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The social vulnerability index as a risk stratification tool for health disparity research in cancer patients: a scoping review.

PurposeThe social vulnerability index (SVI), developed by the Centers for Disease Control and Prevention, is a novel composite measure encompassing multiple variables that correspond to key social determinants of health. The objective of this review was to investigate innovative applications of the SVI to oncology research and to employ the framework of the cancer care continuum to elucidate further research opportunities.MethodsA systematic search for relevant articles was performed in five databases from inception to 13 May 2022. Included studies applied the SVI to analyze outcomes in cancer

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… Single institution(s) in NYC, 2012–19 Prevention Diagnosis Low Papageorge et al., 2021, J Am Coll Surg [ 49 ] Liver ( n = 19,751 in 12 states) Was county -level SVI associated with the impact of Medicaid expansion on the diagnosis of HCC? … Taylor K Diaz A Nuliyalu U Dimick JB Nathan H Association of Medicaid eligibility with non-elective surgery outcomes, and costs for colon cancer among Medicare patients (311) Gastroenterology 2021 160 6 883 10.1016/S0016-5085(21)02840-7 54. …

Socioeconomic status-based survival disparities and nomogram prediction for patients with multiple myeloma: Results from American and Chinese populations.

ObjectiveThis study aimed to comprehensively investigate the relationship between the survival differences and socioeconomic status (SES) in patients with multiple myeloma (MM) and construct a predictive nomogram to assess clinical outcomes of MM patients.MethodsThe Surveillance, Epidemiology, and End Results (SEER) census tract-level SES database provides two specialized attributes: SES index and rurality. Using this database, 37,819 patients diagnosed with MM between January 2007 and December 2016 were enrolled. We evaluated the effects of SES index on overall survival (OS) and myeloma-speci

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… In the lowest SES group (Q1), the relative proportions of those designated as NHB, Medicaid, or single were the largest. Table 1 Baseline sociodemographic characteristics of MM patients in the SEER cohort, grouped by SES index. … Those who were insured had more substantial survival gains in OS and MSS than those with uninsured or Medicaid status. With less insurance support, patients will have more obstacles in accessing qualified healthcare, social support, and advanced therapies ( 9 ). …

Resource Use and Care Quality Differences Among Medicare Beneficiaries Undergoing Chemotherapy.

ImportanceMedicare Advantage (MA) has grown significantly over the last decade; however, MA's performance for patients with serious conditions, such as cancer, remains unclear.ObjectiveTo compare resource use and care quality between MA and traditional Medicare (TM) beneficiaries undergoing cancer chemotherapy.Design, setting, and participantsThis cohort study used TM claims and MA encounter records from January 2015 to December 2019. Participants were MA and TM beneficiaries who initiated cancer chemotherapy between January 2016 and December 2019. Inverse probability of treatment weighting ba

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… Health Serv Res . 2022 ; 57 ( 4 ): 957 - 962 . doi: 10.1111/1475-6773.13970 35411550 PMC10501335 20 Centers for Medicare & Medicaid Services . Enhancing oncology model. 2023 . … Accessed April 12, 2024. https://www.cms.gov/priorities/innovation/innovation-models/enhancing-oncology-model 21 Centers for Medicare & Medicaid Services . Oncology care model performance-based payment methodology version 7.1. 2021 . …

Chronic hip pain in a boy with mental retardation and cerebral palsy.

Jonny is a 13 year old boy with spastic quadriparesis and severe mental retardation following Haemophilus influenza type B (HIB) meningitis … trician suggested that Jonny was eligible for the state's managed care program, which would convert Medicaid coverage to a state sponsored program with more extensive services and case management, Jonny's mother repeatedly said that she would "think it over." At the current visit, the pediatrician recommended an adjustment of Jonny's wheelchair, a hip x-ra …

Using existing population-based data sets to measure the American Academy of Pediatrics definition of medical home for all children and children with special health care needs.

OBJECTIVE: National health goals include ensuring that all children have a medical home. Historically, medical home has been determined by t … ble to include in the annual National Healthcare Quality Report, in state reports on the quality of Medicaid, State Children's Health Insurance Program, and Title V programs as well as to evaluate performance on the Healthy People 2010 objectives and the President's New Freedom Initiative.

The BirthPlace collaborative practice model: results from the San Diego Birth Center Study.

Objective: The search for quality, cost-effective health care programs in the United States is now a major focus in the era of health care r … ary results also show that the average total cost for pregnancy-related services paid by California Medicaid was $4,550 for the birth center and $5,535 for the traditional care group. Final results based on the full study sample (full data available February 1998) details of payor costs such as provider, facility, NICU, and ancillary along with costs from …

Leveraging stories of cardiac amyloidosis patients of African ancestry or descent to support patient-derived data elements for efficient diagnosis and treatment.

