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Christopher D Witiw, Fabrice Smieliauskas, John E O'Toole, Michael G Fehlings, Richard G Fessler
BACKGROUND: Surgery for cervical radiculopathy is often approached by either anterior cervical discectomy and fusion (ACDF) or posterior cervical foraminotomy (PCF). ACDF is more common; however, recent single center studies suggest comparable efficacy and significant cost savings with PCF in appropriately selected patients. OBJECTIVE: To compare utilization, adverse events, and costs for each approach from a national perspective. METHODS: Adults undergoing single level ACDF or PCF for cervical radiculopathy were included from a US commercial health insurance claims database spanning 2003 to 2014...
March 14, 2018: Neurosurgery
Carla T Murray, Matthew Schmit
Introduction: We estimate the effect on health care spending of an option to change TRICARE. Under the option, which is based on a proposal made by the Military Compensation and Retirement Modernization Commission (MCRMC), most beneficiaries could choose from a range of commercial health networks instead of the current TRICARE plans. Military treatment facilities would become network providers under the commercial plans. Materials and Methods: We used data from the Department of Defense (DoD) to estimate the cost of providing the current health care benefit to working-age retirees and their dependents and survivors, and active duty family members...
March 14, 2018: Military Medicine
Mark A Henry, David H Howard, Benjamin J Davies, Christopher P Filson
OBJECTIVE To examine how Medicare reimbursement for prostate biopsies was allocated to physicians, ambulatory surgical centers (ASC), and hospitals from 2012-2015. MATERIALS AND METHODS Using Medicare Provider Utilization and Payment Data (2012-2015), we assessed provider payments to physicians and ASCs for transrectal ultrasound-guided prostate biopsies (CPT 55700, 76842, 76972) for fee-for-service Medicare beneficiaries. Data were aggregated at provider-level for those reporting >10 biopsies per year. Hospital payments were estimated based on Outpatient Prospective Payment System...
March 12, 2018: Urology
Ashley H Snyder, Carol S Weisman, Guodong Liu, Douglas Leslie, Cynthia H Chuang
OBJECTIVES: The Affordable Care Act (ACA) contraceptive coverage mandate issued in August 2012 requires most private health insurance plans to cover all U.S. Food and Drug Administration-approved contraceptive methods without cost sharing. We evaluate the impact of this policy on out-of-pocket costs and use of long-acting reversible contraceptives (LARCs) and other prescription methods through 2014. METHODS: Data from Truven Health MarketScan were used to examine out-of-pocket costs and contraceptive use patterns for all reversible prescription contraceptives before and after the implementation of the contraceptive mandate for privately insured women ages 13 to 45...
March 2, 2018: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Emily M Ko, Laura J Havrilesky, Ronald D Alvarez, Oliver Zivanovic, Leslie R Boyd, Elizabeth L Jewell, Patrick F Timmins, Randall S Gibb, Anuja Jhingran, David E Cohn, Sean C Dowdy, Matthew A Powell, Eva Chalas, Yongmei Huang, Jill Rathbun, Jason D Wright
Health care in the United States is in the midst of a significant transformation from a "fee for service" to a "fee for value" based model. The Medicare Access and CHIP Reauthorization Act of 2015 has only accelerated this transition. Anticipating these reforms, the Society of Gynecologic Oncology developed the Future of Physician Payment Reform Task Force (PPRTF) in 2015 to develop strategies to ensure fair value based reimbursement policies for gynecologic cancer care. The PPRTF elected as a first task to develop an Alternative Payment Model for thesurgical management of low risk endometrial cancer...
March 12, 2018: Gynecologic Oncology
Tarisai Chiyaka, Phillis Mushati, Bernadette Hensen, Sungai Chabata, James R Hargreaves, Sian Floyd, Isolde J Birdthistle, Frances M Cowan, Joanna R Busza
Young women (aged 15-24) who exchange sex for money or other support are among the highest risk groups for HIV acquisition, particularly in high prevalence settings. To prepare for introduction and evaluation of the DREAMS programme in Zimbabwe, which provides biomedical and social interventions to reduce adolescent girls' and young women's HIV vulnerability, we conducted a rapid needs assessment in 6 towns using a "social mapping" approach. In each site, we talked to adult sex workers and other key informants to identify locations where young women sell sex, followed by direct observation, group discussions and interviews...
2018: PloS One
Tanuj Mathur, Gurudas Das, Hemendra Gupta
Most studies have associated "un-affordability" as a plausible cause for the lower take-up of private voluntary health insurance plans. However, others refuted this claim on the pretext that when people can afford "inpatient-care" from pocket then insurance premium cost is far less than those payments. Thus, economic factors remain insufficient in clearly explaining the reason for poor private voluntary health insurance take-up. An attempt is being made by shifting the focus towards non-economic factors and understanding the role of perception and health insurance literacy in transforming people preferences to invest in private voluntary health insurance plans...
January 1, 2018: Health Services Management Research
Adrian V Horodnic, Sorin Mazilu, Liviu Oprea
In order to explain informal payments in public health care services in Romania, this paper evaluates the relationship between extra payments or valuable gifts (apart from official fees) and the level of tolerance to corruption, as well as the socio-economic and spatial patterns across those individuals offering informal payments. To evaluate this, a survey undertaken in 2013 is reported. Using logistic regression analysis, the findings are that patients with a high tolerance to corruption, high socio-economic risk (those divorced, separated, or with other form of marital status, and those not working), and located in rural or less affluent areas are more likely to offer (apart from official fees) extra payments or valuable gifts for health care services...
