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https://www.readbyqxmd.com/read/27905888/medicare-program-end-stage-renal-disease-prospective-payment-system-coverage-and-payment-for-renal-dialysis-services-furnished-to-individuals-with-acute-kidney-injury-end-stage-renal-disease-quality-incentive-program-durable-medical-equipment-prosthetics-orthotics
#1
(no author information available yet)
This rule updates and makes revisions to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year 2017. It also finalizes policies for coverage and payment for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury. This rule also sets forth requirements for the ESRD Quality Incentive Program, including the inclusion of new quality measures beginning with payment year (PY) 2020 and provides updates to programmatic policies for the PY 2018 and PY 2019 ESRD QIP...
November 4, 2016: Federal Register
https://www.readbyqxmd.com/read/27870667/the-role-of-dedicated-musculoskeletal-urgent-care-centers-in-reducing-cost-and-improving-access-to-orthopaedic-care
#2
Travis J Anderson, Peter L Althausen
OBJECTIVES: Over the past few years, the United States has seen the rapid growth of dedicated musculoskeletal urgent care centers owned and operated by individual orthopaedic practices. In June of 2014, our practice opened the first dedicated orthopaedic urgent care in the region staffed by physician assistants and supervised by orthopaedic surgeons. Our hypothesis is that such centers can safely improve orthopaedic care for ambulatory orthopaedic injuries, decrease volume for overburdened emergency departments (EDs), reduce wait times and significantly decrease the cost of care while improving access to orthopaedic specialists...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27694354/the-abcds-of-managing-morbidly-obese-patients-in-intensive-care-units
#3
Luis A Berrios
More than one-third of the US adult population and 17% of the youth are now obese, and obesity is associated with more than $147 billion a year in health care costs. Critical care nurses should understand the physiological differences and practice guidelines for patients with a body mass index greater than 30. The ABCD approach encompasses key clinical concepts in the management of critically ill obese and morbidly obese patients, including management of airways and breathing, minimizing nurses' back and other injuries, increasing awareness of bias, circulation problems, risks of decubitus ulcers and other skin breakdown, differences in drug calculations and metabolism, limitations in diagnostic equipment and imaging, diet and nutritional recommendations, and concerns with durable medical equipment...
October 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27688109/geographic-variation-in-medicare-treatment-costs-and-outcomes-for-advanced-head-and-neck-cancer
#4
Vasu Divi, Li Tao, Alice Whittemore, Ingrid Oakley-Girvan
BACKGROUND: Advanced head and neck cancer (HNC) is a complex group of diseases that requires the input and coordination of multiple providers. While there are general guidelines for treatment, there is also considerable variation in how patients are treated, and how long they survive after treatment. It is unclear how the treatment variations relate to treatment costs and survival. METHODS: We identified 3678 Medicare patients with advanced HNC treated in 12 US regions between 2004 and 2009 using the linked database containing Medicare and Surveillance Epidemiology and End Results (SEER) data...
October 2016: Oral Oncology
https://www.readbyqxmd.com/read/27662393/measuring-the-cost-implications-of-the-collaborative-accountable-care-initiative-in-texas
#5
Vivian Ho, Timothy K Allen, Urie Kim, William P Keenan, Meei-Hsiang Ku-Goto, Mark Sanderson
OBJECTIVES: We analyzed changes in healthcare spending associated with the implementation of Cigna's Collaborative Accountable Care (CAC) initiative in a large multi-clinic physician practice. STUDY DESIGN: We compared claims from 2009, prior to the CAC initiative, against claims for 2010 to 2011, contrasting the patients covered by Cigna's CAC initiative with patients in other practices in the same geographic area covered by Cigna's medical plan. METHODS: We used a propensity weighted difference-in-differences approach, adjusting for age, sex, health status, and secular trends to isolate the treatment effect of the CAC...
2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27479830/providing-orthopaedic-care-for-the-incarcerated-obstacles-and-challenges
#6
Shafic A Sraj
Scant information on healthcare delivery to inmates is available in the medical literature. Healthcare provision to inmates has different rules than that for the general population and presents particular challenges for orthopaedic surgeons because of the nature of this population and restrictions imposed by their confinement. This population is typically of a lower socioeconomic status and is less well educated, has accumulated injuries over a lifetime, and has a considerable prevalence of communicable and blood-borne diseases, along with a high prevalence of smoking and high-risk behavior, such as drug-seeking, abuse, and self-inflicted injury...
September 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27153374/polyvinyl-chloride-plastisol-breast-phantoms-for-ultrasound-imaging
#7
Isabela Miller de Carvalho, Lucas Lobianco De Matheo, José Francisco Silva Costa Júnior, Cecília de Melo Borba, Marco Antonio von Krüger, Antonio Fernando Catelli Infantosi, Wagner Coelho de Albuquerque Pereira
Ultrasonic phantoms are objects that mimic some features of biological tissues, allowing the study of their interactions with ultrasound (US). In the diagnostic-imaging field, breast phantoms are an important tool for testing performance and optimizing US systems, as well as for training medical professionals. This paper describes the design and manufacture of breast lesions by using polyvinyl chloride plastisol (PVCP) as the base material. Among the materials available for this study, PVCP was shown to be stable, durable, and easy to handle...