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… , 2023 ; Centers for Medicare and Medicaid, 2023 ). … Center for Medicare and Medicaid (2023). ICD-10-CM official guidelines for coding and reporting FY 2023. Available at: https://www.cms.gov/files/document/fy-2023-icd-10-cm-coding-guidelines-updated-01/11/2023.pdf . Centers for Medicare and Medicaid (2023). …

Autologous stem cell transplantation in an older adult population.

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… Analysis of National Cancer Database (NCDB) showed that ASCT improved survival for MM patients from all economic backgrounds, but uninsured patients or those with Medicaid had significantly lower overall survival. 19 Similar trends have been observed with in patients with NHL. 20 Figure 1. … Survival disparities by Medicaid status: an analysis of 8 cancers. Cancer. 2012;118(17):4271-4279. …

Patterns of bisphosphonate treatment among patients with multiple myeloma treated at oncology clinics across the USA: observations from real-world data.

PurposeCurrent guidelines recommend that intravenous bisphosphonates be initiated in all patients with multiple myeloma for management of bone disease. The objective of this study was to describe real-world bisphosphonate treatment patterns.MethodsThis was a retrospective observational study using oncology electronic health record (EHR) data contained in Amgen's Oncology Services Comprehensive Electronic Records (OSCER) database, generated by Flatiron Health (New York, NY), representing over 1.5 million US oncology patients. Patients were newly diagnosed with multiple myeloma between January 1

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… Patients represent all payer types (commercial, Medicare, Medicaid, self-pay, and other). … unknown in 3667 patients Characteristic | Patients, n (%) Sex, n (%) | Female | 4944 (44.5) Male | 6168 (55.5) Age at diagnosis, years | 18–39 | 101 (0.9) 40–49 | 511 (4.6) 50–64 | 3168 (28.5) 65–74 | 3603 (32.4) ≥ 75 | 3729 (33.6) Insurance type | Commercial | 3152 (28.4) Medicare | 5244 (47.2) Medicaid …

Cost-effectiveness of cancer drugs: Comparative analysis of the United States and England.

BackgroundEngland's National Institute for Health and Care Excellence (NICE) and the US' Institute for Clinical and Economic Review (ICER) both conduct cost-effectiveness evaluations for new cancer drugs to help payers make drug coverage decisions. However, NICE and ICER assessments have been noted to reach different conclusions. We aim to better understand the degree to which their recommendations diverge and what drives these apparent differences.MethodsWe compared the methods and results of publicly available cost-effectiveness evaluations performed by ICER and NICE of similarly assessed ca

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… In contrast to private insurers which have some discretion in limiting formulary inclusion, Medicare and Medicaid, two of the largest payers in the US, are required to include nearly every FDA-approved cancer drug within the public formulary [15] . … Consequently, public financing for cancer drugs in the US particularly suffers from inefficiencies, whereby Medicare and Medicaid are required to pay for me-too cancer drugs and drugs without validated improvements in clinical or cost-effectiveness over the standard of care [16] . …

Does the Stopping Opioids After Surgery Score Perform Well Among Racial and Socioeconomic Subgroups?

BACKGROUND: The Stopping Opioids After Surgery (SOS) score is a validated tool that was developed to determine the risk of sustained opioid … tients were of low socioeconomic status, defined by prior SOS score investigations as patients with Medicaid insurance. Components of the SOS score and the observed frequency of sustained postoperative opioid prescriptions were abstracted. The performance of the SOS score was compared across racial, ethnic, and socioeconomic subgroups using the c-statistic …

A Pharmacist Telephone Intervention to Identify Adherence Barriers and Improve Adherence Among Nonadherent Patients with Comorbid Hypertension and Diabetes in a Medicare Advantage Plan.

BACKGROUND: Patients with comorbid hypertension (HTN) and diabetes mellitus (DM) are at a high risk of developing macrovascular and microvas … y (primary care vs. specialist), health plan (low-income subsidy vs. other), Centers for Medicare & Medicaid risk score, Charlson Comorbidity Index, and number of distinct medications. RESULTS: In total, 186 hypertensive diabetic patients, nonadherent to ACEIs/ARBs (PDC < 0.8), were included in the study. Of the 186 patients, 87 received the pharmacist ph …

Ethnic Disparities in AL Amyloidosis Outcomes Among Hospitalized Patients in the United States.

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… analysis were patient age (categorized into 18–34, 35–49, 50–64, 65 + years), race/ethnicity (sub-classified as non-Hispanic (NH) White, NH-Black, Hispanic, other), gender (female or male), zip code–based median household income (lowest, 2nd, 3rd and highest quartile), primary insurance (Medicare, Medicaid … Zip income quartile < 0.01 Lowest quartile 27,087,639 6450 23.8 405 6.3 2nd quartile 23,573,515 6390 27.1 375 5.9 3rd quartile 21,131,411 6705 31.7 445 6.6 Highest quartile 17,467,172 7195 41.2 425 5.9 Missing 1,609,644 410 25.5 30 7.3 Primary payer < 0.01 Medicare 43,114,755.3 18,385 42.6 1140 6.2 Medicaid …

Epidemiology of Non-Emergent Cancer-Related Emergency Department Visits in Korea between 2016 and 2020.

