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Reimbursements

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https://www.readbyqxmd.com/read/28742674/committee-opinion-no-709-commercial-enterprises-in-medical-practice
#1
(no author information available yet)
Monetary reimbursement of physicians in exchange for medical advice and treatment is well established and accepted in medical practice. However, financial pressures and the pervasiveness of entrepreneurial values have led some physicians to widen the scope of activities for which they seek reimbursement. Some of these commercial activities are ethically problematic in the clinical setting. Obstetrician-gynecologists should strive to ensure that commercial enterprises in medical practice do not compromise the patient-focused mission of clinical care...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742668/committee-opinion-no-709-summary-commercial-enterprises-in-medical-practice
#2
(no author information available yet)
Monetary reimbursement of physicians in exchange for medical advice and treatment is well established and accepted in medical practice. However, financial pressures and the pervasiveness of entrepreneurial values have led some physicians to widen the scope of activities for which they seek reimbursement. Some of these commercial activities are ethically problematic in the clinical setting. Obstetrician-gynecologists should strive to ensure that commercial enterprises in medical practice do not compromise the patient-focused mission of clinical care...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28741873/cost-effectiveness-of-left-ventricular-assist-devices-for-patients-with-end-stage-heart-failure-analysis-of-the-french-hospital-discharge-database
#3
Abir Tadmouri, Josefin Blomkvist, Cécile Landais, Jerome Seymour, Alexandre Azmoun
AIMS: Although left ventricular assist devices (LVADs) are currently approved for coverage and reimbursement in France, no French cost-effectiveness (CE) data are available to support this decision. This study aimed at estimating the CE of LVAD compared with medical management in the French health system. METHODS AND RESULTS: Individual patient data from the 'French hospital discharge database' (Medicalization of information systems program) were analysed using Kaplan-Meier method...
July 25, 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28741101/bundled-payments-in-total-joint-replacement-keeping-our-care-affordable-and-high-in-quality
#4
REVIEW
Alexander S McLawhorn, Leonard T Buller
PURPOSE OF REVIEW: The purpose of this review was to evaluate the literature regarding bundle payment reimbursement models for total joint arthroplasty (TJA). RECENT FINDINGS: From an economic standpoint, TJA are cost-effective, but they represent a substantial expense to the Centers for Medicare & Medicaid Services (CMS). Historically, fee-for-service payment models resulted in highly variable cost and quality. CMS introduced Bundled Payments for Care Improvement (BPCI) in 2012 and subsequently the Comprehensive Care for Joint Replacement (CJR) reimbursement model in 2016 to improve the value of TJA from the perspectives of both CMS and patients, by improving quality via cost control...
July 24, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28740623/patient-access-to-reimbursed-biological-disease-modifying-antirheumatic-drugs-in-the-european-region
#5
Zoltán Kaló, Zoltán Vokó, Andrew Östör, Emma Clifton-Brown, Radu Vasilescu, Alysia Battersby, Edward Gibson
Background & Objectives: Biological disease-modifying antirheumatic drugs (bDMARDs) for the treatment of rheumatoid arthritis (RA) are not always accessible to all patients in accordance with international guidelines, partly owing to their high direct costs against a background of restricted healthcare budgets. This study compares the size of RA patient populations with access to reimbursed bDMARDs across 37 European countries, Russia, and Turkey, according to their treatment eligibility defined by European League Against Rheumatism (EULAR) recommendations and national reimbursement criteria...
2017: Journal of Market Access & Health Policy
https://www.readbyqxmd.com/read/28740622/drug-pricing-and-reimbursement-information-management-processes-and-decision-making-in-the-global-economy
#6
Dimitrios Tsourougiannis
Background: Cost-containment initiatives are re-shaping the pharmaceutical business environment and affecting market access as well as pricing and reimbursement decisions. Effective price management procedures are too complex to accomplish manually. Prior to February 2013, price management within Astellas Pharma Europe Ltd was done manually using an Excel database. The system was labour intensive, slow to update, and prone to error. An innovative web-based pricing information management system was developed to address the shortcomings of the previous system...