August 2016: Ultrasonics
https://www.readbyqxmd.com/read/26885569/the-evolution-of-prostacyclins-in-pulmonary-arterial-hypertension-from-classical-treatment-to-modern-management
#8
Charles D Burger, Lesley D'Albini, Susan Raspa, Janis A Pruett
Prostacyclins for the treatment of pulmonary arterial hypertension (PAH) have historically been covered under the insurance medical benefit because they require durable medical equipment and are administered by an intravenous, subcutaneous, or inhalation route. However, more treatment options that target the prostacyclin pathway have become available. As the number and type of options expand, an improved understanding of these drugs will aid managed care decision makers in evaluating new treatment options and making clinically sound and cost-effective treatment decisions...
January 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/26717582/medicare-program-prior-authorization-process-for-certain-durable-medical-equipment-prosthetics-orthotics-and-supplies-final-rule
#9
(no author information available yet)
This final rule establishes a prior authorization program for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items that are frequently subject to unnecessary utilization. This rule defines unnecessary utilization and creates a new requirement that claims for certain DMEPOS items must have an associated provisional affirmed prior authorization decision as a condition of payment. This rule also adds the review contractor's decision regarding prior authorization of coverage of DMEPOS items to the list of actions that are not initial determinations and therefore not appealable...
December 30, 2015: Federal Register
https://www.readbyqxmd.com/read/26673912/a-scoping-literature-review-the-state-of-knowledge-on-home-care-equipment-and-supplies
#10
Kimberly D Fraser, Jonathan Lai, Catherine Nissen, Queenie Choo, Jamie Davenport, Abram Gutscher
We explored the state of knowledge on home care supplies and equipment because not much is known about this topic. We used a scoping review for the literature review because it was the most appropriate approach considering the state of the literature. We searched for articles published in both the gray and peer-reviewed literature. We established five overarching themes based on the findings. These were supply management, durable medical equipment, wound care, best practices, and costs. This review demonstrates that although knowledge about home care supplies and equipment is growing, it is still an understudied area...
2015: Care Management Journals: Journal of Case Management ; the Journal of Long Term Home Health Care
https://www.readbyqxmd.com/read/26360818/who-s-at-risk-when-the-power-goes-out-the-at-home-electricity-dependent-population-in-the-united-states-2012
#11
Noelle Angelique M Molinari, Bei Chen, Nevin Krishna, Thomas Morris
OBJECTIVES: Natural and man-made disasters can result in power outages that can affect certain vulnerable populations dependent on electrically powered durable medical equipment. This study estimated the size and prevalence of that electricity-dependent population residing at home in the United States. METHODS: We used the Truven Health MarketScan* 2012 database to estimate the number of employer-sponsored privately insured enrollees by geography, age group, and sex who resided at home and were dependent upon electrically powered durable medical equipment to sustain life...
September 10, 2015: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/26311543/medicare-utilization-and-expenditures-around-incident-dementia-in-a-multiethnic-cohort
#12
Carolyn W Zhu, Stephanie Cosentino, Katherine Ornstein, Yian Gu, Nikolaos Scarmeas, Howard Andrews, Yaakov Stern
BACKGROUND: Few studies have examined patterns of health care utilization and costs during the period around incident dementia. METHODS: Participants were drawn from the Washington Heights-Inwood Columbia Aging Project, a multiethnic, population-based, prospective study of cognitive aging of Medicare beneficiaries in a geographically defined area of northern Manhattan. Medicare utilization and expenditure were examined in individuals with clinically diagnosed dementia from 2 years before until 2 years after the initial diagnosis...
November 2015: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/26238974/effects-of-achieving-target-measures-in-rheumatoid-arthritis-on-functional-status-quality-of-life-and-resource-utilization-analysis-of-clinical-practice-data
#13
Evo Alemao, Seongjung Joo, Hugh Kawabata, Maiwenn J Al, Paul D Allison, Maureen P M H Rutten-van Mölken, Michelle L Frits, Christine K Iannaccone, Nancy A Shadick, Michael E Weinblatt
OBJECTIVE: To evaluate associations between achieving guideline-recommended targets of disease activity, defined by the Disease Activity Score in 28 joints using C-reactive protein level (DAS28-CRP) <2.6, the Simplified Disease Activity Index (SDAI) ≤3.3, or the Clinical Disease Activity Index (CDAI) ≤2.8, and other health outcomes in a longitudinal observational study. METHODS: Other defined thresholds included low disease activity (LDA), moderate (MDA), or severe disease activity (SDA)...
