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Cost sharing in healthcare

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https://www.readbyqxmd.com/read/29035338/integrating-medication-therapy-management-mtm-services-provided-by-community-pharmacists-into-a-community-based-accountable-care-organization-aco
#1
Brian Isetts
(1) Background: As the U.S. healthcare system evolves from fee-for-service financing to global population-based payments designed to be accountable for both quality and total cost of care, the effective and safe use of medications is gaining increased importance. The purpose of this project was to determine the feasibility of integrating medication therapy management (MTM) services provided by community pharmacists into the clinical care teams and the health information technology (HIT) infrastructure for Minnesota Medicaid recipients of a 12-county community-based accountable care organization (ACO)...
October 16, 2017: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29034727/examining-the-impacts-of-health-literacy-on-healthcare-costs-an-evidence-synthesis
#2
Rocco Palumbo
Scholars and practitioners share a significant concern about rising healthcare costs. Health literacy is widely presented as a solution to this momentous issue, paving the way for a more appropriate access to care and therefore, for cost savings. However, to date little is still known about the ultimate effects of better health literacy on healthcare costs. Drawing from the findings of a systematic literature review which ultimately involved 29 papers retrieved from Scopus-Elsevier and PubMed. This manuscript is aimed at shedding light on the relationship between health literacy and healthcare costs...
January 1, 2017: Health Services Management Research
https://www.readbyqxmd.com/read/29027820/using-cost-effectiveness-analysis-to-quantify-the-value-of-genomic-based-diagnostic-tests-recommendations-for-practice-and-research
#3
Eldon Spackman, Sebastian Hinde, Laura Bojke, Katherine Payne, Mark Sculpher
AIMS: New sequencing technologies allow increased opportunities to use genomic-based diagnostic tests (genomic tests) in routine clinical practice, which will impact healthcare budgets and patients' outcomes. This article aims to generate a list of recommendations on how the principles and methods of cost-effectiveness analysis (CEA) can be used to quantify the costs and benefits of genomic tests. METHODS: A systematic literature search identified publications describing the use of CEA to evaluate genomic tests...
October 13, 2017: Genetic Testing and Molecular Biomarkers
https://www.readbyqxmd.com/read/29017578/family-integrated-care-ficare-in-level-ii-neonatal-intensive-care-units-study-protocol-for-a-cluster-randomized-controlled-trial
#4
Karen M Benzies, Vibhuti Shah, Khalid Aziz, Wanrudee Isaranuwatchai, Luz Palacio-Derflingher, Jeanne Scotland, Jill Larocque, Kelly Mrklas, Esther Suter, Christopher Naugler, Henry T Stelfox, Radha Chari, Abhay Lodha
BACKGROUND: Every year, about 15 million of the world's infants are born preterm (before 37 weeks gestation). In Alberta, the preterm birth rate was 8.7% in 2015, the second highest among Canadian provinces. Approximately 20% of preterm infants are born before 32 weeks gestation (early preterm), and require care in a Level III neonatal intensive care unit (NICU); 80% are born moderate (32 weeks and zero days [32(0/7)] to 33(6/7) weeks) and late preterm (34(0/7) to 36(6/7) weeks), and require care in a Level II NICU...
October 10, 2017: Trials
https://www.readbyqxmd.com/read/29016565/colonoscopy-vs-fecal-immunochemical-test-in-reducing-mortality-from-colorectal-cancer-confirm-rationale-for-study-design
#5
Jason A Dominitz, Douglas J Robertson, Dennis J Ahnen, James E Allison, Margaret Antonelli, Kathy D Boardman, Maria Ciarleglio, Barbara J Del Curto, Grant D Huang, Thomas F Imperiale, Meaghan F Larson, David Lieberman, Theresa O'Connor, Timothy J O'Leary, Peter Peduzzi, Dawn Provenzale, Aasma Shaukat, Shahnaz Sultan, Amy Voorhees, Robert Wallace, Peter D Guarino
RATIONALE: Colorectal cancer (CRC) is preventable through screening, with colonoscopy and fecal occult blood testing comprising the two most commonly used screening tests. Given the differences in complexity, risk, and cost, it is important to understand these tests' comparative effectiveness. STUDY DESIGN: The CONFIRM Study is a large, pragmatic, multicenter, randomized, parallel group trial to compare screening with colonoscopy vs. the annual fecal immunochemical test (FIT) in 50,000 average risk individuals...