PurposeAs people living with cancer increase in the aging society, cancer-related emergency department (ED) visits are also increasing. This study aimed to investigate the epidemiologic characteristics of non-emergent cancer-related ED visits using a nationwide ED database.Materials and methodsA cross-sectional study was conducted using the National Emergency Department Information System (NEDIS) database. All cancer-related ED visits between 2016 and 2020 were included. The study outcome was non-emergent ED visits, defined as patients triaged into non-emergent condition at both the time of ar

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… (1.9) | | 19–64 | 537364 (45.3) | 414726 (43.2) | 122638 (54.4) | | 65–120 | 623469 (52.6) | 524986 (54.7) | 98483 (43.7) | | Median, IQR | 66 (56–75) | 66 (56–76) | 62 (52–72) | <0.001 Sex | | | | | Female | 493953 (41.7) | 394183 (41.0) | 99770 (44.2) | <0.001 Insurance | | | | | Medicaid … Centers for Medicare & Medicaid Services. Admissions and emergency department visits for patients receiving outpatient chemotherapy measure technical report. Baltimore, MD: Centers for Medicare & Medicaid Services, US Dept of Health and Human Services; 2016. 30. …

Risk of Major Adverse Cardiovascular Events and Major Hemorrhage Among White and Black Patients Undergoing Percutaneous Coronary Intervention.

Background Data on racial disparities in major adverse cardiovascular events (MACE) and major hemorrhage (HEM) after percutaneous coronary intervention are limited. Factors contributing to these disparities are unknown. Methods and Results PRiME-GGAT (Pharmacogenomic Resource to Improve Medication Effectiveness-Genotype-Guided Antiplatelet Therapy) is a prospective cohort. Patients aged ≥18 years undergoing percutaneous coronary intervention were enrolled and followed for up to 1 year. Racial disparities in risk of MACE and HEM were assessed using an incident rate ratio. Sequential cumulative

The Escalating Growth of Spending on Medicare Advantage Plans: A 2026 Update on Controlling Costs, Preserving Medicare Solvency, and Balancing the Federal Budget.

BACKGROUND: In September/October 2025, Manchikanti et al. published an analysis showing that Medicare Advantage (MA) spending growth was out … the year since, MA now covers more than half of all Medicare beneficiaries, Centers for Medicare & Medicaid Services (CMS) has undertaken the largest Risk Adjustment Data Validation (RADV) audit expansion in program history, a federal court has struck down CMS's ability to extrapolate audit findings across whole contracts, and a separate court has found C …

What Is the Incidence of and Outcomes After Debridement, Antibiotics, and Implant Retention (DAIR) for the Treatment of Periprosthetic Joint Infections in the AJRR Population?

BACKGROUND: Debridement, antibiotics, and implant retention (DAIR) is used to manage acute periprosthetic joint infections (PJIs) after tota … Technology) codes, reported to the AJRR from 2012 to 2020 were merged with Centers for Medicare and Medicaid Services (CMS) data from 2012 to 2020 to determine the incidence of patients aged 65 and older who underwent additional PJI-related procedures on the same joint. Linking to CMS ensures no loss to follow-up or patient migration to a non-AJRR site. As …

Racial and Ethnic Differences in Hospice Use and Hospitalizations at End-of-Life Among Medicare Beneficiaries With Dementia.

IMPORTANCE: The pool of studies examining ethnic and racial differences in hospice use and end-of-life hospitalizations among patients with dementia is limited and results are conflicting, making it difficult to assess health care needs of underresourced racial and ethnic groups. OBJECTIVE: To explore differences in end-of-life utilization of hospice and hospital services among patients with dementia by race and ethnicity. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used national survey data from the Health and Retirement Study linked with Medicare and Medicaid claims that reflected…

Deep Learning Assistance Closes the Accuracy Gap in Fracture Detection Across Clinician Types.

BACKGROUND: Missed fractures are the most common diagnostic errors in musculoskeletal imaging and can result in treatment delays and prevent … le Medicare Part B Physician/Supplier Procedure Summary data provided by the Centers for Medicare & Medicaid Services to determine the trends in musculoskeletal radiograph interpretation by clinician type. In addition, we conducted a multiple-reader, multiple-case study to assess whether clinician accuracy in diagnosing fractures on radiographs was superio …

Factors Influencing the Use of Second-Generation Antipsychotics in Children with Psychosis.

BACKGROUND: In 2011, the U.S. Department of Health and Human Services sent a letter to state Medicaid directors explaining the need for oversight of psychiatric prescriptions for children with mental health disorders. The National Committee for Quality Alliance proposed 3 quality measures for rating managed care organizations (MCOs) that involve use of second-generation or atypical antipsychotics in children. In order to ensure appropriate use and to effectively manage the use of second-generation antipsychotics in children, MCOs need to better understand the factors that influence medication …