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Global Budget Revenue Model and Care for Patients Receiving Chemotherapy.

ImportanceMaryland's Global Budget Revenue (GBR) model provided fixed global payments to hospitals, aiming to control revenue growth while improving care quality. The implications of GBR implementation in 2014 for cancer care have not been robustly evaluated.ObjectiveTo examine the association between GBR implementation and subsequent changes in episode-based Medicare payments, hospital utilization, and quality of care among Medicare beneficiaries undergoing systemic therapy for cancer.Design, setting, and participantsThis cohort study used a difference-in-differences approach to compare chang

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… These control states are in adjacent Census divisions and—similar to Maryland—expanded their Medicaid program in 2014, minimizing potential spillover effects from Medicaid expansion coincident with GBR’s rollout. 19 Details on identifying the chemotherapy episodes are provided in eAppendix 1 and eTable … Third, we leveraged Medicare fee-for-service claims for our analysis, and the findings may not generalize to Medicare Advantage, Medicaid, or commercially insured patients. …

Longitudinal patterns of cancer patient reported outcomes in end of life care predict survival.

PurposePatients with advanced cancer typically demonstrate sharp deterioration in physical function and psychological status during the last months of life. This study evaluates the relationship between survival in patients with advanced cancer and longitudinal assessment of anxiety, depression, fatigue, pain interference, and/or physical function using the US National Institute of Health Patient Reported Outcomes Information System.MethodsMixed-effects models were used to evaluate patient-reported outcome trajectories over time among patients with advanced loco-regional or metastatic cancer r

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… Dillon report receiving funding from grants from Centers for Medicare and Medicaid Services Innovation Center during the conduct of the study. Dr. … The Center for Medicare and Medicaid Innovation (Innovation Center) at the Centers for Medicare and Medicaid Services (CMS). Accessed on June 30, 2015 at http://innovation.cms.gov/initiatives/Oncology-Care/ …

Opportunities for Savings in Risk Arrangements for Oncologic Care.

ImportanceAs the US accelerates adoption of alternative payment through global payment models such as Accountable Care Organizations (ACOs) or Medicare Advantage (MA), high spending for cancer care is a potential target for savings.ObjectiveTo quantify the extent to which ACOs and other risk-bearing organizations operating in a specific geographic area (hospital referral region [HRR]) could achieve savings by steering patients to efficient medical oncology practices.Design, setting, and participantsThis observational study included serial cross-sections of Medicare beneficiaries with cancer fr

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… We identified patients with low incomes and limited financial resources based on enrollment in Medicaid or the Part D Low-Income Subsidy, and classified patients into 1 of 3 mutually exclusive groups: enrolled in full Medicaid for at least 1 month, enrolled in partial Medicaid for at least 1 month (without … full Medicaid), or enrolled in the Part D Low-Income Subsidy for at least 1 month (without any Medicaid coverage). …

Быстрый обзор мер по улучшению ухода за людьми, страдающими множественным склерозом, диабетической ретинопатией и раком легких.

В Соединенных Штатах пациенты, страдающие хроническими заболеваниями, сталкиваются с различиями в показателях здоровья по всему спектру услуг по уходу. Среди пациентов с множественным склерозом, диабетической ретинопатией и раком легких не хватает доказательств, резюмирующих меры по улучшению ухода и сокращению этих различий. Цель этого оперативного обзора литературы заключалась в том, чтобы определить меры, принимаемые пациентами с такими хроническими заболеваниями в целях улучшения состояния здоровья и сокращения неравенства в плане выявления, диагностики, доступа к лечению и специалистам, с

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… Liu, 2020 [ 48 ] | State-level Medicaid expansion | Compared to men in states that did not expand Medicaid, those in states that did expand Medicaid had greater increases in 2-year survival and early-stage diagnosis. … Outcomes for women did not differ among states that did and did not expand Medicaid. Loehrer, 2018 [ 49 ] | State-level Medicaid expansion | Rates of complex surgical care increased relative to non-expansion states. …

The Impact of Evolving Endometriosis Guidelines on Diagnosis and Observational Health Studies.

STUDY QUESTION: Do recent changes in European Society of Human Reproduction and Embryology (ESHRE) clinical guidelines result in more compre … s data from the Merative™ MarketScan® Commercial Database (CCAE), Merative™ MarketScan® Multi-State Medicaid Database (MDCD), Optum® de-identified Electronic Health Record dataset (Optum® EHR), and electronic health record (EHR) data from a large academic medical center in New York City (CUIMC EHR). To examine the potential impact of expanding clinical cri …

Suicidal Thoughts and Behaviors Among Adults Aged ≥18 Years - United States, 2015-2019.