October 10, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29016484/a-novel-combination-of-biomarkers-to-herald-the-onset-of-sepsis-prior-to-the-manifestation-of-symptoms
#6
Hallie H Dolin, Thomas J Papadimos, Stanislaw Stepkowski, Xiaohuan Chen, Zhixing K Pan
Sepsis, which kills over 200,000 patients and costs over $20 billion in the U.S. alone, presents a constant but preventable challenge in the healthcare system. Among the more challenging problems that it presents is misdiagnosis due to conflation with other inflammatory processes, as its mechanisms are identical to those of other inflammatory states. Unfortunately, current biomarker tests can only assess the severity and mortality risk of each case, While no single test exists that can predict sepsis prior to the onset of symptoms for the purpose of pre-emptive care and monitoring...
October 6, 2017: Shock
https://www.readbyqxmd.com/read/28978208/overview-of-atopic-dermatitis
#7
Carmela Avena-Woods
Atopic dermatitis (AD), also known as atopic eczema, is a chronic relapsing inflammatory skin condition. Incidence of AD has increased 2- to 3-fold in industrialized nations, impacting approximately 15% to 20% of children and 1% to 3% of adults worldwide. AD has a wide-ranging impact on a patient's quality of life and the burden from direct and indirect costs (approximately $37.7 billion in out-of-pocket costs) is shared by the families and caregivers of patients with AD. This article reviews the epidemiology, burden of disease, pathophysiology, and diagnostic criteria important for early diagnosis and treatment...
June 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28972523/shared-decision-making-interventions-theoretical-and-empirical-evidence-with-implications-for-health-literacy
#8
Dawn Stacey, Sophie Hill, Kirsten McCaffery, Laura Boland, Krystina B Lewis, Lidia Horvat
Basic health literacy is required for making health decisions. The aim of this chapter is to discuss the use of shared decision making interventions for supporting patient involvement in making health decisions. The chapter provides a definition of shared decision making and discusses the link between shared decision making and the three levels of health literacy: functional, communicative/interactive, and critical. The Interprofessional Shared Decision Making Model is used to identify the various players involved: the patient, the family/surrogate/significant others, decision coach, and health care professionals...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28957347/changes-in-inpatient-payer-mix-and-hospitalizations-following-medicaid-expansion-evidence-from-all-capture-hospital-discharge-data
#9
Seth Freedman, Sayeh Nikpay, Aaron Carroll, Kosali Simon
CONTEXT: The Affordable Care Act resulted in unprecedented reductions in the uninsured population through subsidized private insurance and an expansion of Medicaid. Early estimates from the beginning of 2014 showed that the Medicaid expansion decreased uninsured discharges and increased Medicaid discharges with no change in total discharges. OBJECTIVE: To provide new estimates of the effect of the ACA on discharges for specific conditions. DESIGN, SETTING, AND PARTICIPANTS: We compared outcomes between states that did and did not expand Medicaid using state-level all-capture discharge data from 2009-2014 for 42 states from the Healthcare Costs and Utilization Project's FastStats database; for a subset of states we used data through 2015...
2017: PloS One
https://www.readbyqxmd.com/read/28956521/status-of-disinvestment-initiatives-in-latin-america-results-from-a-systematic-literature-review-and-a-questionnaire
#10
Ion Agirrezabal, Joseph Burgon, Gavin Stewart, Iñaki Gutierrez-Ibarluzea
OBJECTIVES: Disinvestment of existing healthcare technologies that deliver low or no health benefit for their cost can be used as a tool to improve access to effective technologies, while ensuring the long-term sustainability of healthcare systems. The objective of this research was to identify disinvestment initiatives in Latin American countries (LAC). METHODS: First, a systematic literature review (SLR) was conducted. In February 2015, MEDLINE, MEDLINE In-Process, EMBASE, The Cochrane Library, and LILACS were searched for relevant journal articles, including terms related to "disinvestment," "reallocation," "obsolete technologies," and "Latin America...
