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https://www.readbyqxmd.com/read/27922946/patient-reported-outcome-measurement-for-patients-with-total-knee-arthroplasty
#1
Stephen Lyman, Kaitlyn L Yin
Total knee arthroplasty is a large contributor to Medicare costs. In an effort to lower costs and improve outcomes, the Centers for Medicaid and Medicare Services has implemented the Comprehensive Care for Joint Replacement model, which incentivizes surgeons to submit both general health and joint-specific patient-reported outcome measures (PROMs). However, in addition to using PROMs for reporting purposes, surgeons should also consider incorporating PROMs into clinical practice. Currently, PROMs are not widely implemented in the clinical setting despite their value in measuring factors such as patients' expectations and mental state, which impact outcomes...
December 5, 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27922910/impact-of-medicare-s-nonpayment-program-on-hospital-acquired-conditions
#2
Caroline P Thirukumaran, Laurent G Glance, Helena Temkin-Greener, Meredith B Rosenthal, Yue Li
BACKGROUND: Medicare's Nonpayment Program of 2008 (hereafter called Program) withholds hospital reimbursement for costs related to hospital-acquired conditions (HACs). Little is known whether a hospital's Medicare patient load [quantified by the hospital's Medicare utilization ratio (MUR), which is the proportion of inpatient days financed by Medicare] influences its response to the Program. OBJECTIVE: To determine whether the Program was associated with changes in HAC incidence, and whether this association varies across hospitals with differential Medicare patient load...
December 5, 2016: Medical Care
https://www.readbyqxmd.com/read/27920317/contrary-to-popular-belief-medicaid-hospital-admissions-are-often-profitable-because-of-additional-medicare-payments
#3
Jeffrey Stensland, Zachary R Gaumer, Mark E Miller
It is generally believed that most hospitals lose money on Medicaid admissions. The data suggest otherwise. Medicaid admissions are often profitable for hospitals because of payments from both the Medicaid program and the Medicare program, including payments for uncompensated care and from the Medicare disproportionate-share hospital program. On average, adding a single Medicaid patient day in fiscal year 2017 will increase most hospitals' Medicare payments by more than $300. When added to Medicaid payments, these payments often cause Medicaid patients to be profitable for hospitals...
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27920312/dental-care-and-medicare-beneficiaries-access-gaps-cost-burdens-and-policy-options
#4
Amber Willink, Cathy Schoen, Karen Davis
Despite the wealth of evidence that oral health is related to physical health, Medicare explicitly excludes dental care from coverage, leaving beneficiaries at risk for tooth decay and periodontal disease and exposed to high out-of-pocket spending. To profile these risks, we examined access to dental care across income groups and types of insurance coverage in 2012. High-income beneficiaries were almost three times as likely to have received dental care in the previous twelve months, compared to low-income beneficiaries-74 percent of whom received no dental care...
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27920305/projections-of-dental-care-use-through-2026-preventive-care-to-increase-while-treatment-will-decline
#5
Chad D Meyerhoefer, Irina Panovska, Richard J Manski
This study provides a forward-thinking assessment of the factors likely to affect future trends in dental care in the United States. We developed a forecasting model based on historical data from the Medical Expenditure Panel Survey to determine how demographic trends and recent health care policies will affect dental care use in the future. Our forecasts suggest that the medical and dental insurance reforms instituted under the Affordable Care Act will increase rates of dental care use and the number of dental visits, with utilization rates reaching 47 percent in 2026 and the number of visits reaching 334 million, under optimistic assumptions about take-up of pediatric dental coverage...
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27920302/seeking-dental-care-for-older-americans
#6
Susan Jaffe
Since Medicare doesn't cover most dental care, seniors often go without treatment.
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27919580/variation-in-diagnoses-for-hip-arthroplasty-among-new-york-state-hospitals-implications-for-the-comprehensive-care-for-joint-replacement-model
#7
John A Buza, Jeffrey M Jancuska, James D Slover, Richard Iorio, Joseph A Bosco
BACKGROUND: The Comprehensive Care for Joint Replacement model is designed to minimize costs and improve quality for Medicare patients undergoing joint arthroplasty. The cost of hip arthroplasty (HA) episode varies depending on the preoperative diagnosis and is greater for fracture than for osteoarthritis. Hospitals that perform a higher percentage of HA for OA may therefore have an advantage in the Comprehensive Care for Joint Replacement model. The purposes of this study are to (1) determine the variability in underlying diagnosis for HA in New York State hospitals, and (2) determine hospital characteristics, such as volume, associated with this...
