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https://www.readbyqxmd.com/read/28545159/the-value-transformation-of-health-care-impact-on-neuromuscular-and-electrodiagnostic-medicine
#1
Pushpa Narayanaswami, Millie Suk, Lyell K Jones
INTRODUCTION: Beginning in 2017, most physicians who participate in Medicare are subject to the Medicare Access and CHIP Reauthorization Act (MACRA), the milestone legislation that signals the US health care system's transition from volume-based to value-based care. METHODS: Review of emerging trends in development of value-based healthcare systems in the US. RESULTS: MACRA and the resulting Quality Payment Program (QPP) create two participation pathways, the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (AAPM) pathway...
May 25, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28544946/perceived-barriers-to-healthcare-and-receipt-of-recommended-medical-care-among-elderly-medicare-beneficiaries
#2
Jibby E Kurichi, Liliana Pezzin, Joel E Streim, Pui L Kwong, Ling Na, Hillary R Bogner, Dawei Xie, Sean Hennessy
PURPOSE: Many Medicare beneficiaries perceive barriers to receiving healthcare, although the consequences are unknown. Facilitators can aid in the receipt of healthcare services. The objective was to assess the relationship between perceived facilitators and barriers to healthcare and actual receipt of recommended medical care among elderly beneficiaries. METHODS: A cohort study using data from the 2001-2008 entry panels of the Medicare Current Beneficiary Survey that included 24,607 community-dwelling beneficiaries 65 years of age and older...
May 18, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28544945/longitudinal-association-between-diabetes-and-cognitive-decline-the-national-health-and-aging-trends-study
#3
Alexandra M V Wennberg, Clinton E Hagen, Rebecca F Gottesman, Vadim Zipunnikov, Christopher N Kaufmann, Marilyn S Albert, George W Rebok, Judith D Kasper, Adam P Spira
Type II diabetes mellitus (DM) is associated with increased risk of dementia; however, few studies have examined the longitudinal association between DM and cognitive outcomes in large nationally representative cohorts. We investigated these associations in 7605 participants enrolled in the National Health and Aging Trends Study, a nationally representative prospective study of Medicare beneficiaries ≥65, from 2011 to 2015. Participants or proxy respondents reported DM and dementia diagnosis, and participants completed immediate and delayed recall word list learning tests and the Clock Drawing Test...
May 16, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28544584/examining-differences-in-characteristics-between-patients-receiving-primary-care-from-nurse-practitioners-or-physicians-using-medicare-current-beneficiary-survey-data-and-medicare-claims-data
#4
Figaro L Loresto, Daniel Jupiter, Yong-Fang Kuo
BACKGROUND: Few studies have examined differences in functional, cognitive, and psychological factors between patients utilizing only nurse practitioners (NPs) and those utilizing only primary care medical doctors (PCMDs) for primary care. PURPOSE: Patients utilizing NP-only or PCMD-only models for primary care will be characterized and compared in terms of functional, cognitive, and psychological factors. METHODOLOGY: Cohorts were obtained from the Medicare Current Beneficiary Survey linked to Medicare claims data...
May 25, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28542732/impact-of-subsequent-metastases-on-costs-and-medical-resource-use-for-prostate-cancer-patients-initially-diagnosed-with-localized-disease
#5
Tracy T Li, Neal D Shore, Maneesha Mehra, Mary B Todd, Ryan Saadi, Gaetan Leblay, Jyoti Aggarwal, Robert I Griffiths
BACKGROUND: The impact of subsequent metastases on costs and medical resource use (MRU) for prostate cancer (PC) patients initially diagnosed with localized disease was estimated. METHODS: Surveillance, Epidemiology, and End Results data, linked to Medicare (1999-2012), were used to identify 7482 patients diagnosed with subsequent metastases 12 months or more after the initial diagnosis of localized PC (cases), and they were matched to 25,709 localized PC patients without subsequent metastases (controls)...
May 23, 2017: Cancer
https://www.readbyqxmd.com/read/28541791/subsidies-for-oral-chemotherapy-and-use-of-immunomodulatory-drugs-among-medicare-beneficiaries-with-myeloma
#6
Adam J Olszewski, Stacie B Dusetzina, Charles B Eaton, Amy J Davidoff, Amal N Trivedi
Purpose The low-income subsidy (LIS) substantially lowers out-of-pocket costs for qualifying Medicare Part D beneficiaries who receive orally administered chemotherapy. We examined the association of LIS with the use of novel oral immunomodulatory drugs (IMiDs; lenalidomide and thalidomide) among beneficiaries with myeloma, who can receive either orally administered or parenteral (bortezomib-based) therapy. Methods Using SEER-Medicare data, we identified Part D beneficiaries diagnosed with myeloma in 2007 to 2011...
