Assessing Physician Resident Contributions to Outpatient Clinical Workload
Conclusions:
Although residents rotating through most VA clinics generate revenue to cover their direct costs as they learn, some federal subsidies may be necessary to encourage hospital- and community-based clinics to accept residents from the less profitable primary care and mental health specialties. (Source: Medical Care)
Source: Medical Care - August 14, 2022 Category: Health Management Tags: Original Articles Source Type: research
Association of Patient and System-Level Factors With Social Determinants of Health Screening
Conclusion:
Patient and system-level factors were associated with completion and modality. The lower completion and greater WelcomeTablet use among patients who use interpreters and racial and ethnic minorities points to the need to improve screening in these groups and that the availability of the WelcomeTablet may have prevented greater differences. The higher completion in primary care visits may mean more outreach is needed for specialists. (Source: Medical Care)
Source: Medical Care - August 14, 2022 Category: Health Management Tags: Original Articles Source Type: research
Adoption of Patient Engagement Strategies by Physician Practices in the United States
Conclusions:
This national study is the first to characterize the adoption of patient engagement strategies by US physician practices. We found modest adoption of shared decision-making and motivational interviewing, and low adoption of shared medical appointments. Risk-based payment reform has the potential to motivate greater practice-level patient engagement, but the extent to which it occurs may depend on internal practice capabilities. (Source: Medical Care)
Source: Medical Care - August 14, 2022 Category: Health Management Tags: Original Articles Source Type: research
Design, Implementation, and Evolution of the Medicaid Outcomes Distributed Research Network (MODRN)
Conclusions:
MODRN created a new, scalable, successful model for conducting policy research while complying with federal and state regulations to protect beneficiary health information. Platforms like MODRN may prove useful for emerging health challenges to facilitate evidence-based policymaking in Medicaid programs. (Source: Medical Care)
Source: Medical Care - August 14, 2022 Category: Health Management Tags: Applied Methods Source Type: research
The Impact of the COVID-19 Pandemic on Health Care Utilization Among Insured Individuals With Common Chronic Conditions
Objective:
The COVID pandemic has had a significant impact on the US health care system. Our primary objective was to understand the impact of the COVID pandemic on non–COVID-related health care utilization among insured individuals with chronic conditions. Our secondary objective was to examine the differential impact by individual characteristics.
Main Data Source:
Medical and pharmacy claims data for individuals enrolled in a large insurer across the United States.
Research Design:
A retrospective and repeated cross-sectional study. Overall and condition-specific health care utilization and cost metr...
Source: Medical Care - August 14, 2022 Category: Health Management Tags: Brief Report Source Type: research
The Influence of Practice Structure on Urologists’ Treatment of Men With Low-Risk Prostate Cancer
Background:
Vertical and horizontal integration among health care providers has transformed the practice arrangements under which many physicians work.
Objective:
To examine the influence of type of practice structure, and by implication the financial incentives associated with each structure, on treatment received among men newly diagnosed with low-risk prostate cancer.
Research Design:
We compiled a unique database from cancer registry records from 4 large states, Medicare enrollment and claims for the years 2005−2014 and SK & A physician surveys corroborated by extensive internet searches. We estimat...
Source: Medical Care - August 14, 2022 Category: Health Management Tags: Original Articles Source Type: research
The Economic Burden of Disease in France From the National Health Insurance Perspective: The Healthcare Expenditures and Conditions Mapping Used to Prepare the French Social Security Funding Act and the Public Health Act
Conclusions:
These results have provided policy-makers, evaluators, and public health specialists with key insights into identifying health priorities and a better understanding of trends in health care expenditures in France. (Source: Medical Care)
Source: Medical Care - August 14, 2022 Category: Health Management Tags: Original Articles Source Type: research
Variation in Usual Source of Care in Asian American, Native Hawaiian, and Other Pacific Islander Adult Medicaid Beneficiaries
The objective of this study was to examine differences in access to care between White and AANHPI adult Medicaid beneficiaries, both in the aggregate and disaggregated into 9 ethnic subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, Other Asian, Native Hawaiian, and Pacific Islander).
