Access to In-Network Mental Health Care Still Lags Far Behind Other Medical Care
Patients are far more likely to go out of network to obtain health care from mental health professionals than from medical or surgical professionals, areport by RTI International has found.In research that was partially funded by APA, Tami L. Mark, Ph.D., M.B.A., and William J. Parish, Ph.D., M.A., analyzed enrollment data and claims from more than 22 million individuals captured annually from 2019 through 2021 to evaluate out-of-network use and reimbursement rates across all 50 states.The researchers found that patients went out of network 3.5 times more often to see a behavioral health professional (physician or nonphysi...
Source: Psychiatr News - April 17, 2024 Category: Psychiatry Tags: billing codes health care insurance out of network parity pay disparities reimbursement RTI International Source Type: research
Development of a person-centred care approach for persons with chronic multimorbidity in general practice by means of participatory action research
CONCLUSIONS: A person-centred chronic care approach targeting patients with multimorbidity in general practice was developed and piloted in co-creation with stakeholders. More consultation time facilitated better understanding of persons' situations, their functioning, priorities and dilemma's, and positively impacted work satisfaction of care providers. Challenges need to be tackled before widespread implementation. Future evaluation on the quadruple aims is recommended.PMID:38627610 | DOI:10.1186/s12875-024-02364-x (Source: Primary Care)
Source: Primary Care - April 16, 2024 Category: Primary Care Authors: Mieke Jl Bogerd Pauline Slottje Jettie Bont Hein Pj Van Hout Source Type: research
Cardiovascular Emergencies During the SARS-CoV-2 Pandemic as Seen Through the Lens of a Major Insurance Company
Eur J Vasc Endovasc Surg. 2024 Apr 12:S1078-5884(24)00339-3. doi: 10.1016/j.ejvs.2024.04.003. Online ahead of print.NO ABSTRACTPMID:38615910 | DOI:10.1016/j.ejvs.2024.04.003 (Source: PubMed: Eur J Vasc Endovasc ...)
Source: PubMed: Eur J Vasc Endovasc ... - April 14, 2024 Category: Surgery Authors: Jean-Baptiste Ricco Alexandre Vall ée Source Type: research
Cardiovascular Emergencies During the SARS-CoV-2 Pandemic as Seen Through the Lens of a Major Insurance Company
Eur J Vasc Endovasc Surg. 2024 Apr 12:S1078-5884(24)00339-3. doi: 10.1016/j.ejvs.2024.04.003. Online ahead of print.NO ABSTRACTPMID:38615910 | DOI:10.1016/j.ejvs.2024.04.003 (Source: PubMed: Eur J Vasc Endovasc ...)
Source: PubMed: Eur J Vasc Endovasc ... - April 14, 2024 Category: Surgery Authors: Jean-Baptiste Ricco Alexandre Vall ée Source Type: research
Exploring kidney dialysis costs in the United States: a scoping review
CONCLUSIONS: These findings indicate that prevention of or delay in progression to ESRD could have considerable cost savings for Medicare and private payers, particularly in patients with high-risk conditions such as type 2 diabetes. More efficient use of resources is needed, including low-cost medication, to improve clinical outcomes and lower overall costs, especially in high-risk groups. Widening access to PD where it is safe and appropriate may help to reduce dialysis costs.PMID:38605648 | DOI:10.1080/13696998.2024.2342210 (Source: Journal of Medical Economics)
Source: Journal of Medical Economics - April 12, 2024 Category: Health Management Authors: Fiona Stewart Kristin Kistler Yuxian Du Rakesh R Singh Bonnie B Dean Sheldon X Kong Source Type: research
Patient experiences using public and private insurance coverage for abortion in Illinois: Implementation successes and remaining gaps
ConclusionWhen abortion was fully covered by insurance, it reduced financial burdens and enhanced reproductive autonomy. Illinois Medicaid policy —with seamless enrollment options and appropriate reimbursement rates—offers a model for improving abortion access in other states. Further investigation is needed to determine compliance among private insurance companies and increase transparency. (Source: Perspectives on Sexual and Reproductive Health)
Source: Perspectives on Sexual and Reproductive Health - April 12, 2024 Category: Sexual Medicine Authors: Madeline Quasebarth,
Madeleine Boesche,
Tecora Turner,
Amy Moore,
Danielle Young,
Debra Stulberg,
Lee Hasselbacher Tags: SPECIAL ISSUE ARTICLE Source Type: research
Cardiovascular Emergencies During the SARS-CoV-2 Pandemic as Seen Through the Lens of a Major Insurance Company
(Source: European Journal of Vascular and Endovascular Surgery)
Source: European Journal of Vascular and Endovascular Surgery - April 11, 2024 Category: Surgery Authors: Jean-Baptiste Ricco, Alexandre Vall ée Tags: Invited Commentary Source Type: research
