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https://www.readbyqxmd.com/read/29161521/lessons-from-the-camden-coalition-of-healthcare-providers-first-medicaid-shared-savings-performance-evaluation
#1
Aaron Truchil, Natasha Dravid, Stephen Singer, Zachary Martinez, Teagan Kuruna, Scott Waulters
Accountable Care Organizations (ACOs) aim to reduce health care costs while improving patient outcomes. Camden Coalition of Healthcare Providers' (Camden Coalition) work already aligned with this aim before receiving state approval to operate a certified Medicaid ACO in New Jersey. Upon its formation, the Camden Coalition ACO partnered with UnitedHealthcare and, through state legislation, Rutgers Center for State Health Policy (CSHP) was established as its external evaluator. In evaluating the Camden Coalition ACO, Rutgers CSHP built on the Medicare Shared Savings model, but modified it based on the understanding that the Medicaid population differs from the Medicare population...
November 21, 2017: Population Health Management
https://www.readbyqxmd.com/read/29160678/opting-out-of-medicare-how-to-get-out-and-stay-out
#2
Daniel F Shay
No abstract text is available yet for this article.
November 2017: Family Practice Management
https://www.readbyqxmd.com/read/29159797/correlation-of-opioid-mortality-with-prescriptions-and-social-determinants-a-cross-sectional-study-of-medicare-enrollees
#3
Christos A Grigoras, Styliani Karanika, Elpida Velmahos, Michail Alevizakos, Myrto-Eleni Flokas, Christos Kaspiris-Rousellis, Ioannis-Nektarios Evaggelidis, Panagiotis Artelaris, Constantinos I Siettos, Eleftherios Mylonakis
BACKGROUND: The opioid epidemic is an escalating health crisis. We evaluated the impact of opioid prescription rates and socioeconomic determinants on opioid mortality rates, and identified potential differences in prescription patterns by categories of practitioners. METHODS: We combined the 2013 and 2014 Medicare Part D data and quantified the opioid prescription rate in a county level cross-sectional study with data from 2710 counties, 468,614 unique prescribers and 46,665,037 beneficiaries...
November 20, 2017: Drugs
https://www.readbyqxmd.com/read/29159676/the-posterior-anterior-flexed-view-is-better-than-the-anterior-posterior-view-for-assessing-osteoarthritis-of-the-knee
#4
Kilian Rueckl, Friedrich Boettner, Noor Maza, Armin Runer, Ulrich Bechler, Peter Sculco
OBJECTIVE: The aim of this study is to determine whether the posterior-anterior (PA)-flexed view improves the radiographic assessment of patients with knee pain compared with the standard standing anterior-posterior radiograph. MATERIALS AND METHODS: Three hundred and sixty-five patients with knee pain underwent anterior-posterior (AP), PA flexed, lateral, and Merchant radiographs of the knee. Knees were grouped as mild (Kellgren and Lawrence [K-L] 1-2) or severe (K-L 3-4) osteoarthritis (OA) and either varus (medial compartment), valgus (lateral compartment), or patellofemoral OA...
November 20, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/29158039/association-between-the-american-board-of-internal-medicine-s-general-internist-s-maintenance-of-certification-requirement-and-mammography-screening-for-medicare-beneficiaries
#5
Bradley M Gray, Jonathan L Vandergrift, Rebecca S Lipner
BACKGROUND: Breast cancer is a leading cause of death in the United States. Continuing medical education programs such as the American Board of Internal Medicine's Maintenance of Certification (MOC) program can increase early detection of cancers by educating physicians about the benefits of screening. Did the imposition of American Board of Internal Medicine's MOC requirement affect guideline-compliant mammography screening? METHOD: To address this question, we took advantage of a natural experiment that occurred when one group of general internists was required to complete MOC by 2001 because they initially certified in 1991 (MOC required) and another group was grandfathered out of this requirement because they initially certified in 1989 (MOC grandfathers)...
November 17, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/29157888/quality-measurement-affecting-surgical-practice-utility-versus-utopia
#6
REVIEW
Leonard R Henry, Urs W von Holzen, Michael J Minarich, Ashley N Hardy, Wilbur A Beachy, M Susan Franger, Roderich E Schwarz
The Triple Aim: improving healthcare quality, cost and patient experience has resulted in massive healthcare "quality" measurement. For many surgeons the origins, intent and strengths of this measurement barrage seems nebulous-though their shortcomings are noticeable. This article reviews the major organizations and programs (namely the Centers for Medicare and Medicaid Services) driving the somewhat burdensome healthcare quality climate. The success of this top-down approach is mixed, and far from convincing...
November 11, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29157786/the-seasonal-variability-of-surgical-site-infections-in-knee-and-hip-arthroplasty
#7
Chris A Anthony, Ryan A Peterson, Daniel K Sewell, Linnea A Polgreen, Jacob E Simmering, John J Callaghan, Philip M Polgreen
BACKGROUND: Surgical site infections (SSIs) after total knee (TKA) and total hip (THA) arthroplasty are devastating to patients and costly to healthcare systems. The purpose of this study is to investigate the seasonality of TKA and THA SSIs at a national level. METHODS: All data were extracted from the National Readmission Database for 2013 and 2014. Patients were included if they had undergone TKA or THA. We modeled the odds of having a primary diagnosis of SSI as a function of discharge date by month, payer status, hospital size, and various patient co-morbidities...
