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https://www.readbyqxmd.com/read/28812229/economics-and-cost-effectiveness-of-multiple-sclerosis-therapies-in-the-usa
#1
REVIEW
Daniel M Hartung
Multiple sclerosis (MS) is a disabling, chronic disease that imposes a significant economic burden on patients and the US healthcare system. The largest cost component for individuals with MS are prescription drugs, specifically disease-modifying therapies (DMTs). Despite an increase in the number and diversity of DMTs over the past 10 years, acquisition costs for all DMTs have escalated dramatically at rates substantially higher than medical inflation. Currently, costs for most DMTs exceed $70,000 a year. Recent cost-effectiveness studies suggest the cost for nearly all DMTs exceeds generally accepted thresholds for what is considered a good value in the USA, even after factoring expected rebates...
August 15, 2017: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/28809954/the-burden-of-septic-arthritis-on-the-u-s-inpatient-care-a-national-study
#2
Jasvinder A Singh, Shaohua Yu
OBJECTIVE: To assess the health care burden of septic arthritis in the U.S. and examine the associated factors. METHODS: We used the U.S. Nationwide Emergency Department Sample (NEDS) data of patients hospitalized with septic arthritis as the primary diagnosis from 2009-12 to assess time-trends. Multivariable-adjusted models assessed demographics, comorbidity and hospital characteristics as potential predictors of duration of hospitalization, total hospital (inpatient and ED) charges and discharge to home...
2017: PloS One
https://www.readbyqxmd.com/read/28809645/screening-for-functional-cognition-in-postacute-care-and-the-improving-medicare-post-acute-care-transformation-impact-act-of-2014
#3
Gordon Muir Giles, Dorothy Farrar Edwards, M Tracy Morrison, Carolyn Baum, Timothy J Wolf
Occupational therapists have a long history of assessing functional cognition, defined as the ability to use and integrate thinking and performance skills to accomplish complex everyday activities. In response to passage of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 (Pub. L. 113-185), the American Occupational Therapy Association has been advocating that the Centers for Medicare and Medicaid Services consider functional cognition for inclusion in routine patient assessment in postacute care settings, with important implications for occupational therapy...
September 2017: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
https://www.readbyqxmd.com/read/28809035/nurse-staffing-patterns-and-patient-experience-of-care-an-empirical-analysis-of-u-s-hospitals
#4
Eva-Maria Oppel, Gary J Young
OBJECTIVE: To examine the relationship between nurse staffing patterns and patients' experience of care in hospitals with a particular focus on staffing flexibility. DATA SOURCES/STUDY SETTING: The study sample comprised U.S. general hospitals between 2010 and 2012. Nurse staffing data came from the American Hospital Association Annual Survey, and patient experience data came from the Medicare Hospital Consumer Assessment of Healthcare Providers and Systems. STUDY DESIGN: An observational research design was used entailing a pooled, cross-sectional data set...
August 14, 2017: Health Services Research
https://www.readbyqxmd.com/read/28808869/hospitalizations-and-nursing-facility-stays-during-the-transition-from-ckd-to-esrd-on-dialysis-an-observational-study
#5
Maria E Montez-Rath, Yuanchao Zheng, Manjula Kurella Tamura, Vanessa Grubbs, Wolfgang C Winkelmayer, Tara I Chang
BACKGROUND: There is little information on hospital and nursing facility stays during the transition from pre-dialysis kidney disease to end-stage renal disease treated with dialysis. OBJECTIVES: To examine hospital and nursing facility stays in the years pre- and post-dialysis initiation, and to develop a novel method for visualizing these data. DESIGN: Observational study of patients in the US Renal Data System initiating dialysis from October 2011 to October 2012...
August 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28808670/utilization-and-predictors-of-expectant-management-among-elderly-men-with-low-and-intermediate-risk-localized-prostate-cancer-in-u-s-urological-practice
#6
Huei-Ting Tsai, George Philips, Kathryn L Taylor, Keith Kowalczyk, Kuo Huai-Ching, Arnold L Potosky
INTRODUCTION: Expectant management (EM) reduces overtreatment in low-risk but not intermediate-risk localized prostate cancer (PCa). We assessed the use and predictors of EM to understand its uptake in U.S. practice. METHODS: Using the U.S. SEER-Medicare database, we conducted a retrospective cohort study of men 66 years and older diagnosed with low-risk (N=25,506) or intermediate-risk (N=25,597) localized PCa between 2004 - 2011 and followed through December 31, 2012...
