Capitalizing on Central Registries for Expanded Cancer Surveillance and Research
Conclusions:
Central cancer registries, often in collaboration with researchers, have enriched their data through linkages. These linkages demonstrate registries’ ability to contribute to a data infrastructure, but a coordinated and maintained approach is needed to leverage these data for research. Sparsely populated states reported the fewest linkages, suggesting possible gaps in our knowledge about cancer in these states. Many more linkages exist than have been reported in the literature, highlighting potential opportunities to further use the data for research purposes. (Source: Medical Care)
Source: Medical Care - January 19, 2022 Category: Health Management Tags: Applied Methods Source Type: research
Comparing Postoperative Readmission Rates Between Veterans Receiving Total Knee Arthroplasty in the Veterans Health Administration Versus Community Care
Conclusions:
Given VA’s history in providing high-quality surgical care to Veterans, it is important to closely monitor and track whether the shift to CC for surgical care will impact quality in both settings over time. (Source: Medical Care)
Source: Medical Care - January 19, 2022 Category: Health Management Tags: Original Articles Source Type: research
Interventions to Reduce Hospital and Emergency Department Utilization Among People With Alcohol and Substance Use Disorders: A Scoping Review
Conclusions:
Overall, we found few studies assessing interventions to reduce health care utilization among people with SUDs. The studies that we did identify differed across multiple domains and included few randomized trials. Study heterogeneity limits our ability to compare interventions or to recommend one specific approach to reducing health care utilization among this high-risk population. (Source: Medical Care)
Source: Medical Care - January 19, 2022 Category: Health Management Tags: Original Articles Source Type: research
The 2018 Merit-based Incentive Payment System: Participation, Performance, and Payment Across Specialties
Background:
The Merit-based Incentive Payment System (MIPS) incorporates financial incentives and penalties intended to drive clinicians towards value-based purchasing, including alternative payment models (APMs). Newly available Medicare-approved qualified clinical data registries (QCDRs) offer specialty-specific quality measures for clinician reporting, yet their impact on clinician performance and payment adjustments remains unknown.
Objectives:
We sought to characterize clinician participation, performance, and payment adjustments in the MIPS program across specialties, with a focus on clinician use of QCDRs...
Source: Medical Care - January 19, 2022 Category: Health Management Tags: Original Articles Source Type: research
The Transforming Outcomes for Patients Through Medical Home Evaluation and reDesign (TOPMED) Cluster Randomized Controlled Trial: Cost and Utilization Results
The objective of this study was to determine if a focus on achieving HVEs extracted from successful primary care transformation models would reduce cost and utilization as compared with a focus on achieving PCMH quality improvement goals.
Research Design:
A stratified, cluster randomized controlled trial with 2 arms. All practices received equal financial incentives, health information technology support, and in-person practice facilitation. Analyses consisted of multivariable modeling, adjusting for the cluster, with difference-in-difference results.
Subjects:
Eight primary care clinics that were engaged in ...
Source: Medical Care - January 19, 2022 Category: Health Management Tags: Original Articles Source Type: research
Survey of Information Exchange and Advanced Use of Other Health Information Technology in Primary Care Settings: Capabilities In and Outside of the Safety Net
Background:
Advanced use of health information technology (IT) functionalities can support more comprehensive, coordinated, and patient-centered primary care services. Safety net practices may benefit disproportionately from these investments, but it is unclear whether IT use in these settings has kept pace and what organizational factors are associated with varying use of these features.
Objective:
The aim was to estimate advanced use of health IT use in safety net versus nonsafety net primary care practices. We explore domains of patient engagement, population health management (decision support and registries...
Source: Medical Care - January 19, 2022 Category: Health Management Tags: Original Articles Source Type: research
Differential Effects by Mental Health Status of Filling the Medicare Part D Coverage Gap
The objective of this study was to study how changes in insurance benefit design affect medication use of older adults with mental disorders.
Data Sources:
US Medicare claims data from 2007 to 2018.
Study Design:
Exploiting the gradual elimination of the Medicare prescription drug coverage gap beginning in 2011, we examine the effects on medication use and out-of-pocket spending by drug type with a difference-in-differences approach. We identify subpopulations by mental disorder and compare the estimates across mental health groups and to the general Medicare population.