November 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29157785/history-of-breast-cancer-increases-90-day-pulmonary-embolism-rates-and-reimbursements-after-total-hip-arthroplasty-a-national-matched-pair-analysis
#8
Samuel Rosas, Alejandro Marquez-Lara, Daniel N Bracey, Jennifer Kurowicki, Martin W Roche, Cynthia L Emory
BACKGROUND: Rates of total hip arthroplasty (THA) are projected to increase in the coming decades. Multiple studies have focused on identifying risk factors for adverse events after joint arthroplasty, and recent attention has been directed toward cancer. Very limited data have been published examining the effects of history of malignancy on outcomes after THA. With a concomitant increase in breast cancer diagnosis and treatments in recent years, it is expected that orthopedic surgeons will likely see more breast cancer survivors in clinic...
October 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29156054/hospice-care-cancer-directed-therapy-and-medicare-expenditures-among-older-patients-dying-with-malignant-brain-tumors
#9
Laura L Dover, Caleb R Dulaney, Courtney P Williams, John B Fiveash, Bradford E Jackson, Paula P Warren, Elizabeth A Kvale, D Hunter Boggs, Gabrielle B Rocque
Background: End-of-life care for older adults with malignant brain tumors is poorly understood. The purpose of this study is to quantify end-of-life utilization of hospice care, cancer-directed therapy, and associated Medicare expenditures among older adults with malignant brain tumors. Methods: This retrospective cohort study included deceased Medicare beneficiaries age ≥65 with primary (PMBT) or secondary (SMBT) malignant brain tumor receiving care within a Southeastern cancer community network including academic and community hospitals from 2012-2015...
November 15, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/29155687/united-states-life-tables-2014
#10
Elizabeth Arias, Melonie Heron, Jiaquan Xu
Objectives-This report presents complete period life tables for the United States by race, Hispanic origin, and sex, based on age-specific death rates in 2014. Methods-Data used to prepare the 2014 life tables are 2014 final mortality statistics; July 1, 2014 population estimates based on the 2010 decennial census; and 2014 Medicare data for persons aged 66-99. The methodology used to estimate the life tables for the Hispanic population remains unchanged from the methodology developed for the publication of life tables by Hispanic origin for data year 2006...
August 2017: National Vital Statistics Reports
https://www.readbyqxmd.com/read/29155452/nursing-home-regulations-redefined-implications-for-providers
#11
Kathleen T Unroe, Joseph G Ouslander, Debra Saliba
The Centers for Medicare and Medicaid Services (CMS) finalized a comprehensive update to nursing home requirements of participation in October 2016. Nearly 10,000 public comments were received regarding the proposed rule, and CMS made multiple modifications based on comments from providers, advocacy organizations, and others before issuing the final rule. The final rule describing nursing home requirements of participation modernizes nursing home regulation. It is being implemented in three phases-beginning in November 2016, November 2017, and November 2019...
November 20, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29155445/individualizing-prevention-for-older-adults
#12
Sei J Lee, Christine M Kim
Prevention can help older adults avoid illness by identifying and addressing conditions before they cause symptoms, but prevention can also harm older adults if conditions that are unlikely to cause symptoms in the individual's lifetime are identified and treated. To identify older adults who preventive interventions are most likely to benefit (and most likely to harm), we propose a framework that compares an individual's life expectancy (LE) with the time to benefit (TTB) for an intervention. If LE is less than the TTB, the individual is unlikely to benefit but is exposed to the risks of the intervention, and the intervention should generally NOT be recommended...
November 20, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29155338/financial-toxicity-in-bladder-cancer-patients-reasons-for-delay-in-care-and-effect-on-quality-of-life
#13
Marianne M Casilla-Lennon, Seul Ki Choi, Allison M Deal, Jeannette T Bensen, Gopal Narang, Pauline Filippou, Benjamin McCormick, Raj Pruthi, Eric Wallen, Hung-Jui Tan, Michael Woods, Matthew Nielsen, Angela Smith
PURPOSE: Costly surveillance and treatment of bladder cancer can lead to financial toxicity (FT), a treatment-related financial burden. Our objective was to define the prevalence of FT among bladder cancer patients and identify delays in care and its effect on health-related quality of life (HRQOL). METHODS: We identified bladder cancer patients in the UNC Health Registry/Cancer Survivorship Cohort. FT was defined as agreement with having "to pay more for medical care than you can afford...