PROBLEM/CONDITION: Suicidal thoughts and behaviors are important public health concerns in the United States. In 2019, suicide was the 10th … se with a family income at or above the federal poverty threshold and higher among those covered by Medicaid or the Children's Health Insurance Program than among those with other types of health insurance or no health insurance coverage. INTERPRETATION: The findings in this report highlight differences in the adult prevalence of suicidal thoughts, plans …

Volume-outcome relationship in halo vest utilization for C2 fractures.

BACKGROUND CONTEXT: The prevalence of C2 fractures has increased in recent years. The treatment of these fractures include halo-vest immobil … private insurance and worker's compensation had lower likelihood of future readmission compared to Medicaid patients. Patients >80 had higher rates of major in-hospital complications (52% vs. 40%, 18%, and 19% for groups 60-79, 40-59, and <40, respectively; p<.01), mortality (14% vs. 5%, 1%, and 1% for groups 60-79, 40-59, and <40, respectively; p<.01), a …

Risk of Nondherence to Diabetes Medications Among Medicare Advantage Enrollees: Development of a Validated Risk Prediction Tool.

BACKGROUND: Low adherence to oral antidiabetic drugs (OADs) in the Medicare population can greatly reduce Centers for Medicare & Medicaid Services (CMS) star ratings for managed care organizations (MCOs). OBJECTIVE: To develop and validate a risk assessment tool (Prescription Medication Adherence Prediction Tool for Diabetes Medications [RxAPT-D]) to predict nonadherence to OADs using Medicare claims data. METHODS: In this retrospective observational study, claims data for members enrolled in a Medicare Advantage Prescription Drug (MA-PD) program in Houston, Texas, were used. Data from 2012 …

Surgical Risks and Costs of Care are Greater in Patients Who Are Super Obese and Undergoing THA.

BACKGROUND: Patients with morbid obesity, defined as a BMI greater than 40 kg/m2, and super obesity, defined as a BMI greater than 50 kg/m2, … eight only, often as part of a multivariate analysis. On October 1, 2010 the Centers for Medicare & Medicaid Services added a fifth digit to the BMI data, V85.xx, in the Medicare data bank, which allowed data mining of cases of patients with higher BMI. To our knowledge, our study is the first large retrospective Medicare data mining study, which allows us …

Behavioral and clinical characteristics of persons receiving medical care for HIV infection - Medical Monitoring Project, United States, 2009.

PROBLEM: As of December 31, 2009, an estimated 864,748 persons were living with human immunodeficiency virus (HIV) infection in the 50 U.S. … est proportion (23.1%) were aged 45-49 years. Most patients (81.1%) had medical coverage; 40.3% had Medicaid, 30.6% had private health insurance, and 25.7% had Medicare. An estimated 69.6% of patients had three or more documented CD4+ T-lymphocyte cell (CD4+) or HIV viral load tests. Most patients (88.7%) were prescribed antiretroviral therapy (ART), and 7 …

Neuropsychiatric disorders in adults undergoing chimeric antigen receptor T cells therapy for aggressive lymphomas and acute lymphoblastic leukemia.

ObjectiveTo evaluate risk factors for neuropsychiatric disorders (NPD) in recipients of CART therapy.MethodsPatients ≥ 18 years with acute lymphoblastic leukemia (ALL), and aggressive B-cell lymphomas who received CART in 2018 were evaluated. Patients with and without NPD were compared.ResultsNPD was diagnosed in 31.2% of patients. Compared to patients without NPD, patients with NPD were likely to be females (P = 0.035) and have ALL (P = 0.039). NPD was significantly associated with female gender (OR = 2.03) and diagnosis of ALL (OR = 2.76). No association between NPD and outcomes.ConclusionsF

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… Table 2 Characteristics NPD ( n = 295) No NPD ( n = 650) P Age, median, years 55 59 0.055 Gender (%) 0.035 Female 55.9 38.5 Male 44.1 61.5 Race (%) 0.734 White 70.9 60.7 Black 1.8 1.6 Hispanic 14.6 16.4 Insurance (%) 0.143 Medicare 19.6 25.2 Medicaid 14.3 11.0 Private (including HMO) 66.1 56.7 Self-pay … Characteristics | NPD ( n = 295) | No NPD ( n = 650) | P Age, median, years | 55 | 59 | 0.055 Gender (%) | | | 0.035 Female | 55.9 | 38.5 Male | 44.1 | 61.5 Race (%) | | | 0.734 White | 70.9 | 60.7 Black | 1.8 | 1.6 Hispanic | 14.6 | 16.4 Insurance (%) | | | 0.143 Medicare | 19.6 | 25.2 Medicaid …

Application of a diazepam milligram equivalency algorithm to assess benzodiazepine dose intensity in Rhode Island in 2018.

