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BCM Health Policy Journal Club

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14 papers 0 to 25 followers Articles previously reviewed or considered for discussion during our monthly student health policy journal club at Baylor College of Medicine. Join us every first Tuesday of the month for discussion led by our clinical faculty with special interests in policy.
By Cedric Dark MD, MPH, FACEP, FAAEM
https://www.readbyqxmd.com/read/27421814/where-do-freestanding-emergency-departments-choose-to-locate-a-national-inventory-and-geographic-analysis-in-three-states
#1
Jeremiah D Schuur, Olesya Baker, Jaclyn Freshman, Michael Wilson, David M Cutler
STUDY OBJECTIVE: We determine the number and location of freestanding emergency departments (EDs) across the United States and determine the population characteristics of areas where freestanding EDs are located. METHODS: We conducted a systematic inventory of US freestanding EDs. For the 3 states with the highest number of freestanding EDs, we linked demographic, insurance, and health services data, using the 5-digit ZIP code corresponding to the freestanding ED's location...
July 12, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27532694/changes-in-utilization-and-health-among-low-income-adults-after-medicaid-expansion-or-expanded-private-insurance
#2
Benjamin D Sommers, Robert J Blendon, E John Orav, Arnold M Epstein
Importance: Under the Affordable Care Act (ACA), more than 30 states have expanded Medicaid, with some states choosing to expand private insurance instead (the "private option"). In addition, while coverage gains from the ACA's Medicaid expansion are well documented, impacts on utilization and health are unclear. Objective: To assess changes in access to care, utilization, and self-reported health among low-income adults in 3 states taking alternative approaches to the ACA...
October 1, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/26733698/house-calls-california-program-for-homebound-patients-reduces-monthly-spending-delivers-meaningful-care
#3
Glenn A Melnick, Lois Green, Jeremy Rich
In 2009 HealthCare Partners Affiliates Medical Group, based in Southern California, launched House Calls, an in-home program that provides, coordinates, and manages care primarily for recently discharged high-risk, frail, and psychosocially compromised patients. Its purpose is to reduce preventable emergency department visits and hospital readmissions. We present data over time from this well-established program to provide an example for other new programs that are being established across the United States to serve this population with complex needs...
January 2016: Health Affairs
https://www.readbyqxmd.com/read/27355810/primary-care-appointment-availability-and-nonphysician-providers-one-year-after-medicaid-expansion
#4
Renuka Tipirneni, Karin V Rhodes, Rodney A Hayward, Richard L Lichtenstein, HwaJung Choi, Elyse N Reamer, Matthew M Davis
OBJECTIVES: With insurance enrollment greater than expected under the Affordable Care Act, uncertainty about the availability and timeliness of healthcare services for newly insured individuals has increased. We examined primary care appointment availability and wait times for new Medicaid and privately insured patients before and after Medicaid expansion in Michigan. STUDY DESIGN: Simulated patient ("secret shopper") study. METHODS: Extended follow-up of a previously reported simulated patient ("secret shopper") study assessing accessibility of routine new patient appointments in a stratified proportionate random sample of Michigan primary care practices before versus 4, 8, and 12 months after Medicaid expansion...
June 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27400401/united-states-health-care-reform-progress-to-date-and-next-steps
#5
REVIEW
Barack Obama
IMPORTANCE: The Affordable Care Act is the most important health care legislation enacted in the United States since the creation of Medicare and Medicaid in 1965. The law implemented comprehensive reforms designed to improve the accessibility, affordability, and quality of health care. OBJECTIVES: To review the factors influencing the decision to pursue health reform, summarize evidence on the effects of the law to date, recommend actions that could improve the health care system, and identify general lessons for public policy from the Affordable Care Act...
August 2, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/26378026/uninsurance-disparities-have-narrowed-for-black-and-hispanic-adults-under-the-affordable-care-act
#6
Stacey McMorrow, Sharon K Long, Genevieve M Kenney, Nathaniel Anderson
No abstract text is available yet for this article.
October 2015: Health Affairs
https://www.readbyqxmd.com/read/26107056/the-elusive-right-to-health-care-under-u-s-law
#7
Jennifer Prah Ruger, Theodore W Ruger, George J Annas
Is there a right to health care in the United States? No U.S. Supreme Court decision has ever interpreted the Constitution as guaranteeing a right to health care for all Americans. The Constitution does not contain the words "health," "health care," "medical care," or "medicine." But if we look..
June 25, 2015: New England Journal of Medicine
https://www.readbyqxmd.com/read/25946142/the-affordable-care-act-at-5-years
#8
David Blumenthal, Melinda Abrams, Rachel Nuzum
Just over 5 years ago, on March 23, 2010, President Barack Obama signed the Affordable Care Act (ACA) into law. Its enactment may constitute the most important event of the Obama presidency and could fundamentally affect the future of health care in the United States. From a historical perspective,..
