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NEJM—Health Policy and Reform

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https://www.readbyqxmd.com/read/28099837/cost-effectiveness-analysis-2-0
#1
Peter J Neumann, Gillian D Sanders
Cost-effectiveness analysis in U.S. health care seems poised for a second act of sorts. Although it has never actually gone away, efforts to apply it have encountered resistance, and the federal government and some health care organizations have sometimes prohibited its use or relegated it to a..
January 19, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28099827/variant-creutzfeldt-jakob-disease-in-a-patient-with-heterozygosity-at-prnp-codon-129
#2
LETTER
Tzehow Mok, Zane Jaunmuktane, Susan Joiner, Tracy Campbell, Catherine Morgan, Benjamin Wakerley, Farhad Golestani, Peter Rudge, Simon Mead, H Rolf Jäger, Jonathan D F Wadsworth, Sebastian Brandner, John Collinge
To the Editor: Prions cause lethal neurodegenerative diseases in mammals and are composed of multichain assemblies of misfolded host-encoded cellular prion protein (PrP). A common polymorphism at codon 129 of the PrP gene (PRNP), where either methionine (M) or valine (V) is encoded, affects the..
19, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28099823/transparency-and-trust-online-patient-reviews-of-physicians
#3
Vivian Lee
After years of academic debate over the role and value of patient-satisfaction scores and reviews of health care providers, Yelp, the online powerhouse of documenting customer satisfaction, is forcing the issue. With more than 102 million customer reviews to date, 6% of them in the health care..
January 19, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28099819/powerful-ideas-for-global-access-to-medicines
#4
Suerie Moon
One of the few issues uniting U.S. voters in the 2016 election was outrage over the high prices of medicines. From the quadrupling of EpiPen prices to $1,000-per-pill hepatitis C treatments, from six-digit pricing of cancer drugs to the 55-fold price increase on a 62-year-old toxoplasmosis drug,..
January 18, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28099066/new-vaccines-against-epidemic-infectious-diseases
#5
John-Arne Røttingen, Dimitrios Gouglas, Mark Feinberg, Stanley Plotkin, Krishnaswamy V Raghavan, Andrew Witty, Ruxandra Draghia-Akli, Paul Stoffels, Peter Piot
The vaccine-development response to the 2014 Ebola epidemic in West Africa, though a valiant effort, was too little, too late. Three vaccine candidates were tested successfully under challenging conditions. Governments and foundations mobilized funds quickly. Companies and research-and-development..
January 18, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28099063/improve-quality-control-spending-maintain-access-can-the-merit-based-incentive-payment-system-deliver
#6
Eric C Schneider, Cornelia J Hall
Medicare is poised to overhaul the way it pays for ambulatory care services. The Centers for Medicare and Medicaid Services (CMS) has published a final rule codifying the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which directed CMS to gradually replace fee-for-service..
January 18, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28076708/patient-reported-outcomes-harnessing-patients-voices-to-improve-clinical-care
#7
Ethan Basch
Symptom management is a cornerstone of clinical care, particularly for patients with chronic conditions. Yet patients’ symptoms and physical impairments go undetected by health care providers as much as half the time, particularly between clinic visits. As a result, we miss opportunities to..
January 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28058966/repealing-the-aca-without-a-replacement-the-risks-to-american-health-care
#8
Barack H Obama
Health care policy often shifts when the country’s leadership changes. That was true when I took office, and it will likely be true with President-elect Donald Trump. I am proud that my administration’s work, through the Affordable Care Act (ACA) and other policies, helped millions more Americans..
January 6, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28051917/economic-effects-of-medicaid-expansion-in-michigan
#9
John Z Ayanian, Gabriel M Ehrlich, Donald R Grimes, Helen Levy
Under the Affordable Care Act, 31 U.S. states have opted to expand Medicaid coverage to nonelderly adults with annual incomes up to 138% of the federal poverty level (approximately $16,400 for a single adult in 2016). The federal government currently pays the full cost of Medicaid expansion in..
January 4, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28051914/intimate-choices-public-threats-reproductive-and-lgbtq-rights-under-a-trump-administration
#10
Melissa Murray
In the weeks since the election of Donald Trump, many experts have begun assessing the likely implications of his administration in various realms, from immigration and education to financial institutions and international relations. My concerns are decidedly more quotidian, though no less..
January 4, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28029924/engineering-social-incentives-for-health
#11
David A Asch, Roy Rosin
Who is more likely to be around when patients are deciding what to eat or whether to watch TV or take a walk — a doctor or a spouse? A nurse-navigator or a friend? Convention has organized the process of health care into interactions between a clinician and a patient. But even patients with chronic..