September 28, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/28954630/multi-disciplinary-patient-centered-model-for-the-expedited-provision-of-costly-therapies-in-community-settings-the-case-of-new-medication-for-hepatitis-c
#11
Nitzan Avisar, Yael Heller, Clara Weil, Aviva Ben-Baruch, Shani Potesman-Yona, Ran Oren, Gabriel Chodick, Varda Shalev, Nachman Ash
BACKGROUND: In January 2015, the first interferon-free direct-acting antiviral (DAA) therapy for chronic hepatitis C virus (HCV) infection was approved for inclusion in Israel's national basket of health services. During 2015, HCV genotype 1 patients with advanced liver fibrosis (stage F3-F4) were eligible for treatment with ombitasvir/paritaprevir/ritonavir and dasabuvir (OMB/PTV/r + DSV) provided through the four national health plans. As all health plans committed to identifying eligible patients nationwide, risk-sharing agreements created an additional incentive to develop an innovative model for rapid treatment delivery...
September 28, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28929818/improving-accountability-in-vaccine-decision-making
#12
James Kenneth Timmis, Steven Black, Rino Rappuoli
Healthcare decisions, in particular those affecting entire populations, should be evidence-based and taken by decision-makers sharing broad alignment with affected stakeholders. However, criteria, priorities and procedures for decision-making are sometimes non-transparent, frequently vary considerably across equivalent decision-bodies, do not always consider the broader benefits of new health-measures, and therefore do not necessarily adequately represent the relevant stakeholder-spectrum. Areas covered: To address these issues in the context of the evaluation of new vaccines, we have proposed a first baseline set of core evaluation criteria, primarily selected by members of the vaccine research community, and suggested their implementation in vaccine evaluation procedures...
November 2017: Expert Review of Vaccines
https://www.readbyqxmd.com/read/28927443/towards-achieving-semantic-interoperability-of-clinical-study-data-with-fhir
#13
Hugo Leroux, Alejandro Metke-Jimenez, Michael J Lawley
BACKGROUND: Observational clinical studies play a pivotal role in advancing medical knowledge and patient healthcare. To lessen the prohibitive costs of conducting these studies and support evidence-based medicine, results emanating from these studies need to be shared and compared to one another. Current approaches for clinical study management have limitations that prohibit the effective sharing of clinical research data. METHODS: The objective of this paper is to present a proposal for a clinical study architecture to not only facilitate the communication of clinical study data but also its context so that the data that is being communicated can be unambiguously understood at the receiving end...
September 19, 2017: Journal of Biomedical Semantics
https://www.readbyqxmd.com/read/28917140/impact-of-medical-subsidy-disqualification-on-children-s-healthcare-utilization-a-difference-in-differences-analysis-from-japan
#14
Atsushi Miyawaki, Haruko Noguchi, Yasuki Kobayashi
Financial support for children's medical expenses has been introduced in many countries. Limited work has been done on price elasticity in children's healthcare demand, especially in countries other than the United States. Moreover, it remains unclear how the effects of a change in the cost sharing rate on healthcare demand would differ by medical condition. We investigated the impact of an increase in the cost sharing rate on medical service utilization among school children as a whole and for each of nine common conditions, applying a difference-in-differences approach...
September 5, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28905303/measuring-what-matters-to-the-patient-health-related-quality-of-life-after-aortic-valve-and-thoracic-aortic-surgery
#15
Frederiek de Heer, Arjen L Gökalp, Jolanda Kluin, Johanna J M Takkenberg
With improved outcomes following cardiac surgery, health related quality of life (HRQoL) gains increasing importance for the better judgement of choosing the preferred treatment strategy in the individual patient. The physician perception of patient preferences can differ considerably from actual patient preferences, underlining the importance of gathering evidence of actual patient preferences before and quality of life after cardiac surgery. The objective of the current review is to provide an overview of current insights into the quality of life measurements after aortic valve and thoracic aortic surgery and to provide starting points for the application of HRQoL measurements toward the future...