March 2017: Urology Practice
https://www.readbyqxmd.com/read/28808668/physician-preferences-for-aggressive-treatment-at-the-end-of-life-and-area-level-health-care-spending-the-johns-hopkins-precursors-study
#7
Joseph J Gallo, Martin S Andersen, Seungyoung Hwang, Lucy Meoni, Ravishankar Jayadevappa
Objective: To determine whether physician preferences for end-of-life care were associated with variation in health care spending. Method: We studied 737 physicians who completed the life-sustaining treatment questionnaire in 1999 and were linked to end-of-life care data for the years 1999 to 2009 from Medicare-eligible beneficiaries from the Dartmouth Atlas of Health Care (in hospital-related regions [HRRs]). Using latent class analysis to group physician preferences for end-of-life treatment into most, intermediate, and least aggressive categories, we examined how physician preferences were associated with health care spending over a 7-year period...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/28807926/use-of-antihypertensive-medications-and-risk-of-adverse-breast-cancer-outcomes-in-a-seer-medicare-population
#8
Lu Chen, Jessica Chubak, Denise M Boudreau, William E Barlow, Noel S Weiss, Christopher I Li
BACKGROUND: It is unclear if use of common antihypertensive medications influences the risk of adverse breast cancer outcomes. METHODS: Using the linked Surveillance, Epidemiology and End-Results (SEER)-Medicare database, we identified 14,766 women between ages 66 and 80 years diagnosed with incident stage I/II breast cancer between 2007-2011. Medicare Part D data were obtained to characterize women's post-cancer use of various antihypertensive medications. Outcomes included a second breast cancer event (SBCE, a composite outcome defined as the first of a recurrence or a second contralateral primary breast cancer), breast cancer recurrence, and breast-cancer specific mortality...
August 14, 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/28807692/community-use-of-physical-and-occupational-therapy-after-stroke-and-risk-of-hospital-readmission
#9
Janet K Freburger, Dongmei Li, Erin P Fraher
OBJECTIVES: To determine whether receipt of therapy and number and timing of therapy visits decreased hospital readmission risk in stroke survivors discharged home. DESIGN: Retrospective cohort analysis of Medicare claims (2010-2013). SETTING: Acute care hospital and community. PARTICIPANTS: Patients hospitalized for stroke who were discharged home and survived the first 30 days (N=23,413; mean [SD] age of 77.6 [7.5] years)...
August 11, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28807384/external-validation-of-vascular-study-group-of-new-england-risk-predictive-model-of-mortality-after-elective-abdominal-aorta-aneurysm-repair-in-the-vascular-quality-initiative-and-comparison-against-established-models
#10
Mohammad H Eslami, Denis V Rybin, Gheorghe Doros, Jeffrey J Siracuse, Alik Farber
OBJECTIVE: The purpose of this study is to externally validate a recently reported Vascular Study Group of New England (VSGNE) risk predictive model of postoperative mortality after elective abdominal aortic aneurysm (AAA) repair and to compare its predictive ability across different patients' risk categories and against the established risk predictive models using the Vascular Quality Initiative (VQI) AAA sample. METHODS: The VQI AAA database (2010-2015) was queried for patients who underwent elective AAA repair...
August 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28807366/prospective-screening-with-the-validated-opioid-risk-tool-demonstrates-gynecologic-oncology-patients-are-at-low-risk-for-opioid-misuse
#11
Christine Garcia, Carolyn Lefkowits, Elizabeth Pelkofski, Leslie Blackhall, Linda R Duska
OBJECTIVE: To characterize risk for opioid misuse among gynecologic oncology patients. METHODS: The Opioid Risk Tool (ORT), a validated screen for opioid misuse risk, was administered to a convenience sample of patients with gynecologic cancer receiving opioid prescriptions in gynecologic oncology or palliative care clinics from January 2012-June 2016. Demographic and clinical information was abstracted on chart review. The primary outcome was ORT risk level (low vs...
August 11, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28807351/cost-effectiveness-of-nivolumab-in-advanced-renal-cell-carcinoma
#12
Michal Sarfaty, Moshe Leshno, Noa Gordon, Assaf Moore, Victoria Neiman, Eli Rosenbaum, Daniel A Goldstein
BACKGROUND: In recent years, new drugs have been introduced for second-line treatment of advanced renal cell carcinoma (RCC). Nivolumab increases overall survival and is associated with less toxicity compared to everolimus in this setting according to the CheckMate 025 study. However, because of the high cost of nivolumab, there is a need to define its value by considering both efficacy and cost. OBJECTIVE: To estimate the cost effectiveness of nivolumab for second-line treatment of advanced RCC from the US payer perspective...
August 11, 2017: European Urology
https://www.readbyqxmd.com/read/28806586/the-new-frontier-of-strategic-alliances-in-health-care-new-partnerships-under-accountable-care-organizations
#13
Valerie A Lewis, Katherine I Tierney, Carrie H Colla, Stephen M Shortell
Accountable care organizations (ACOs) and similar reforms aim to improve coordination between health care providers; however, due to the fragmented nature of the US health care system, successful coordination will hinge in large part on the ability of health care organizations to successfully partner across organizational boundaries. Little is known about new partnerships formed under the ACO model. We use mixed methods data from the National Survey of ACOs, Medicare ACO performance data and interviews with executive leaders across 31 ACOs to examine the prevalence, characteristics, and capabilities of partnership ACOs and why and how ACO partnerships form...