2017: Journal of Market Access & Health Policy
https://www.readbyqxmd.com/read/28740619/should-new-health-technology-be-available-only-for-patients-able-and-willing-to-pay
#7
REVIEW
Piet Calcoen, Albert Boer, Wynand P M M van de Ven
New health technology comes on the market at a rapid pace and - sometimes - at a huge cost. Providing access to new health technology is a serious challenge for many countries with mandatory health insurance. This article analyses access to new health technology in Belgium and the Netherlands, using eight concrete examples as a starting point for comparing the two - neighbouring - countries. Contrary to the Netherlands, out-of-pocket payments for new health technology are widely accepted and practiced in Belgium...
2017: Journal of Market Access & Health Policy
https://www.readbyqxmd.com/read/28739479/emergency-department-visits-after-lumbar-spine-surgery-are-associated-with-lower-hcahps-scores
#8
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/28735995/a-study-on-adherence-to-follow-up-quality-of-life-and-associated-factors-among-renal-transplant-recipients-in-china
#9
L Zhao, J Yan, G-L Yang, Y Liu
BACKGROUND: Adherence to follow-up is vital for the medical surveillance of the postoperative blood concentration, but relatively little research has examined it, and there is less study on relationships between adherence to follow-up and quality of life (QoL). We investigated the status of adherence to follow-up and QoL and associated factors among kidney transplantation recipients in China. METHODS: A cross-sectional study with the use of a Kidney Transplantation Recipient's Adherence to Follow-Up Questionnaire and a Quality of Life of Kidney Transplantation Recipients Questionnaire was conducted among 250 kidney transplantation recipients in Changsha, China, from January to March in 2015...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28735919/sleep-disturbances-at-the-time-of-a-new-diagnosis-a-comparative-study-of-human-immunodeficiency-virus-patients-cancer-patients-and-general-population-controls
#10
Yen-Chin Chen, Cheng-Yu Lin, Carol Strong, Chung-Yi Li, Jeen-Shing Wang, Wen-Chien Ko, Nai-Ying Ko
OBJECTIVES: Sleep disturbances are a prevalent and troubling symptom of patients with highly stressful illnesses, such as human immunodeficiency virus (HIV) and cancer. The aim of this study was to compare the prevalence and incidence of sleep disturbances among persons with HIV, those with cancer, and the general population of Taiwan. METHODS: A matched cohort study design was used to compare the risk of sleep disturbances among three groups using reimbursement claims recorded in Taiwan's National Health Insurance Research Database (NHIRD)...
August 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28735494/trends-in-use-of-warfarin-and-direct-oral-anticoagulants-in-atrial-fibrillation-in-norway-2010-to-2015
#11
Lars J Kjerpeseth, Hanne Ellekjær, Randi Selmer, Inger Ariansen, Kari Furu, Eva Skovlund
PURPOSE: Since 2011, several direct oral anticoagulants (DOACs; dabigatran, rivaroxaban, apixaban) have been introduced as alternatives to warfarin for stroke prophylaxis in atrial fibrillation. We wanted to investigate changes in utilization of oral anticoagulants for atrial fibrillation in Norway following the introduction of DOACs. METHODS: Using nationwide registries, we identified all adults with pharmacy dispensings for warfarin or DOACs between January 2010 and December 2015 in Norway, and used ambulatory reimbursement codes to identify atrial fibrillation as indication...