March 15, 2018: International Journal of Health Planning and Management
Paula Chatterjee, Karen E Joynt Maddox
Importance: Hospitals in the United States have been subject to mandatory public reporting of mortality rates for acute myocardial infarction (AMI) and heart failure (HF) since 2007 and to value-based payment programs for these conditions since 2011. However, whether hospitals with initially poor baseline performance have improved relative to other hospitals under these programs, and whether patterns of improvement differ by condition, is unknown. Understanding trends within public reporting and value-based payment can inform future efforts in these areas...
March 14, 2018: JAMA Cardiology
Anders Anell, Margareta Dackehag, Jens Dietrichson
BACKGROUND: Providing equal access to health care is an important objective in most health care systems. It is especially pertinent in systems like the Swedish primary care market, where private providers are free to establish themselves in any part of the country. To improve equity in access to care, 15 out 21 county councils in Sweden have implemented risk-adjusted capitation based on the Care Need Index, which increases capitation to primary care centers with a large share of patients with unfavorable socioeconomic and demographic characteristics...
March 14, 2018: BMC Health Services Research
David F Penson
No abstract text is available yet for this article.
May 2017: Journal of Urology
Karen E Joynt Maddox
No abstract text is available yet for this article.
March 15, 2018: New England Journal of Medicine
Lisa B VanWagner, Fasiha Kanwal
With the passage of the Affordable Care Act (ACA) followed by the physician payment reform, there is an urgent need to better understand the complex relationships between structure (including incentives), processes, and outcomes of health care and, based on this understanding, identify interventions that can ensure delivery of high value care to patients with liver disease. As hepatologists, how do we systematically address these issues and ensure that we provide high-value care to our patients? These factors combine in the burgeoning field of health services research...
March 14, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Carole Therasse, Isabelle Fusier, Anne-Laure Cordonnier, Florence Bérard, Olivier Parent de Curzon, François Bocquet, Pascal Paubel
AIM: Erythropoiesis-stimulating agents (ESAs) are particularly used to treat dialysis patients suffering from anemia due to renal failure. Since March 2014, ESAs have no longer been funded on top-of-diagnosis-related groups (DRGs) in French hospitals and are funded via DRGs. There are two ways to fund dialysis in French hospitals: the 'DRG for dialysis in session' and the 'off-dialysis DRG', which is not a DRG and consists in a supplement tariff specific to dialysis for patients hospitalized for another main reason than dialysis...
March 14, 2018: Journal of Comparative Effectiveness Research
Daniel Belatti, Megan Lykke
No abstract text is available yet for this article.
March 2018: Family Practice Management
Karen Van Nuys, Geoffrey Joyce, Rocio Ribero, Dana P Goldman
No abstract text is available yet for this article.
March 13, 2018: JAMA: the Journal of the American Medical Association
Grant D Innes, Frank X Scheuermeyer, Julian Marsden, Chad Kim Sing, Dan Kalla, Rob Stenstrom, Michael Law, Eric Grafstein
CLINICIAN'S CAPSULE What is known about the topic? Fee-for-service compensation may motivate physicians to see more patients and improve throughput, or drive excessive testing and referral behaviour that undermine emergency performance. What did this study ask? Does fee-for-service payment reduce emergency wait times, length of stay, and left without being seen rates? What did this study find? We observed an unsustained 24% reduction in time to physician, but no change in length of stay or left without being seen rates...
March 2018: CJEM
Howard Ovens
No abstract text is available yet for this article.
March 2018: CJEM
Edeltraud J Lenk, William K Redekop, Marianne Luyendijk, Christopher Fitzpatrick, Louis Niessen, Wilma A Stolk, Fabrizio Tediosi, Adriana J Rijnsburger, Roel Bakker, Jan A C Hontelez, Jan H Richardus, Julie Jacobson, Epke A Le Rutte, Sake J de Vlas, Johan L Severens
BACKGROUND: The control or elimination of neglected tropical diseases (NTDs) has targets defined by the WHO for 2020, reinforced by the 2012 London Declaration. We estimated the economic impact to individuals of meeting these targets for human African trypanosomiasis, leprosy, visceral leishmaniasis and Chagas disease, NTDs controlled or eliminated by innovative and intensified disease management (IDM). METHODS: A systematic literature review identified information on productivity loss and out-of-pocket payments (OPPs) related to these NTDs, which were combined with projections of the number of people suffering from each NTD, country and year for 2011-2020 and 2021-2030...
March 2018: PLoS Neglected Tropical Diseases
Francesca Ometto, Ugo Fedeli, Elena Schievano, Costantino Botsios, Leonardo Punzi, Maria Chiara Corti
OBJECTIVES: The aim of our study was to investigate cause-specific mortality in rheumatoid arthritis (RA) subjects living in Italy. METHODS: We identified in the electronic archive of the Veneto Region patients aged 20-89 years who were exempt from co-payment for RA in January 2010, and linked them with the archive of causes of deaths of the period 2010-2015. Causes of death were coded according to the International Classification of Diseases, 10th Edition. Standardised mortality ratios (SMRs) with 95% confidence intervals were computed as the ratios between deaths observed in the cohort, and those expected according to age- and gender-specific regional mortality rates...
March 2, 2018: Clinical and Experimental Rheumatology
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