Research Design:
Nationwide Adult Medicaid Consumer Assessment of Healthcare Providers and Systems data (2014–2015), a cross-sectional survey representative of all Medicaid beneficiaries.
Subjects:
A total of 126,728 White and 10,089 AANHPI Medicaid beneficiaries were included.
Measures:
The study...
Source: Medical Care - August 14, 2022 Category: Health Management Tags: Original Articles Source Type: research
Advancing Public Health Interventions to Address the Harms of the Carceral System: A Policy Statement Adopted by the American Public Health Association, October 2021
No abstract available (Source: Medical Care)
Source: Medical Care - August 14, 2022 Category: Health Management Tags: Invited Commentary Source Type: research
Effects of the Affordable Care Act Medicaid Expansion on the Compensation of New Primary Care Physicians
Background:
It is well-documented that the Affordable Care Act Medicaid expansion increased health care utilization by low-income Americans. Emerging studies also found that the expansion changed the geographical distribution of new physicians. However, the effect of the expansion on physician compensation has not been studied.
Objectives:
We aimed to assess how the Medicaid expansion affected the compensation of new primary care physicians (PCPs) and whether the effect differed by specialty, gender, and geography.
Research Design:
We used a quasiexperimental difference-in-differences design to assess cha...
Source: Medical Care - July 10, 2022 Category: Health Management Tags: Original Articles Source Type: research
Cost and Cost Savings of Navigation Services to Avoid Rehospitalization for a Comorbid Substance Use Disorder Population
Conclusion:
Our findings show that patient navigation interventions should be considered by payors and policy makers to reduce the high hospital costs associated with comorbid SUD patients. (Source: Medical Care)
Source: Medical Care - July 10, 2022 Category: Health Management Tags: Original Articles Source Type: research
Do Chargemaster Prices Matter?: An Examination of Acute Care Hospital Profitability
Background:
It remains widely debated whether chargemaster price markups are tied to hospital profitability.
Objective:
To evaluate the effect of chargemaster markups on hospital profitability in the presence of unobserved hospital-specific (time-invariant) confounders, and cross-sectional dependence due to latent (common) policy shocks.
Design:
We use interactive fixed effects methods to address concerns of unobserved hospital-specific (time-invariant) confounders, and cross-sectional dependence.
Setting:
US acute care hospitals, 1996 through 2017 (ie, 22 y).
Participants:
Using primarily...
Source: Medical Care - July 10, 2022 Category: Health Management Tags: Original Articles Source Type: research
Multimorbidity Confers Greater Risk for Older Patients in Emergency General Surgery Than the Presence of Multiple Comorbidities: A Retrospective Observational Study
Background:
Little is known about the impact of multimorbidity on outcomes for older emergency general surgery patients.
Objective:
The aim was to understand whether having multiple comorbidities confers the same amount of risk as specific combinations of comorbidities (multimorbidity) for a patient undergoing emergency general surgery.
Research Design:
Retrospective observational study using state discharge data.
Subjects:
Medicare beneficiaries who underwent an operation for an emergency general surgery condition in New York, Florida, or Pennsylvania (2012–2013).
Measures:
Patients were ...
Source: Medical Care - July 10, 2022 Category: Health Management Tags: Original Articles Source Type: research
Predicting High-risk and High-cost Patients for Proactive Intervention
Conclusions:
The predictive model developed in this study exhibits substantially higher predictive power than what has been reported in the literature. The algorithm based on administrative data and a publicly available patient classification system can be readily implemented by other value-based health systems to identify HRHC patients for proactive intervention. (Source: Medical Care)
Source: Medical Care - July 10, 2022 Category: Health Management Tags: Original Articles Source Type: research
Identifying and Investigating Ambulatory Care Sequences Before Invasive Coronary Angiography
Conclusions:
Our analyses demonstrate the potential of SSA for exploratory health care research. We show how SSA can be used on insurance claims data to identify, visualize, and investigate care patterns and their deviations from guideline recommendations. (Source: Medical Care)
Source: Medical Care - July 10, 2022 Category: Health Management Tags: Original Articles Source Type: research