May 25, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28541396/prospective-disability-in-different-combinations-of-somatic-and-mental-multimorbidity
#7
Ana R Quiñones, Sheila Markwardt, Stephen Thielke, Ola Rostant, Elizabeth Vásquez, Anda Botoseneanu
BACKGROUND.: Multimorbidity (multiple co-occurring chronic conditions) may be an important contributor to disability and poor health-related quality of life. The functional consequences of specific combinations of somatic and mental health conditions are unclear. METHODS.: Nationally-representative prospective cohort study using the National Health and Aging Trends Study data of Medicare beneficiaries. We included 4,017 participants aged 65 years or older interviewed in 2013 and 2014...
May 24, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28541385/long-term-pm2-5-exposures-and-respiratory-cancer-and-cardiovascular-mortality-in-american-older-adults
#8
Vivian C Pun, Fatemeh Kazemiparkouhi, Justin Manjourides, Helen H Suh
The impact of chronic exposure to fine particulate matter (PM2.5) on respiratory disease and lung cancer mortality is poorly understood. In a cohort of 18.9 million Medicare beneficiaries (4.2 million deaths) living across the conterminous United States between 2000 to 2008, we examined the association of chronic PM2.5 exposure and cause-specific mortality, and evaluated confounding through adjustment of neighborhood behavioral covariates and decomposition of PM2.5 into two spatiotemporal scales. We found significantly positive associations of 12-month moving average PM2...
May 24, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28541137/clinical-use-of-continuous-glucose-monitoring-in-adults-with-type-2-diabetes
#9
Anders L Carlson, Deborah M Mullen, Richard M Bergenstal
Hemoglobin A1c is an excellent population health measure for the risk of vascular complications in diabetes, while continuous glucose monitoring (CGM) is a tool to help personalize a diabetes treatment plan. The value of CGM in individuals with type 1 diabetes (T1D) has been well demonstrated when compared with utilizing self-monitoring of blood glucose (SMBG) to guide treatment decisions. CGM is a tool for patients and clinicians to visualize the important role that diet, exercise, stress management, and the appropriate selection of diabetes medications can have in managing type 2 diabetes (T2D)...
May 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28540648/impact-of-2015-update-to-the-beers-criteria-on-estimates-of-prevalence-and-costs-associated-with-potentially-inappropriate-use-of-antimuscarinics-for-overactive-bladder
#10
Brandon T Suehs, Cralen Davis, Daniel B Ng, Katherine Gooch
BACKGROUND: Research has demonstrated that the use of potentially inappropriate medication (PIM) is highly prevalent among older individuals and may lead to increased healthcare costs, adverse drug reactions, hospitalizations, and mortality. OBJECTIVES: The purpose of this study was to examine the impact of the 2015 updates to the Beers Criteria on estimates of prevalence and cost associated with potentially inappropriate use of antimuscarinic medications indicated for treatment of overactive bladder (OAB)...
May 24, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28538626/the-capacity-of-icd-10-cm-pcs-to-characterize-surgical-care
#11
Garth H Utter, Kevin M Schuster, Preston R Miller, Nathan T Mowery, Suresh K Agarwal, Robert J Winchell, Marie L Crandall
The International Classification of Diseases, 10th edition, Clinical Modification and Procedure Coding System (ICD-10-CM/PCS) have been in effect since October 1, 2015 and offer much greater capacity than previous classifications to characterize the nature and treatment of surgical conditions. However, the diagnosis codes of ICD-10-CM are unevenly specific across the spectrum of surgical conditions and currently do not adequately allow description of important distinctions in disease severity for many common surgical conditions...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538351/care-transitions-among-medicare-beneficiaries-at-the-end-of-life
#12
(no author information available yet)
No abstract text is available yet for this article.
June 2017: Nursing
https://www.readbyqxmd.com/read/28538332/examining-drivers-of-health-care-spending-evidence-on-self-referral-among-a-privately-insured-population
#13
Jean M Mitchell, James D Reschovsky, Roy J Film, Luisa Franzini
BACKGROUND: Despite the enactment of laws to restrict the practice of self-referral, exceptions in these prohibitions have enabled these arrangements to persist and proliferate. Most research documenting the effects of self-referral arrangements analyzed claims records from Medicare beneficiaries. Empirical evidence documenting the effects of self-referral on use of services and spending incurred by persons with private insurance is sparse. OBJECTIVES: We analyzed health insurance claims records from a large private insurer in Texas to evaluate the effects of physician self-referral arrangements involving physical therapy on the treatment of patients with frozen shoulder syndrome, elbow tendinopathy or tendinitis, and patellofemoral pain syndrome...
May 19, 2017: Medical Care
https://www.readbyqxmd.com/read/28538031/association-between-surgeon-specific-features-and-number-of-stages-flaps-and-grafts-in-mohs-micrographic-surgery-a-retrospective-observational-study-of-59-early-mid-and-advanced-career-mohs-surgeons
#14
Marwan Alhaddad, John Zade, Adam Nabatian, David Kriegel, Hooman Khorasani
BACKGROUND: There is limited data available to correlate Mohs surgeons' behavior and years of experience. Moreover, the recent standardization of Mohs surgery training programs may allow for the prediction of future trends in Mohs micrographic surgery surgery based on the current behavior of recently trained Mohs surgeons. OBJECTIVE: To better understand the relationship between surgeon-specific characteristics and the number of Mohs micrographic surgery total cases, stages per case, number of grafts, and number of flaps performed by each surgeon...