July 22, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28734109/the-cost-of-oropharyngeal-cancer-in-england-a-retrospective-hospital-data-analysis
#12
Sam T Keeping, Michael J Tempest, Stephanie J Stephens, Stuart M Carroll, Richard Simcock, Terence M Jones, Richard Shaw
OBJECTIVES: To estimate the total costs of treating head and neck cancers, specifically oropharyngeal, laryngeal and oral cavity cancer, in secondary care facilities in England during the period 2006/2007 to 2010/2011. DESIGN: Patient records were extracted from an English hospital database to estimate the number of patients treated for oropharyngeal, laryngeal and oral cavity cancer in England. Identified resource use was linked to published United Kingdom cost estimates to quantify the reimbursement of treatment through the Payment by Results system...
July 22, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28733711/a-brief-history-of-neurological-botulinum-toxin-therapy-in-germany
#13
REVIEW
Dirk Dressler, Peter Roggenkaemper
Botulinum toxin (BT) has long been infamous in food safety and biological warfare. In the early 1970s, Alan B Scott of San Francisco invented its therapeutic use originally in extraocular eye muscles to treat strabismus using a therapeutic BT type A preparation provided by Edward J Schantz and Eric A Johnson. Subsequently a large number of medical indications based on motor and glandular hyperactivity and-most recently-chronic migraine are now treated by BT therapy. BT's highly specific and elaborate mechanism of action represents a completely novel therapeutic principle which will have consequences far beyond existing indications...
July 21, 2017: Journal of Neural Transmission
https://www.readbyqxmd.com/read/28731000/appropriateness-based-reimbursement-of-elective-invasive-coronary-procedures-in-low-and-middle-income-countries-preliminary-assessment-of-feasibility-in-india
#14
Ganesan Karthikeyan, Umesh Shirodkar, Meeta Rajiv Lochan, Stephen Birch
BACKGROUND: Elective coronary interventional procedures are often overused and sometimes inappropriately used. The incentives for overuse are greater in low- and middle-income countries, where much of healthcare is provided by poorly regulated, fee-for-service systems. Overuse and inappropriate use increase healthcare costs and are potentially harmful to patients. Linking appropriate use of elective procedures to their reimbursement might deter overuse. METHODS: We explored the feasibility of introducing appropriateness criteria as a precondition to settling reimbursement claims in a publicly funded health insurance scheme in Maharashtra, India...
January 2017: National Medical Journal of India
https://www.readbyqxmd.com/read/28730884/the-effect-of-financial-compensation-on-willingness-to-supply-a-child-s-blood-sample-a-randomized-controlled-trial
#15
Yubraj Acharya, Edward C Norton, Julie C Lumeng
Medical researchers frequently need to collect blood samples from study participants. The determination of whether and how much compensation to provide to the participants is challenging. Institutional review boards typically allow researchers to provide a compensation that reimburses participants for their time and effort but is not so large as to be coercive. Using a randomized controlled trial, we estimate parents' responsiveness to financial compensation in terms of their willingness to provide their child's blood sample...
September 2017: Evaluation & the Health Professions
https://www.readbyqxmd.com/read/28730640/2016-updated-thai-rheumatism-association-recommendations-for-the-use-of-biologic-and-targeted-synthetic-disease-modifying-anti-rheumatic-drugs-in-patients-with-rheumatoid-arthritis
#16
Worawit Louthrenoo, Nuntana Kasitanon, Wanruchada Katchamart, Duangkamol Aiewruengsurat, Parawee Chevaisrakul, Praveena Chiowchanwisawakit, Pornchai Dechanuwong, Punchong Hanvivadhanakul, Ajanee Mahakkanukrauh, Siriporn Manavathongchai, Chayawee Muangchan, Pongthorn Narongroeknawin, Veerapong Phumethum, Boonjing Siripaitoon, Anawat Suesuwan, Siraphop Suwannaroj, Parichat Uea-Areewongsa, Sittichai Ukritchon, Paijit Asavatanabodee, Ajchara Koolvisoot, Ratanavadee Nanagara, Kitti Totemchokchyakarn, Kanokrut Nuntirooj, Tasanee Kitumnuaypong
AIM: In June 2015, the Thai Rheumatism Association (TRA) approved an update of its recommendation for the use of biologic disease-modifying anti-rheumatic drugs (bDMARDs) and targeted synthetic (tsDMARD) in the treatment of rheumatoid arthritis (RA) to cover those currently available in Thailand (etanercept, infliximab, golimumab, rituximab, tocilizumab, abatacept and tofacitinib). METHOD: A search of the literature was performed between January 2000 and June 2015...