June 18, 2015: New England Journal of Medicine
https://www.readbyqxmd.com/read/25443989/chief-complaint-based-performance-measures-a-new-focus-for-acute-care-quality-measurement
#9
Richard T Griffey, Jesse M Pines, Heather L Farley, Michael P Phelan, Christopher Beach, Jeremiah D Schuur, Arjun K Venkatesh
Performance measures are increasingly important to guide meaningful quality improvement efforts and value-based reimbursement. Populations included in most current hospital performance measures are defined by recorded diagnoses using International Classification of Diseases, Ninth Revision codes in administrative claims data. Although the diagnosis-centric approach allows the assessment of disease-specific quality, it fails to measure one of the primary functions of emergency department (ED) care, which involves diagnosing, risk stratifying, and treating patients' potentially life-threatening conditions according to symptoms (ie, chief complaints)...
April 2015: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/25607431/institute-of-medicine-report-on-gme-a-call-for-reform
#10
John K Iglehart
For more than three decades, administrations from that of Republican Ronald Reagan (1981–1989) to Democrat Barack Obama have proposed sharp reductions in the robust support by Medicare of graduate medical education (GME) programs. Teaching hospitals, the major recipients of an annual federal GME..
January 22, 2015: New England Journal of Medicine
https://www.readbyqxmd.com/read/25490329/spending-patterns-in-region-of-residency-training-and-subsequent-expenditures-for-care-provided-by-practicing-physicians-for-medicare-beneficiaries
#11
Candice Chen, Stephen Petterson, Robert Phillips, Andrew Bazemore, Fitzhugh Mullan
IMPORTANCE: Graduate medical education training may imprint young physicians with skills and experiences, but few studies have evaluated imprinting on physician spending patterns. OBJECTIVE: To examine the relationship between spending patterns in the region of a physician's graduate medical education training and subsequent mean Medicare spending per beneficiary. DESIGN, SETTING, AND PARTICIPANTS: Secondary multilevel multivariable analysis of 2011 Medicare claims data (Part A hospital and Part B physician) for a random, nationally representative sample of family medicine and internal medicine physicians completing residency between 1992 and 2010 with Medicare patient panels of 40 or more patients (2851 physicians providing care to 491,948 Medicare beneficiaries)...
December 10, 2014: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/25248963/to-extend-or-not-to-extend-the-primary-care-fee-bump-in-medicaid
#12
Adam S Wilk, David K Jones
Policy makers and researchers are eager to learn the effects of the Patient Protection and Affordable Care Act of 2010 (ACA) and its many provisions, but to date, they have been frustrated by the dearth of robust evidence on the ACA's true impacts on important health care and patient outcomes (e.g., access to primary care services). The present limitations of evidence, often a consequence of delays and inconsistencies in the law's implementation, have begun to affect policy making in the ACA's wake. In this article, we consider the debates among state and federal policy makers about whether to extend the ACA's so-called fee bump provision, whereby Medicaid fees for primary care services were increased to 100 percent of Medicare levels during 2013 and 2014...
December 2014: Journal of Health Politics, Policy and Law
https://www.readbyqxmd.com/read/25201663/a-comparison-of-hospital-administrative-costs-in-eight-nations-us-costs-exceed-all-others-by-far
#13
COMPARATIVE STUDY
David U Himmelstein, Miraya Jun, Reinhard Busse, Karine Chevreul, Alexander Geissler, Patrick Jeurissen, Sarah Thomson, Marie-Amelie Vinet, Steffie Woolhandler
A few studies have noted the outsize administrative costs of US hospitals, but no research has compared these costs across multiple nations with various types of health care systems. We assembled a team of international health policy experts to conduct just such a challenging analysis of hospital administrative costs across eight nations: Canada, England, Scotland, Wales, France, Germany, the Netherlands, and the United States. We found that administrative costs accounted for 25.3 percent of total US hospital expenditures--a percentage that is increasing...
September 2014: Health Affairs
https://www.readbyqxmd.com/read/25092832/california-emergency-department-closures-are-associated-with-increased-inpatient-mortality-at-nearby-hospitals
#14
Charles Liu, Tanja Srebotnjak, Renee Y Hsia
Between 1996 and 2009 the annual number of emergency department (ED) visits in the United States increased by 51 percent while the number of EDs nationwide decreased by 6 percent, which placed unprecedented strain on the nation's EDs. To investigate the effects of an ED's closing on surrounding communities, we identified all ED closures in California during the period 1999-2010 and examined their association with inpatient mortality rates at nearby hospitals. We found that one-quarter of hospital admissions in this period occurred near an ED closure and that these admissions had 5 percent higher odds of inpatient mortality than admissions not occurring near a closure...
August 2014: Health Affairs
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