Economic burden of type-2 diabetes in Peru: a cost-of-illness study valuing cost differences associated with the level of glycemic control
CONCLUSIONS: T2DM places a heavy burden on the Peruvian healthcare budget that will be even greater if poor glycemic control is maintained.PMID:38584495 | DOI:10.1080/14737167.2024.2333337 (Source: Expert Review of Pharmacoeconomics and Outcomes Research)
Source: Expert Review of Pharmacoeconomics and Outcomes Research - April 8, 2024 Category: Health Management Authors: Janice Seinfeld Alfredo Sobrevilla Mar ía Laura Rosales Mauricio Ib áñez Delia Ruiz Eduardo Penny Sergio Londo ño Source Type: research
Do medical specialists accept claims-based Audit and Feedback for quality improvement? A focus group study
Conclusions
Using claims-based A&F for QI is, for some clinical topics and under certain conditions, accepted by medical specialists. Acceptance of claims-based A&F can be shaped by how A&F is implemented into clinical practice. When designing A&F for QI, it should be considered whether claims data, as the most resource-efficient data source, can be used or whether it is necessary to collect more specific data. (Source: BMJ Open)
Source: BMJ Open - April 8, 2024 Category: General Medicine Authors: de Weerdt, V., Ybema, S., Repping, S., van der Hijden, E., Willems, H. Tags: Open access, Health services research Source Type: research
Use of metamizole and other non-opioid analgesics in Switzerland between 2014 and 2019: an observational study using a large health insurance claims database
CONCLUSION: In Switzerland, metamizole was increasingly claimed between 2014 and 2019. Metamizole was most frequently claimed by older adults and patients with comedications suggestive of underlying conditions, which can be worsened or caused by use of nonsteroidal anti-inflammatory drugs. The lack of studies regarding the effectiveness and safety of metamizole in this population warrants further investigation.PMID:38579298 | DOI:10.57187/s.3535 (Source: Swiss Medical Weekly)
Source: Swiss Medical Weekly - April 5, 2024 Category: General Medicine Authors: Stephan Gut Marlene Rauch Manuel Haschke Carola A Huber Jan Gaertner Nadine Schur Christoph R Meier Julia Spoendlin Source Type: research
Use of metamizole and other non-opioid analgesics in Switzerland between 2014 and 2019: an observational study using a large health insurance claims database
CONCLUSION: In Switzerland, metamizole was increasingly claimed between 2014 and 2019. Metamizole was most frequently claimed by older adults and patients with comedications suggestive of underlying conditions, which can be worsened or caused by use of nonsteroidal anti-inflammatory drugs. The lack of studies regarding the effectiveness and safety of metamizole in this population warrants further investigation.PMID:38579298 | DOI:10.57187/s.3535 (Source: Swiss Medical Weekly)
Source: Swiss Medical Weekly - April 5, 2024 Category: General Medicine Authors: Stephan Gut Marlene Rauch Manuel Haschke Carola A Huber Jan Gaertner Nadine Schur Christoph R Meier Julia Spoendlin Source Type: research
Use of metamizole and other non-opioid analgesics in Switzerland between 2014 and 2019: an observational study using a large health insurance claims database
CONCLUSION: In Switzerland, metamizole was increasingly claimed between 2014 and 2019. Metamizole was most frequently claimed by older adults and patients with comedications suggestive of underlying conditions, which can be worsened or caused by use of nonsteroidal anti-inflammatory drugs. The lack of studies regarding the effectiveness and safety of metamizole in this population warrants further investigation.PMID:38579298 | DOI:10.57187/s.3535 (Source: Swiss Medical Weekly)
Source: Swiss Medical Weekly - April 5, 2024 Category: General Medicine Authors: Stephan Gut Marlene Rauch Manuel Haschke Carola A Huber Jan Gaertner Nadine Schur Christoph R Meier Julia Spoendlin Source Type: research
Cost-effectiveness of behavioural counselling intervention compared with non-intervention for adult patients with metabolic syndrome to prevent cardiovascular diseases and type 2 diabetes in Japan: a microsimulation modelling study
Conclusions
This study suggests that even small effects of counselling and education on behavioural modification may lead to the prevention of acute life-threatening events and chronic diseases, in addition to the reduction of medication resulting from metabolic syndrome, which results in cost savings. (Source: BMJ Open)
Source: BMJ Open - April 5, 2024 Category: General Medicine Authors: Akune, Y., Anezaki, H., Nakao, Y. M., Goto, R. Tags: Open access, Health economics Source Type: research
