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End-of-Life Care: New Strategies for Working with Families Who Aren’t Ready to Let a Terminal Patient Go
Check out this 90-minute webinar from the American Health Lawyers Association, on December 17:  "End-of-Life Care: New Strategies for Working with Families Who Aren’t Ready to Let a Terminal Patient Go." Five major critical care organizations have issued a Joint Policy Statement recommending the use of conflict resolution and mediation processes when health care providers and families have conflicts over end-of-life care. Further, the Centers for Medicare & Medicaid Services recently proposed changes to the 2016 Medicare Physician Fee Schedule to allow for end-of-life care planning payments, highlighting the...
Source: blog.bioethics.net - December 10, 2015 Category: Medical Ethics Authors: Thaddeus Mason Pope Tags: Health Care medical futility blog syndicated Source Type: blogs

Medicaid managed care reduces readmissions for youths with type 1 diabetes.
CONCLUSIONS: From the largest, national, defined cohort available for contemporary study, youths with T1D on Medicaid managed care plans were less likely to be readmitted within 90 days of discharge. PMID: 27143290 [PubMed - in process]
Source: The American Journal of Managed Care - March 31, 2016 Category: Health Management Authors: Healy-Collier K, Jones WJ, Shmerling JE, Robertson KR, Ferry RJ Tags: Am J Manag Care Source Type: research

GAO Report Harshly Critical of Medicare Advantage Plans
This report follows an October 2014 audit by the GAO that was prompted by the Center for Public Integrity's "Medicare Advantage Money Grab" series. The series documented nearly $70 billion in improper payments to health plans, most of which were inflated fees from overstating patients' health risks, from 2008 through 2013 alone. The investigation performed by the Center for Public Integrity traced the overpayments to abuse of a billing formula known as a risk score, which pays higher rates for sicker patients and less for people in good health. Since 2004, that risk score has been used on the "honor system," despite crit...
Source: Policy and Medicine - June 19, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Hospital-Level Changes in Adult ICU Bed Supply in the United States
We described the number of beds, teaching status, ownership, intensive care occupancy, and urbanicity for each hospital in each year of the study. We then examined the relationship between increasing intensive care beds and these characteristics, controlling for other factors. The study included 4,457 hospitals and 55,865 hospital-years. Overall, the majority of intensive care bed growth occurred in teaching hospitals (net, +13,471 beds; 72.1% of total growth), hospitals with 250 or more beds (net, +18,327 beds; 91.8% of total growth), and hospitals in the highest quartile of occupancy (net, +10,157 beds; 54.0% of total gr...
Source: Critical Care Medicine - December 17, 2016 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Variation in Family Experience of Pediatric Inpatient Care As Measured by Child HCAHPS
CONCLUSIONS: Family experience of pediatric inpatient care shows substantial room for improvement and varies considerably across hospitals and measures.
Source: PEDIATRICS - March 31, 2017 Category: Pediatrics Authors: Toomey, S. L., Elliott, M. N., Zaslavsky, A. M., Klein, D. J., Ndon, S., Hardy, S., Wu, M., Schuster, M. A. Tags: Administration/Practice Management, Quality Improvement Article Source Type: research

Influence of Insurance Type on the Access to Pediatric Care for Children With Distal Radius Torus Fractures
This study evaluated the willingness of pediatricians to provide care for minor orthopaedic injuries and whether or not the patient’s insurance status influenced the decision to provide care. Methods: Ninety-nine pediatric primary care offices were randomly selected from 2 regions in Florida. Each office was contacted twice, 2 to 3 months apart, and presented with a fictionalized account of a patient that had sustained a torus (“buckle”) fracture of the distal radius. In the first call, the patient was presented as having private insurance, and in the second call as having Medicaid insurance. If the patient was de...
Source: Journal of Pediatric Orthopaedics - April 12, 2019 Category: Orthopaedics Tags: Trauma Source Type: research

Reducing Churn to Increase Value in Health Care: Solutions for Payers, Providers, and Policymakers
Conclusion Churn has vexed insurance executives for decades and is considered by many at this point an inevitable challenge. But now that the value-based movement has led to a refocusing on social determinants of health, incentives are aligned to address this issue. This solution may be a key step towards a healthcare system focused on investing in health rather than in treating illness. Niko has a background in research and consulting and enjoys writing about and solving problems facing the US health care industry. Saeed has more than 25 years of health information technology experience, with a track record of ...
Source: The Health Care Blog - May 15, 2019 Category: Consumer Health News Authors: Christina Liu Tags: Economics The Business of Health Care Uncategorized Churn health innovation Health policy health20 niko lehman-white saeed aminzadeh Source Type: blogs

Health Insurance and Out-of-Pocket Costs in the Last Year of Life Among Decedents Utilizing the ICU
Conclusions: Across all categories of insurance coverage, out-of-pocket spending in the last 12 months of life is high and represents a significant portion of assets for many patients requiring intensive care and their families. Medicare fee-for-service alone does not insulate individuals from the financial burden of high-intensity care, due to lack of an out-of-pocket maximum and a relatively high co-payment for hospitalizations. Medicaid plays an important role in the social safety net, providing the most complete hospital coverage of all the insurance groups, as well as significantly financing long-term care.
Source: Critical Care Medicine - May 16, 2019 Category: Emergency Medicine Tags: Feature Articles Source Type: research

Air Pollutants and Asthma Hospitalization in the Medicaid Population
CONCLUSIONS: Short-term air pollutant exposures increased risk of asthma hospitalization among Medicaid beneficiaries, even at levels well below national standards. The subgroup differences suggested individual and contextual factors contributed to asthma disparities under effects of air pollutant exposures.PMID:35073244 | DOI:10.1164/rccm.202107-1596OC
Source: American Journal of Respiratory and Critical Care Medicine - January 24, 2022 Category: Respiratory Medicine Authors: Yaguang Wei Xinye Qiu Matthew Benjamin Sabath Mahdieh Danesh Yazdi Kanhua Yin Longxiang Li Adjani A Peralta Cuicui Wang Petros Koutrakis Antonella Zanobetti Francesca Dominici Joel D Schwartz Source Type: research

Characteristics and Outcomes of Young Adult Patients with Severe Sepsis Admitted to Pediatric Intensive Care Units Versus Medical/Surgical Intensive Care Units.
Conclusions: Young adults with severe sepsis experience higher adjusted odds of mortality when treated in PICUs versus MICU/SICUs. However, there was no difference in length of stay. Variation in mortality is likely due to significant differences in the patient populations, including comorbidity status.
Source: Current Awareness Service for Health (CASH) - January 11, 2023 Category: Consumer Health News Source Type: news

Telemedicine and Disparities in Visit Attendance at a Rural Pediatric Primary Care Clinic During the COVID-19 Pandemic
DISCUSSION: The adoption of telemedicine did not reduce pre-existing disparities in visit attendance. Further work is needed to identify the reasons for the disparities and improve visit attendance of historically disadvantaged patient populations.PMID:37464516 | DOI:10.1353/hpu.2023.0048
Source: Journal of Health Care for the Poor and Underserved - July 19, 2023 Category: International Medicine & Public Health Authors: Shaundreal Jamison Yingying Zheng Linh Nguyen Farhan A Khan Dmitry Tumin Kristina Simeonsson Source Type: research