December 29, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/28029922/supporting-family-caregivers-of-older-americans
#12
Jennifer L Wolff, Judy Feder, Richard Schulz
Every day, millions of older Americans (those 65 years of age or older) manage basic health and functioning needs with the help of family caregivers. These family caregivers (defined as relatives, partners, friends, or neighbors who provide help because of a personal relationship rather than..
December 29, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/28029802/should-medicare-value-based-purchasing-take-social-risk-into-account
#13
Karen E Joynt, Nancy De Lew, Steven H Sheingold, Patrick H Conway, Kate Goodrich, Arnold M Epstein
The United States is rapidly moving to a health care delivery system in which value-based payment models are the predominant way of reimbursing clinicians for care. Since caring for patients with social risk factors may cost more and make it harder to achieve high performance on quality metrics,..
December 28, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/28002704/interim-buprenorphine-vs-waiting-list-for-opioid-dependence
#14
RANDOMIZED CONTROLLED TRIAL
Stacey C Sigmon, Taylor A Ochalek, Andrew C Meyer, Bryce Hruska, Sarah H Heil, Gary J Badger, Gail Rose, John R Brooklyn, Robert P Schwartz, Brent A Moore, Stephen T Higgins
To the Editor: Opioid-use disorder has reached epidemic proportions, with high attendant costs in terms of increases in overdoses and infectious diseases and in economic costs. Despite the demonstrated efficacy of maintaining abstinence by treating patients with opioid agonists, patients can remain..
22, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/28002701/a-police-led-addiction-treatment-referral-program-in-massachusetts
#15
LETTER
Davida M Schiff, Mari-Lynn Drainoni, Megan Bair-Merritt, Zoe Weinstein, David Rosenbloom
To the Editor: During the period from 2009 through 2013, only 21% of people with an opioid-use disorder in the United States received any type of treatment. In response to increasing rates of overdose deaths in the community, the Gloucester Police Department developed the Angel Program, a..
22, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/28002700/all-in-a-day-s-work-equity-vs-equality-at-a-public-icu-in-brazil
#16
Flávia R Machado
"Of all forms of inequality, injustice in health care is the most shocking and most inhumane." — Martin Luther King, Jr. We begin another day at 7:00 a.m. and once again we need to decide who will get an intensive care unit (ICU) bed after an elective surgical procedure. A 55-year-old grandmother..
December 22, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/28002698/severe-malaria-in-african-children-the-need-for-continuing-investment
#17
Kathryn Maitland
In large parts of sub-Saharan Africa, the start of the seasonal rains means that within weeks, hospitals will witness a sharp upsurge in admissions to their pediatric wards. Many children who are admitted will be suffering from life-threatening complications of Plasmodium falciparum malaria, such..
December 22, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/28002697/sequenom-v-ariosa-the-death-of-a-genetic-testing-patent
#18
Robert Cook-Deegan, Subhashini Chandrasekharan
Hong Kong physician-scientist Dennis Lo started a technical revolution in 1997 when he observed that DNA derived from placental cells could be detected in maternal blood during pregnancy, revealing information about the fetal genome or genotypes. Lo’s work built on research showing that fragments..
December 22, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/28001473/care-for-the-vulnerable-vs-cash-for-the-powerful-trump-s-pick-for-hhs
#19
Sherry A Glied, Richard G Frank
Representative Tom Price of Georgia, an orthopedic surgeon, will be President-elect Donald Trump’s nominee for secretary of health and human services (HHS). In the 63-year history of the HHS Department and its predecessor, the Department of Health, Education, and Welfare, only two previous..
January 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/27974039/transforming-evidence-generation-to-support-health-and-health-care-decisions
#20
Robert M Califf, Melissa A Robb, Andrew B Bindman, Josephine P Briggs, Francis S Collins, Patrick H Conway, Trinka S Coster, Francesca E Cunningham, Nancy De Lew, Karen B DeSalvo, Christine Dymek, Victor J Dzau, Rachael L Fleurence, Richard G Frank, J Michael Gaziano, Petra Kaufmann, Michael Lauer, Peter W Marks, J Michael McGinnis, Chesley Richards, Joe V Selby, David J Shulkin, Jeffrey Shuren, Andrew M Slavitt, Scott R Smith, B Vindell Washington, P Jon White, Janet Woodcock, Jonathan Woodson, Rachel E Sherman
Making better choices about health and health care requires the best possible evidence. Unfortunately, many of the decisions made today in our health care system are not supported by high-quality evidence derived from randomized, controlled trials or well-designed observational studies. But as..
December 15, 2016: New England Journal of Medicine
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