May 2, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28806455/association-of-state-access-standards-with-accessibility-to-specialists-for-medicaid-managed-care-enrollees
#14
Chima D Ndumele, Michael S Cohen, Paul D Cleary
Importance: Medicaid recipients have consistently reported less timely access to specialists than patients with other types of coverage. By 2018, state Medicaid agencies will be required by the Center for Medicare and Medicaid Services (CMS) to enact time and distance standards for managed care organizations to ensure an adequate supply of specialist physicians for enrollees; however, there have been no published studies of whether these policies have significant effects on access to specialty care...
August 14, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28805961/reducing-branded-prescription-drug-prices-a-review-of-policy-options
#15
G Caleb Alexander, Jeromie Ballreich, Mariana P Socal, Taruja Karmarkar, Antonio Trujillo, Jeremy Greene, Joshua Sharfstein, Gerard Anderson
The high prices of specialty pharmaceuticals are causing some public programs to ration care and many private insurers, including Medicare drug plans, to place specialty drugs on high cost sharing tiers. As a result, access to these drugs is severely restricted, and only a small portion of the population with the disease is receiving treatment. This concern has generated a wide range of proposed solutions. We conducted a literature review and identified fifty-two solutions in the peer reviewed literature that we classified into five broad categories: revising the patent system; encouraging research to increase development of new drugs; altering pharmaceutical regulation; decreasing market demand; and developing innovative pricing strategies...
August 14, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28805473/the-impact-of-persistence-with-mirabegron-usage-versus-switching-to-onabotulinumtoxina-on-healthcare-costs-and-resource-utilization-in-patients-with-overactive-bladder-in-the-united-states
#16
Daniel Bin Ng, Robert Espinosa, Scott J Johnson, David Walker, Katherine Gooch
Aims To compare healthcare costs and resource utilization in patients with overactive bladder (OAB) in the United States who switch from mirabegron to onabotulinumtoxinA (onabotA) with those who persist on mirabegron. Materials and methods A retrospective observational claims analysis of the OptumHealth Administrative Claims database conducted between April 1, 2012 and September 30, 2015 used medical and pharmacy claims to identify patients with at least one OAB diagnosis who switched from mirabegron to onabotA (onabotA group) or persisted on mirabegron for at least 180 days (mirabegron persisters)...
August 14, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28805423/patterns-of-psychiatric-emergency-department-utilization-among-community-dwelling-medicare-beneficiaries-under-65
#17
Jingjing Qian, Saranrat Wittayanukorn, Richard A Hansen
This study estimated patterns and trends in all-cause (any reason, including psychiatry related) and psychiatric emergency department (ED) utilization among Medicare beneficiaries under 65 who were residing in community settings (i.e., noninstitutionalized or in their own homes). Medicare beneficiaries under the age of 65 enrolled in Medicare for Social Security Disability Insurance (SSDI) due to permanent physical or mental disabilities are a population with poor health conditions and high utilization of health services; however, this vulnerable population has received limited attention from researchers and policymakers compared to the Medicare beneficiaries 65 years and older...
August 2017: Psychological Services
https://www.readbyqxmd.com/read/28805361/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the-long-term-care-hospital-prospective-payment-system-and-policy-changes-and-fiscal-year-2018-rates-quality-reporting-requirements-for-specific-providers-medicare
#18
(no author information available yet)
We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2018. Some of these changes implement certain statutory provisions contained in the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, the 21st Century Cures Act, and other legislation...
August 14, 2017: Federal Register
https://www.readbyqxmd.com/read/28805360/medicare-program-fy-2018-hospice-wage-index-and-payment-rate-update-and-hospice-quality-reporting-requirements-final-rule
#19
(no author information available yet)
This final rule will update the hospice wage index, payment rates, and cap amount for fiscal year (FY) 2018. Additionally, this rule includes new quality measures and provides an update on the hospice quality reporting program.
August 4, 2017: Federal Register
https://www.readbyqxmd.com/read/28805359/medicare-program-prospective-payment-system-and-consolidated-billing-for-skilled-nursing-facilities-for-fy-2018-snf-value-based-purchasing-program-snf-quality-reporting-program-survey-team-composition-and-correction-of-the-performance-period-for-the-nhsn-hcp
#20
(no author information available yet)
This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2018. It also revises and rebases the market basket index by updating the base year from 2010 to 2014, and by adding a new cost category for Installation, Maintenance, and Repair Services. The rule also finalizes revisions to the SNF Quality Reporting Program (QRP), including measure and standardized resident assessment data policies and policies related to public display...
August 4, 2017: Federal Register
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