundred sixty-five elderly patients who were surgically treated for an intertrochanteric fracture of the femur at 2 level I trauma centers between January 2009 and August 2014 were retrospectively identified from orthopaedic trauma databases...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27753746/one-year-outcomes-of-diabetes-self-management-training-among-medicare-beneficiaries-newly-diagnosed-with-diabetes
#20
Larisa M Strawbridge, Jennifer T Lloyd, Ann Meadow, Gerald F Riley, Benjamin L Howell
BACKGROUND: Diabetes is highly prevalent among Medicare beneficiaries, resulting in costly health care utilization. Strategies to improve health outcomes, such as disease self-management, could help reduce the increasing burden of diabetes. OBJECTIVES: Short-term benefits of diabetes self-management training (DSMT) are established; however, longer-term impacts among Medicare beneficiaries are unknown. RESEARCH DESIGN: Claims-based observational study with 1-year follow-up beginning 6 months after diabetes diagnosis...
April 2017: Medical Care
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