November 15, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27919104/dual-health-care-system-use-and-high-risk-prescribing-in-patients-with-dementia-a-national-cohort-study
#8
Joshua M Thorpe, Carolyn T Thorpe, Walid F Gellad, Chester B Good, Joseph T Hanlon, Maria K Mor, John R Pleis, Loren J Schleiden, Courtney Harold Van Houtven
Background: Recent federal policy changes attempt to expand veterans' access to providers outside the Department of Veterans Affairs (VA). Receipt of prescription medications across unconnected systems of care may increase the risk for unsafe prescribing, particularly in persons with dementia. Objective: To investigate the association between dual health care system use and potentially unsafe medication (PUM) prescribing. Design: Retrospective cohort study...
December 6, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27918869/paramedic-initiated-cms-sepsis-core-measure-bundle-prior-to-hospital-arrival-a-stepwise-approach
#9
Jason G Walchok, Ronald G Pirrallo, Douglas Furmanek, Martin Lutz, Colt Shope, Brandi Giles, Greta Gue, Aaron Dix
BACKGROUND: To improve patient outcomes, the Center for Medicare and Medicaid Services (CMS) implemented core measures that outline the initial treatment of the septic patient. These measures include initial blood culture collection prior to antibiotics, adequate intravenous fluid resuscitation, and early administration of broad spectrum antibiotics. We sought to determine if Paramedics can initiate the CMS sepsis core measure bundle in the prehospital field reliably. METHODS: This is a retrospective, case series from a 3rd service EMS system model in Greenville, South Carolina between November 17, 2014 and February 20, 2016...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27917479/hospital-postacute-care-referral-networks-is-referral-concentration-associated-with-medicare-style-bundled-payments
#10
Ramandeep Kaur, Jennifer N Perloff, Christopher Tompkins, Christine E Bishop
OBJECTIVE: To evaluate whether Medicare-style bundled payments are lower or higher for beneficiaries discharged from hospitals with postacute care (PAC) referrals concentrated among fewer PAC providers. DATA SOURCE: Medicare Part A and Part B claim (2008-2012) for all beneficiaries residing in any of 17 market areas: the Provider of Service file, the Healthcare Cost Report Information System, and the Dartmouth Atlas. STUDY DESIGN: An observational study in which hospitals were distinguished according to PAC referral concentration, which is the tendency to utilize fewer rather than more PAC providers...
December 5, 2016: Health Services Research
https://www.readbyqxmd.com/read/27917464/relation-of-dysglycemia-to-structural-brain-changes-in-a-multiethnic-elderly-cohort
#11
Christiane Reitz, Vanessa A Guzman, Atul Narkhede, Charles DeCarli, Adam M Brickman, José A Luchsinger
OBJECTIVES: Abnormally high glucose levels (dysglycemia) increase with age. Epidemiological studies suggest that dysglycemia is a risk factor for cognitive impairment but the underlying pathophysiological mechanisms remain unclear. The objective of this study was to examine the relation of dysglycemia clinical categories (normal glucose tolerance (NGT), pre-diabetes, undiagnosed diabetes, known diabetes) with brain structure in older adults. We also assessed the relation between dysglycemia and cognitive performance...
December 5, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27917014/contextual-ecological-and-organizational-variations-in-risk-adjusted-copd-and-asthma-hospitalization-rates-of-rural-medicare-beneficiaries
#12
Thomas T H Wan, Yi-Ling Lin, Judith Ortiz
The purpose of this study is to examine what factors contributing to the variability in chronic obstructive pulmonary disorder (COPD) and asthma hospitalization rates when the influence of patient characteristics is being simultaneously considered by applying a risk adjustment method. A longitudinal analysis of COPD and asthma hospitalization of rural Medicare beneficiaries in 427 rural health clinics (RHCs) was conducted utilizing administrative data and inpatient and outpatient claims from Region 4. The repeated measures of risk-adjusted COPD and asthma admission rate were analyzed by growth curve modeling...
2016: Research in the Sociology of Health Care
https://www.readbyqxmd.com/read/27916358/transfer-of-acute-care-surgery-patients-in-a-rural-state-a-concerning-trend
#13
Brittany Misercola, Kristen Sihler, Molly Douglas, Stephen Ranney, Jonathan Dreifus
BACKGROUND: Regionalized care of complex patients to larger hospitals is an increasingly common practice as the population ages and the physician shortage evolves. The Acute Care Surgery model is new, and there are limited data on the patients being transferred through this system. We hypothesized transfer patients would be older, more complex, and require additional resources. MATERIALS AND METHODS: Retrospective chart review of Acute Care Surgery patients admitted to a single tertiary facility...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27914968/segmenting-high-cost-medicare-patients-into-potentially-actionable-cohorts
#14
Karen E Joynt, Jose F Figueroa, Nancy Beaulieu, Robert C Wild, E John Orav, Ashish K Jha
BACKGROUND: Providers are assuming growing responsibility for healthcare spending, and prior studies have shown that spending is concentrated in a small proportion of patients. Using simple methods to segment these patients into clinically meaningful subgroups may be a useful and accessible strategy for targeting interventions to control costs. METHODS: Using Medicare fee-for-service claims from 2011 (baseline year, used to determine comorbidities and subgroups) and 2012 (spending year), we used basic demographics and comorbidities to group beneficiaries into 6 cohorts, defined by expert opinion and consultation: under-65 disabled/ESRD, frail elderly, major complex chronic, minor complex chronic, simple chronic, and relatively healthy...