November 16, 2017: Journal of Urology
https://www.readbyqxmd.com/read/29155190/use-of-routine-home-health-care-and-deviations-from-an-uncomplicated-recovery-pathway-after-radical-prostatectomy
#14
Deborah R Kaye, John Syrjamaki, Chad Ellimootil, Edward W Schervish, M Hugh Solomon, Susan Linsell, James E Montie, David C Miller, James M Dupree
OBJECTIVE: To evaluate the statistical association between routine home health use after prostatectomy, short-term surgical outcomes, and payments. METHODS: We identified all men who underwent a robotic radical prostatectomy from 04/01/2014 through 10/31/2015 in the Michigan Urological Surgery Improvement Collaborative (MUSIC) with insurance from Medicare or a large commercial payer. We calculated rates of "routine" home care use after prostatectomy by urology practice...
November 16, 2017: Urology
https://www.readbyqxmd.com/read/29154970/patient-engagement-using-new-technology-to-improve-adherence-to-positive-airway-pressure-therapy-a-retrospective-analysis
#15
Atul Malhotra, Maureen E Crocker, Leslee Willes, Colleen Kelly, Sue Lynch, Adam V Benjafield
BACKGROUND: Sleep apnea has major neurocognitive and cardiovascular and metabolic risks. Treatment of sleep apnea is sub-optimal because of variable adherence to existing therapies. METHODS: This trial compared PAP adherence among patients who were provided active patient engagement (APE) technology versus those who received usual care monitoring (UCM). The primary outcome was defined by the U.S. Medicare definition of adherence. PARTICIPANTS: Adherence data from two cloud-based databases (AirView™ and myAir™) were analyzed for patients with sleep apnea...
November 15, 2017: Chest
https://www.readbyqxmd.com/read/29154381/interhospital-transfer-and-receipt-of-specialty-procedures
#16
Stephanie K Mueller, Jie Zheng, John Orav, Jeffrey L Schnipper
The practice of transferring patients between acute care hospitals is variable and largely nonstandardized. Although often-cited reasons for transfer include providing patients access to specialty services only available at the receiving institution, little is known about whether and when patients receive such specialty care during the transfer continuum. We performed a retrospective analysis using 2013 100% Master Beneficiary Summary and Inpatient claims files from Centers for Medicare and Medicaid Services...
November 8, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29153870/factors-associated-with-use-of-disease-modifying-agents-for-rheumatoid-arthritis-in-the-national-hospital-and-ambulatory-medical-care-survey
#17
Priyanka Gaitonde, Laura M Bozzi, Fadia T Shaya
OBJECTIVE: We examined the treatment patterns among adults with rheumatoid arthritis (RA) and identified factors influencing access to traditional and biological disease modifying antirheumatic drugs (DMARDs). METHODS: We analyzed visits recorded in the National Ambulatory Medical Care Survey from 2005 to 2014 with a RA diagnosis. The primary outcome was DMARD use (traditional and/or biological). We included prescriptions of all RA-related treatments such as traditional and biological DMARDs, glucocorticoids, gold preparations, immunosuppressants, and non-steroidal anti-inflammatory drugs...
October 18, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/29153752/hospice-care-for-patients-with-dementia-in-the-united-states-a-longitudinal-cohort-study
#18
Aline De Vleminck, R Sean Morrison, Diane E Meier, Melissa D Aldridge
BACKGROUND: Patients with dementia form an increasing proportion of those entering hospice care. Little is known about the types of hospices serving patients with dementia and the patterns of hospice use, including timing of hospice disenrollment between patients with and without dementia. OBJECTIVES: To characterize the hospices that serve patients with dementia, to compare patterns of hospice disenrollment for patients with dementia and without dementia, and to evaluate patient-level and hospice-level characteristics associated with hospice disenrollment...
November 16, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29153624/the-effect-of-socioeconomic-status-race-and-insurance-type-on-newly-diagnosed-metastatic-prostate-cancer-in-the-united-states-2004-2013
#19
Adam B Weiner, Richard S Matulewicz, Jeffrey J Tosoian, Joseph M Feinglass, Edward M Schaeffer
BACKGROUND: Understanding the characteristics of men who initially present with metastatic prostate cancer (mPCa) can better enable directed improvement initiatives. The objective of this study was to assess the relationship between socioeconomic status (SES) and newly diagnosed mPCa. MATERIALS METHODS: All men diagnosed with PCa in the National Cancer Data Base from 2004 to 2013 were identified. Characteristics of men presenting with and without metastatic disease were compared...
November 15, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/29153542/adherence-to-treatment-recommendations-and-outcomes-for-women-with-ovarian-cancer-at-first-recurrence
#20
Miriam Champer, Yongmei Huang, June Y Hou, Ana I Tergas, William M Burke, Grace Clarke Hillyer, Cande V Ananth, Alfred I Neugut, Dawn L Hershman, Jason D Wright
OBJECTIVE: Treatment selection for recurrent ovarian cancer is typically based on the duration of time between the completion of adjuvant, platinum-based therapy and the time of recurrence, the platinum free interval (PFI). We examined the use of, and outcomes associated with platinum-based chemotherapy based on the PFI in women with recurrent ovarian cancer. METHODS: The Surveillance, Epidemiology, and End Results-Medicare database was used to identify women aged >65years with epithelial ovarian cancer who underwent surgery and platinum-based chemotherapy and who developed a recurrence >3months after the completion of adjuvant therapy...
November 15, 2017: Gynecologic Oncology
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