The Prescription Drug User Fee Act: Much More Than User Fees
Conclusions: The need for PDUFA reauthorization every 5 years has created a recurring legislative vehicle through which far-ranging changes to FDA have been enacted, reshaping the agency’s interactions and relationship with the regulated industry. The majority of policy changes enacted through PDUFA legislation have favored industry through decreasing regulatory standards, shortening approval times, and increasing industry involvement in FDA decision-making. FDA’s budgetary dependence on the industry, the urgency of each PDUFA reauthorization’s passage to maintain uninterrupted funding, and the industry’s requi...
Source: Medical Care - March 16, 2022 Category: Health Management Tags: Policy Analysis Source Type: research

Comparing Gold-standard Copayment and Coinsurance Values From Claims Processing Engines to Values Derived From Behavioral Health Claims Databases
Conclusions: For most plan-years, claims-derived measures correctly identify required specialty mental health copayments and coinsurance, although the claims-derived measures’ accuracy varies across benefit design features. This information should be considered when creating claims-derived benefit features to use for policy analysis. (Source: Medical Care)
Source: Medical Care - March 16, 2022 Category: Health Management Tags: Original Article Source Type: research

Suicide Among American Indian and Alaska Native Veterans Who Use Veterans Health Administration Care: 2004–2018
Conclusions: Results suggest that: (1) suicide is an increasing problem among AI/AN VHA veterans; and (2) younger AI/AN VHA veterans are at particularly high risk and warrant focused prevention efforts. Findings are similar to those observed in general AI/AN population. There is a compelling need to review and strengthen VHA suicide prevention efforts directed towards AI/AN veterans. (Source: Medical Care)
Source: Medical Care - March 16, 2022 Category: Health Management Tags: Brief Report Source Type: research

Veterans Health Administration Is Working Urgently to Reduce High Rates of Suicide Among American Indian and Alaska Native Veteran
No abstract available (Source: Medical Care)
Source: Medical Care - March 16, 2022 Category: Health Management Tags: Editorial Source Type: research

Mapping 2 Decades of Research in Health Services Research, Health Policy, and Health Economics Journals
Conclusion: Findings of this study can be used by the stakeholders of health services research, policy, and economics to develop future research agendas, target journal submissions, and generate interdisciplinary solutions by examining overlapping journals for particular topics. (Source: Medical Care)
Source: Medical Care - February 15, 2022 Category: Health Management Tags: Applied Methods Source Type: research

Variation in Initiation, Engagement, and Retention on Medications for Opioid Use Disorder Based on Health Insurance Plan Design
Conclusions: Among insurance plan cost-sharing measures, only medical services deductible showed an association with decreased MOUD initiation. Policy and benefit design should consider ways to reduce cost barriers to initiation and retention in MOUD. (Source: Medical Care)
Source: Medical Care - February 15, 2022 Category: Health Management Tags: Original Articles Source Type: research

Evaluation of a Natural Language Processing Approach to Identify Social Determinants of Health in Electronic Health Records in a Diverse Community Cohort
Conclusion: This NLP algorithm demonstrated moderate performance in identification of unmet patient social needs. This novel approach may enable improved targeting of interventions, allocation of limited resources and monitoring a health care system’s addressing its patients’ SDoH needs. (Source: Medical Care)
Source: Medical Care - February 15, 2022 Category: Health Management Tags: Original Articles Source Type: research

Understanding the Tradeoffs Between Travel Burden and Quality of Care for In-center Hemodialysis Patients
Conclusions: Most dialysis patients have higher rated facilities located not much further than their closest facility, suggesting many patients could evaluate tradeoffs between distance and quality of care in where they receive dialysis. Our results show that such tradeoffs likely occur. Therefore, quality ratings such as the Dialysis Facility Compare (DFC) Star Rating may provide actionable information to patients and caregivers. However, we were not able to assess whether these associations reflect a causal effect of the Star Ratings on patient choice, as the Star Ratings served only as a marker of quality of care. (...
Source: Medical Care - February 15, 2022 Category: Health Management Tags: Original Articles Source Type: research

Trauma-informed Collaborative Care for African American Primary Care Patients in Federally Qualified Health Centers: A Pilot Randomized Trial
Conclusions: TICC shows promise for addressing PTSD in this population. A larger-scale trial is needed to fully assess the effectiveness of this approach in these settings. (Source: Medical Care)
Source: Medical Care - February 15, 2022 Category: Health Management Tags: Original Articles Source Type: research

Trends in Characteristics of Adults Enrolled in Traditional Fee-for-Service Medicare and Medicare Advantage, 2011–2019
Conclusions: Trends in demographic characteristics and changes in policy and growth in employer group plan offerings will likely continue to impact health care service utilization and costs in the Medicare population. Particularly as Medicare expansion to younger age groups is considered, future research should explore disparities in risk scores and care equity, quality, and costs across different Medicare enrollment options. (Source: Medical Care)
Source: Medical Care - February 15, 2022 Category: Health Management Tags: Brief Report Source Type: research

Assessment of International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) Code Assignment Validity for Case Finding of Medication-related Hypoglycemia Acute Care Visits Among Medicare Beneficiaries
Conclusions: Accuracy of International Classification of Diseases, Tenth Revision codes in administrative claims to identify medication-related hypoglycemia varied substantially by encounter type and diagnosis position. Consideration should be given to the trade-off between PPV and sensitivity when selecting codes, encounter types, and diagnosis positions to identify hypoglycemia. (Source: Medical Care)
Source: Medical Care - February 15, 2022 Category: Health Management Tags: Original Articles Source Type: research

Regional Economic Conditions and Preventable Hospitalization Among Older Patients With Diabetes
Conclusions: Downturns in regional economic conditions could increase demand for VHA care and raise the risk of diabetes-related preventable hospitalization or death among older VHA patients diagnosed with diabetes. Safety-net hospitals may be unfairly penalized for lower quality of care when experiencing higher demand for care because of an economic downturn. (Source: Medical Care)
Source: Medical Care - February 15, 2022 Category: Health Management Tags: Original Articles Source Type: research

Vertical Integration Versus Physician Owners: Trends in Practice Structure Among Breast Cancer Surgeons
Conclusions: Dramatic changes in surgeon practice structure occurred between 2003 and 2014 across the 5 states we examined. The most notable was the sharp decline in the prevalence of the small single-specialty practice and large increases in the proportion of surgeons either employed or with ownership in ACSs or hospitals. (Source: Medical Care)
Source: Medical Care - February 15, 2022 Category: Health Management Tags: Original Articles Source Type: research

Trends in Cancer Treatment Service Availability Across Critical Access Hospitals and Prospective Payment System Hospitals
The objective of this study was to investigate trends in cancer services availability in urban and rural Prospective Payment System (PPS) hospitals and CAHs. Design: Retrospective, time-series analysis using data from 2008 to 2017 American Hospital Association Annual Surveys. Multivariable logistic regressions were used to examine differential trends in cancer services between urban PPS, rural PPS, and CAHs, overall and among small ( (Source: Medical Care)
Source: Medical Care - February 15, 2022 Category: Health Management Tags: Original Articles Source Type: research

Enhancing Cancer Care Coordination Among Rural Residents: A Model to Overcome Disparities in Treatment
No abstract available (Source: Medical Care)
Source: Medical Care - February 15, 2022 Category: Health Management Tags: Editorial Source Type: research