May 22, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28538028/unnecessary-cost-of-post-mohs-permanent-pathology
#15
Kelly M MacArthur, Nikki Tang, George J Hruza, Timothy S Wang, Robert G Egbers
BACKGROUND: By providing tumor-free margins, Mohs micrographic surgery (MMS) results in high cure rates in the treatment of nonmelanoma skin cancers (NMSCs). However, when closure of the post-MMS defect is coordinated with reconstructive surgery, redundant tissue is sometimes submitted for permanent section evaluation. OBJECTIVE: The purpose of our study was to investigate the frequency and effect of this practice. MATERIALS AND METHODS: Patients (12 years and older) with NMSCs cleared by MMS with coordinated closures from 2014 to 2016 were identified...
May 22, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28537988/prevention-of-trastuzumab-and-anthracycline-induced-cardiotoxicity-using-angiotensin-converting-enzyme-inhibitors-or-%C3%AE-blockers-in-older-adults-with-breast-cancer
#16
Saranrat Wittayanukorn, Jingjing Qian, Salisa C Westrick, Nedret Billor, Brandon Johnson, Richard A Hansen
PURPOSE: Although clinical trials have provided some data on the benefit of angiotensin-converting enzyme inhibitors (ACEIs) or β-blockers (BBs) in patients with chemotherapy-induced cardiotoxicity, evidence of ACEIs/BBs on prevention of trastuzumab and/or anthracycline-induced cardiotoxicity outside trials is limited. MATERIALS AND METHODS: A cohort study of 142,990 women (66 y and above) newly diagnosed with breast cancer from 2001 to 2009 was conducted using the Surveillance, Epidemiology, and End Results-Medicare-linked database...
May 23, 2017: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28537965/the-affordable-care-act-and-end-of-life-care-for-patients-with-cancer
#17
Ravi B Parikh, Alexi A Wright
The Affordable Care Act (ACA) expanded access to high-quality end-of-life care for Americans with serious illness, including cancer. Before the ACA was enacted in 2010, nearly 715,000 patients died in hospitals annually, despite evidence that most Americans prefer to die at home. Moreover, fewer than half of Medicare beneficiaries used hospice before death, despite evidence that hospice services improve cancer patients' quality of life near death and caregivers' bereavement outcomes. The ACA-stipulated programs and subsequent efforts were designed to address these deficiencies in access to high-quality end-of-life care...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28537963/out-of-pocket-spending-under-the-affordable-care-act-for-patients-with-cancer
#18
Matthew S Dixon, Ashley L Cole, Stacie B Dusetzina
The Patient Protection and Affordable Care Act (ACA) included several key provisions aimed at lowering the out-of-pocket cost burden for patients. In this review, we summarize the effect of 3 provisions under Medicaid, Medicare, and commercial insurance, respectively: expansion of Medicaid eligibility, closing the doughnut hole for Medicare Part D beneficiaries, and requiring an annual limit on out-of-pocket spending for commercially insured patients. Through this review, we find early evidence that these 3 ACA provisions have reduced the out-of-pocket burden or increased access to health insurance for many patients...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28537961/the-affordable-care-act-and-cancer-care-delivery
#19
Gabriel A Brooks, J Russell Hoverman, Carrie H Colla
The Affordable Care Act (ACA) has reformed US health care delivery through insurance coverage expansion, experiments in payment design, and funding for patient-centered clinical and health care delivery research. The impact on cancer care specifically has been far reaching, with new ACA-related programs that encourage coordinated, patient-centered, cost-effective care. Insurance expansions through private exchanges and Medicaid, along with preexisting condition clauses, have helped more than 20 million Americans gain health care coverage...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28537346/does-length-of-stay-influence-how-patients-rate-their-hospitalization-after-total-hip-arthroplasty
#20
Ronald E Delanois, Chukwuweike Gwam, Jaydev B Mistry, Anton Khlopas, Morad Chughtai, Prem Ramkumar, Nicolas Piuzzi, Ryan Berger, Peter M Bonutti, Arthur L Malkani, Michael A Mont
BACKGROUND: The reimbursement for medical services by Medicare and Medicaid (CMS) has recently changed from fee-for-service to quality-based payments. This is being implemented through the use of patient administered surveys, most commonly Press Ganey. With a recent strive for fast-track total hip arthroplasty (THA), it is important to ascertain whether length-of-stay (LOS) in post-THA patients influences the Press Ganey scores and overall hospital ratings. Therefore, we looked at: 1) Which Press Ganey survey factors affect overall hospital rating in patients who have a short (=2) or longer (>2) length of stay; and 2) whether hospital satisfaction is different between patients who have varied lengths of stay...
May 24, 2017: Surgical Technology International
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