July 21, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28729915/the-concomitant-association-of-thyroid-disorders-and-myasthenia-gravis
#17
Yu-Pei Lin, Usman Iqbal, Phung-Anh Nguyen, Md Mohaimenul Islam, Suleman Atique, Wen-Shan Jian, Yu-Chuan Jack Li, Chen-Ling Huang, Chung-Huei Hsu
BACKGROUND: Some of the thyroid disorders (TD) and Myasthenia gravis (MG) are autoimmune related disease. The purpose of the study to evaluate the relationship of MG with all morphological and functional thyroid disorders. METHODS: We constructed a population-based cohort study during the period from January 2000-December 2002 by using reimbursement data from the Bureau National Health Insurance (NHI) system in Taiwan. Patients with TD and MG were identified by referring to the ICD-9-CM codes...
2017: Translational Neuroscience
https://www.readbyqxmd.com/read/28728524/what-s-at-stake-in-u-s-health-reform-a-guide-to-the-affordable-care-act-and-value-based-care
#18
Betty A Rambur
The U.S. presidential election of 2016 accentuated the divided perspectives on the Patient Protection and Affordable Care Act of 2010, commonly known as Obamacare. The perspectives included a pledge from then candidate Donald J. Trump to "repeal and replace on day one"; Republican congressional leaders' more temperate suggestions in the first weeks of the Trump administration to "repair" the Affordable Care Act (ACA); and President Trump's February 5, 2017 statement-16 days after inauguration-that a Republican replacement for the ACA may not be ready until late 2017 or 2018...
January 1, 2017: Policy, Politics & Nursing Practice
https://www.readbyqxmd.com/read/28726119/a-cost-effectiveness-analysis-of-the-diagnostic-strategies-for-differentiating-focal-nodular-hyperplasia-from-hepatocellular-adenoma
#19
Chong Hyun Suh, Kyung Won Kim, Seong Ho Park, Sangjin Shin, Jeonghoon Ahn, Junhee Pyo, Atul B Shinagare, Katherine M Krajewski, Nikhil H Ramaiya
OBJECTIVES: We evaluated the cost-effectiveness of a gadoxetic acid-enhanced MRI (EOB-MRI) strategy compared with conventional MRI strategy and biopsy to differentiate focal nodular hyperplasia (FNH) from hepatocellular adenoma (HCA). METHODS: A decision tree model was constructed to compare the cost-effectiveness of EOB-MRI, conventional MRI with extracellular contrast agents, and biopsy as the initial diagnostic modality in patients with incidentally detected focal liver lesions suspected of being FNH or HCA...
July 19, 2017: European Radiology
https://www.readbyqxmd.com/read/28722099/-results-of-a-representative-survey-on-the-psychosocial-evaluation-before-living-donor-kidney-transplantation-in-germany
#20
Martina de Zwaan, Yesim Erim, Gertrud Greif-Higer, Sylvia Kröncke, Markus Burgmer, Frank Vitinius, Sabine Kunze, Hendrik Berth
Aim Since there is no consensus about how to perform the predonation psychosocial evaluation of living kidney donor candidates, this is conducted differently in German transplant centers. Thus, the goal of the study was to learn more about how psychosocial evaluations are currently conducted in German transplant centers. Methods The psychosocial evaluators of the 38 transplant centers performing kidney transplantations in 2015 were contacted and asked to participate in an anonymous online survey. Results Psychosocial evaluators from 28 (75%) transplant centers responded...
June 2017: Psychotherapie, Psychosomatik, Medizinische Psychologie
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