BACKGROUND: Benzodiazepines are indicated for the treatment of many conditions, such as anxiety disorders, muscle spasms, alcohol withdrawal … 1.72; aOR = 1.84, 95% CI = 1.76-1.93, respectively). CONCLUSIONS: Individuals aged 35-64 years with Medicaid insurance and those aged under 65 years with Medicare were more likely to be prescribed a benzodiazepine of at least 15 DME per day. Higher benzodiazepine DMEs were also dispensed to patients who concurrently used prescription opioids or stimulants …

What Was the Change in Telehealth Usage and Proportion of No-show Visits for an Orthopaedic Trauma Clinic During the COVID-19 Pandemic?

BACKGROUND: In response to the coronavirus disease 2019 (COVID-19) pandemic, the Centers for Medicare and Medicaid Services pledged payment for telehealth visits for the duration of this public health emergency in an effort to decrease COVID-19 transmission and allow for deployment of residents and attending physicians to support critical-care services. Although the COVID-19 pandemic has vastly expanded telehealth use, no studies to our knowledge have analyzed the implementation and success of telehealth for orthopaedic trauma. This population is unique in that patients who have experienced or…

Impact of Adherence Education and Monitoring on Community Pharmacy Performance Scores and Patient Satisfaction.

BACKGROUND: Adherence, specifically to noninsulin diabetes medications, statins, and renin-angiotensin system antagonists (i.e. angiotensin-converting-enzyme inhibitors (ACEi), angiotensin II receptor blockers (ARBs), and aliskiren), is a measure tracked by the Centers for Medicare and Medicaid Services (CMS) to give Medicare Part D plans a star rating; pharmacies are impacted by these star ratings. The pharmacy is given a performance score based on the measure. Some pharmacies use a performance information management platform (PIMP) that allows pharmacies to better understand performance info…

Effect of increased dose of total body irradiation on graft failure associated with HLA-haploidentical transplantation in patients with severe haemoglobinopathies: a prospective clinical trial.

BACKGROUND: Although severe haemoglobinopathies can be cured with allogeneic blood or bone marrow transplantation, availability of matched d … ality and progression-free survival. However, the coverage decision by the Centers for Medicare and Medicaid Services to only provide payment for allogeneic bone marrow transplantation for patients with sickle cell disease on a clinical trial that had a comparison arm with patients not receiving bone marrow transplantation prompted the closure of this tria …

A Motivational Interviewing Intervention by Pharmacy Students to Improve Medication Adherence.

BACKGROUND: Diabetes mellitus (DM) patients with comorbid hypertension (HTN) are at a higher risk of developing microvascular and macrovascu … , comorbidities, 6-month previous hospitalization, baseline 6-month PDC, and Centers for Medicare & Medicaid Services risk score. RESULTS: A total of 11 students participated in the intervention implementation. Patients receiving calls were randomly selected from those potential subjects for the intervention arm until a target of 250 was reached; 500 cont …

Ezetimibe Use and LDL-C Goal Achievement: A Retrospective Database Analysis of Patients with Clinical Atherosclerotic Cardiovascular Disease or Probable Heterozygous Familial Hypercholesterolemia.

BACKGROUND: Ezetimibe is recommended by clinical practice guidelines as a second-line therapy for lowering low-density lipoprotein cholester … RE 2 database; this included commercial, health insurance exchange, Medicare Advantage, and managed Medicaid patients. The index date was the date of the first LDL-C measurement. Patients were required to have evidence of clinical ASCVD or probable HeFH based on ICD-9-CM codes and ≥ 1 outpatient pharmacy claim for a statin in the 1-year pre-index period, a …

Association of group prenatal care with postpartum visit attendance: a secondary analysis of the Centering and Racial Disparities randomized clinical trial.

OBJECTIVE: The American College of Obstetricians and Gynecologists recommends a comprehensive postpartum visit (PPV) within 12 weeks after b … 3.0% Hispanic, and 36.5% White; the mean age was 25.2 years, 43.7% were nulliparous, and 94.5% were Medicaid-eligible. In the ITT analysis, PPV attendance did not differ between arms (68.8% vs 67.4%; RR, 1.02; 95% confidence interval [CI], 0.96-1.08; P=.55) (Figure). In the exploratory mITT (73.3% vs 68.8%; adjusted RR, 1.10; 95% CI, 1.03-1.17) and PC (76. …