September 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28895493/comparative-health-system-performance-in-six-middle-income-countries-cross-sectional-analysis-using-world-health-organization-study-of-global-ageing-and-health
#16
COMPARATIVE STUDY
Riyadh Alshamsan, John Tayu Lee, Sangeeta Rana, Hasan Areabi, Christopher Millett
Objective To assess and compare health system performance across six middle-income countries that are strengthening their health systems in pursuit of universal health coverage. Design Cross-sectional analysis from the World Health Organization Study on global AGEing and adult health, collected between 2007 and 2010. Setting Six middle-income countries: China, Ghana, India, Mexico, Russia and South Africa. Participants Nationally representative sample of adults aged 50 years and older. Main outcome measures We present achievement against key indicators of health system performance across effectiveness, cost, access, patient-centredness and equity domains...
September 2017: Journal of the Royal Society of Medicine
https://www.readbyqxmd.com/read/28895471/the-indirect-costs-of-palliative-care-in-end-stage-cancer-a-real-life-longitudinal-register-and-questionnaire-based-study
#17
Olli Haltia, Niilo Färkkilä, Risto Paavo Roine, Harri Sintonen, Kimmo Taari, Juha Hänninen, Juho Tuomas Lehto, Tiina Saarto
BACKGROUND: Palliative care needs are increasing as more people are dying from incurable diseases. Healthcare costs have been reported to be highest during the last year of life, but studies on the actual costs of palliative care are scarce. AIM: To explore the resource use and costs of palliative care among end-stage breast, colorectal and prostate cancer patients after termination of life-prolonging oncological treatments, that is, during the palliative care period...
September 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28885534/an-organizational-model-for-excellence-in-healthcare-delivery-evidence-from-winners-of-the-baldrige-quality-award
#18
John R Griffith
Winners of the Baldrige National Quality Award in healthcare have documented top quartile clinical outcomes and patient satisfaction across a variety of American communities and a full spectrum of care. Their results also show high levels of satisfaction among physicians, nurses, and other workers, as well as effective financial performance. The managerial methods they use-collectively, the Baldrige model-are consistent with organizational theory literature and are found across all winners. The winners have sustained excellence after winning and expanded it by acquisition of other healthcare organizations...
September 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28885240/advancing-value-based-population-health-management-through-payer-provider-partnerships-improving-outcomes-for-children-with-complex-conditions
#19
Pamela Peele, Donna Keyser, John Lovelace, Deborah Moss
Population health management (PHM) approaches to improve cost and quality remain limited. To address this gap, stakeholders within an integrated delivery and financing system in Western Pennsylvania designed, implemented, and tested a value-based care model for children with medically complex conditions that could be scaled across the broader pediatric population. The model included: (1) a multilevel, interdisciplinary infrastructure; (2) actionable analytics reports to guide continuous quality improvement; (3) alternative provider payments; (4) consumer-directed spending accounts; and (5) shared savings with practices...
September 1, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28883923/integrated-care-for-resected-early-stage-lung-cancer-innovations-and-exploring-patient-needs
#20
REVIEW
Jan Ho, Annette McWilliams, Jon Emery, Christobel Saunders, Christopher Reid, Suzanne Robinson, Fraser Brims
There is no consensus as to the duration and nature of follow-up following surgical resection with curative intent of lung cancer. The integration of cancer follow-up into primary care is likely to be a key future area for quality and cost-effective cancer care. Evidence from other solid cancer types demonstrates that such follow-up has no adverse outcomes, similar health-related quality of life, high patient satisfaction rates at a lower cost to the healthcare system. Core elements for successful models of shared cancer care are required: clear roles and responsibilities, timely effective communication, guidance on follow-up protocols and common treatments and rapid routes to (re)access specialist care...
2017: BMJ Open Respiratory Research
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