March 2016: Arthritis Care & Research
https://www.readbyqxmd.com/read/26098905/nitrogen-dioxide-sterilization-in-low-resource-environments-a-feasibility-study
#14
Majdi Shomali, David Opie, Trisha Avasthi, Ariel Trilling
Access to sterilization is a critical need for global healthcare, as it is one of the prerequisites for safe surgical care. Lack of sterilization capability has driven up healthcare infection rates as well as limited access to healthcare, especially in low-resource environments. Sterilization technology has for the most part been static and none of the established sterilization methods has been so far successfully adapted for use in low-resource environments on a large scale. It is evident that healthcare facilities in low-resource settings require reliable, deployable, durable, affordable, easily operable sterilization equipment that can operate independently of scarce resources...
2015: PloS One
https://www.readbyqxmd.com/read/25979579/evaluation-and-management-of-amyotrophic-lateral-sclerosis
#15
REVIEW
Nojan Valadi
Motor neuron diseases can cause progressive impairment of voluntary muscles of movement, respiration, speech, and swallowing. This review discusses the most common motor neuron disease, amyotrophic lateral sclerosis (ALS). It reviews the evaluation, diagnosis, and management of ALS, and its epidemiology, pathophysiology, and management. A coordinated approach by the primary care physician and neurologist is necessary with a focus on treatment options, durable medical equipment needs, and end-of-life discussions...
June 2015: Primary Care
https://www.readbyqxmd.com/read/25880151/state-of-emergency-preparedness-for-us-health-insurance-plans
#16
Raina M Merchant, Kristen Finne, Barbara Lardy, German Veselovskiy, Caey Korba, Gregg S Margolis, Nicole Lurie
OBJECTIVES: Health insurance plans serve a critical role in public health emergencies, yet little has been published about their collective emergency preparedness practices and policies. We evaluated, on a national scale, the state of health insurance plans' emergency preparedness and policies. STUDY DESIGN: A survey of health insurance plans. METHODS: We queried members of America's Health Insurance Plans, the national trade association representing the health insurance industry, about issues related to emergency preparedness issues: infrastructure, adaptability, connectedness, and best practices...
January 2015: American Journal of Managed Care
https://www.readbyqxmd.com/read/25856033/clinical-nurse-specialist-prescriber-characteristics-and-challenges-in-oregon
#17
Tracy Klein
PURPOSE/OBJECTIVES: The purpose of this study was to assess role characteristics of clinical nurse specialists (CNSs) with prescriptive authority in Oregon 10 years after passage of Senate Bill 460. Factors examined included role preparation and mentorship, use and maintenance of authority, prescribing benefits and barriers, and types of drugs/nondrugs prescribed. DESIGN: This study was a descriptive survey using both quantitative and qualitative analysis. SAMPLE: The sample was obtained from a list provided on June 13, 2014, by the Oregon State Board of Nursing of all CNSs in Oregon who had ever been granted prescriptive authority (n = 40)...
May 2015: Clinical Nurse Specialist CNS
https://www.readbyqxmd.com/read/25785586/oxygen-therapy-use-in-older-adults-with-chronic-obstructive-pulmonary-disease
#18
Shawn P E Nishi, Wei Zhang, Yong-Fang Kuo, Gulshan Sharma
RATIONALE: Oxygen therapy improves survival and function in severely hypoxemic chronic obstructive pulmonary disease (COPD) patients based on two landmark studies conducted over 40 years ago. We hypothesize that oxygen users in the current era may be very different. We examined trends and subject characteristics associated with oxygen therapy use from 2001-2010 in the United States. METHODS: We examined Medicare beneficiaries with COPD who received oxygen from 2001 to 2010...
2015: PloS One
https://www.readbyqxmd.com/read/25562895/tricare-program-clarification-of-benefit-coverage-of-durable-equipment-and-ordering-or-prescribing-durable-equipment-clarification-of-benefit-coverage-of-assistive-technology-devises-under-the-extended-care-health-option-program-final-rule
#19
(no author information available yet)
This final rule modifies the TRICARE regulation to add a definition of assistive technology (AT) devices for purposes of benefit coverage under the TRICARE Extended Care Health Option (ECHO) Program and to amend the definitions of durable equipment (DE) and durable medical equipment (DME) to better conform the language in the regulation to the statute. The final rule amends the language that specifically limits ordering or prescribing of DME to only a physician under the Basic Program, as this amendment will allow certain other TRICARE authorized individual professional providers, acting within the scope of their licensure, to order or prescribe DME...
December 31, 2014: Federal Register
https://www.readbyqxmd.com/read/25525132/determining-the-utility-and-durability-of-medical-equipment-donated-to-a-rural-clinic-in-a-low-income-country
#20
Melissa Bauserman, Claire Hailey, Justin Gado, Adrien Lokangaka, Jessica Williams, Rebecca Richards-Kortum, Antoinette Tshefu, Carl Bose
BACKGROUND: Health centers in low-income countries often depend on donations to provide appropriate diagnostic equipment. However, donations are sometimes made without an understanding of the recipient's needs, practical constraints or sustainability of supplies. METHODS: We donated a set of physical diagnostic equipment, non-invasive instrument tests and laboratory supplies to a rural health center in the Democratic Republic of Congo. We collected information on the usage and durability of equipment and supplies for each patient encounter over a 1-year period...
July 2015: International Health
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