Principal Findings:
Closing the...
Source: Medical Care - January 19, 2022 Category: Health Management Tags: Original Articles Source Type: research
Coronavirus Disease 2019 and Hospital Readmissions: Patient Characteristics and Socioeconomic Factors Associated With Readmissions in an Urban Safety-Net Hospital System
Conclusion:
We have found some factors associated with increased odds of readmission among patients hospitalized with COVID-19. Awareness of these risk factors, including patients’ social determinants of health, may ultimately help to reduce readmission rates. (Source: Medical Care)
Source: Medical Care - January 19, 2022 Category: Health Management Tags: Original Articles Source Type: research
Impact of Medicaid Eligibility Changes on Long-acting Reversible Contraception Use in Massachusetts and Maine
Background:
Availability of long-acting reversible contraception (LARC) is an important indicator of high-quality women’s health care. There are limited data on the impact of state-level Medicaid eligibility changes on LARC use.
Study Design:
We used All-Payers Claims Databases to examine LARC insertions among women enrolled in Medicaid in Massachusetts, which expanded Medicaid in 2014, and Maine, which restricted Medicaid eligibility in 2013. We used interrupted time series (ITS) analyses to determine the impact of Medicaid eligibility changes on level and trends in LARC insertions in these states.
Results...
Source: Medical Care - January 19, 2022 Category: Health Management Tags: From the States Source Type: research
Disparities of Access, Use, and Barriers to Seeking Health Care Services in Arizona
Conclusions:
BRFSS can be analyzed to identify and quantify unique HC disparities, and the findings can serve as the basis for improving HC in communities. Expansion of HC services and providers may be achieved, in part, through incentives for providers to work in designated health professional shortage areas and/or leveraging telehealth/telemedicine in rural and urban underserved communities. (Source: Medical Care)
Source: Medical Care - January 19, 2022 Category: Health Management Tags: From the States Source Type: research
Association of Social Determinants of Health With Adherence to Second-generation Antipsychotics for People With Bipolar Disorders in a Medicaid Population
The objective of this study was to quantify the associations of risk factors, including social determinants of health, with SGA nonadherence among patients with BD.
Methods:
In this cross-sectional study of 2015–2017 MassHealth Medicaid data, we examined several definitions of adherence and used logistic regression to identify risk factors for nonadherence (medication possession ratio (Source: Medical Care)
Source: Medical Care - January 19, 2022 Category: Health Management Tags: Award Winning Manuscripts from APHA 2020 Source Type: research
2020 American Public Health Association’s Medical Care Section Student Awardees: Special Commentary
No abstract available (Source: Medical Care)
Source: Medical Care - January 19, 2022 Category: Health Management Tags: Special Editorial Source Type: research
Guidelines for Designing and Evaluating Feasibility Pilot Studies
Conclusion:
This commentary offers examples of indicators for evaluating feasibility, and of the limits of effect size estimation in pilot studies. As demonstrated, most pilot studies should not be used to estimate effect sizes, provide power calculations for statistical tests or perform exploratory analyses of efficacy. It is hoped that these guidelines will be useful to those planning pilot/feasibility studies before a larger-scale study. (Source: Medical Care)
Source: Medical Care - December 9, 2021 Category: Health Management Tags: Invited Commentary Source Type: research
The Global Burden of Disease Consortium Should Not Be Funded by Entities With Industry Ties and Possible Vested Commercial Interests
No abstract available (Source: Medical Care)
Source: Medical Care - December 9, 2021 Category: Health Management Tags: Special Commentary Source Type: research
Skilled Nursing Facility Participation in a Voluntary Medicare Bundled Payment Program: Association With Facility Financial Performance
Conclusions:
BPCI led to reduced operating expenses and revenues for SNFs that participated and remained in the program but had no effect on operating profit indicators and mixed effects on SES and racial/ethnic differences across SNFs. (Source: Medical Care)
Source: Medical Care - December 9, 2021 Category: Health Management Tags: Original Articles Source Type: research