November 30, 2016: Healthcare
https://www.readbyqxmd.com/read/27914950/access-to-medications-for-medicare-enrollees-related-to-race-ethnicity-results-from-the-2013-medicare-current-beneficiary-survey
#15
Deborah A Taira, Chengli Shen, Marshaleen King, Doug Landsittel, Mary Helen Mays, Tetine Sentell, Janet Southerland
BACKGROUND: Prescription medications are taken by millions of Americans to manage chronic conditions and treat acute conditions. These medications, however, are not equally accessible to all. OBJECTIVE: To examine medication access by race/ethnicity among Medicare beneficiaries. METHODS: Using the 2013 Medicare Current Beneficiary Survey (n = 10.515), this study examined access to medications related to race/ethnicity, comparing non-Hispanic blacks and Hispanics to whites...
November 23, 2016: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/27914485/reply-to-evidence-based-review-not-change-in-usage-patterns-should-drive-medicare-benefit-schedule-mbs-disinvestment-decisions
#16
Linda Mundy
No abstract text is available yet for this article.
December 5, 2016: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/27913765/prevalence-of-chronic-conditions-and-multimorbidities-in-a-geographically-defined-geriatric-population-with-diverse-races-and-ethnicities
#17
Eunjung Lim, Krupa Gandhi, James Davis, John J Chen
OBJECTIVE: The objective of this study is to examine racial/ethnic differences in prevalence of chronic conditions and multimorbidities in the geriatric population of a state with diverse races/ethnicities. METHOD: Fifteen chronic conditions and their dyads and triads were investigated using Hawaii Medicare 2012 data. For each condition, a multivariable logistic regression model was used to investigate differences in race/ethnicity, adjusting for subject characteristics...
December 2, 2016: Journal of Aging and Health
https://www.readbyqxmd.com/read/27913245/contextual-computing-a-bluetooth-based-approach-for-tracking-healthcare-providers-in-the-emergency-room
#18
Joshua Frisby, Vernon Smith, Stephen Traub, Vimla L Patel
Hospital Emergency Departments (EDs) frequently experience crowding. One of the factors that contributes to this crowding is the "door to doctor time", which is the time from a patient's registration to when the patient is first seen by a physician. This is also one of the Meaningful Use (MU) performance measures that emergency departments report to the Center for Medicare and Medicaid Services (CMS). Current documentation methods for this measure are inaccurate due to the imprecision in manual data collection...
November 29, 2016: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/27913084/quality-of-communication-about-medicines-in-united-states-hospitals-a-national-retrospective-study
#19
Lauren Mullings, Jayashri Sankaranarayanan
BACKGROUND: Despite the benefits of improving transitions across care, literature is very limited on inpatient "Communication about Medicines" (ComMed) by staff across United States (U.S.) hospitals. OBJECTIVES: To evaluate ComMed quality variations by hospital characteristics. METHODS: In a cross-sectional, retrospective study of publicly available U.S. Medicare's Hospital Consumer Assessment of Health Care Plans Survey (HCAHPS) data (January 2013-September 2014), ComMed quality (high = above average/excellent vs...
October 26, 2016: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/27910290/radiation-therapy-staffing-model-2014
#20
Leigh J Smith, Rachel Kearvell, Anthony J Arnold, Kevina Choma, Aniko Cooper, Michael R Young, Donna L Matthews, Bronwyn Hilder, Debbie Howson, Katherine Fox, Katheryn Churcher
INTRODUCTION: In 2001, the Radiation Therapy Advisory Panel (RTAP) of the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT) (formerly known as Australian Institute of Radiography) published a model for radiation therapist staffing in Australian radiation oncology departments. Between 2012-2013, the model was reviewed to ensure it reflected current radiation therapy practice, technology, and to facilitate forward planning of the radiation therapy workforce. METHOD: Twenty-four sites from all states participated and provided data on megavoltage simulation, planning and treatment delivery...
December 2016: Journal of Medical Radiation Sciences
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