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Process of care compliance is associated with fewer diabetes complications.
Conclusions: Employees with diabetes who received all 3 quality measures experienced fewer complications, risk-adjusting for other factors. These results provide support for the importance of care quality. PMID: 24512164 [PubMed - as supplied by publisher]
Source: The American Journal of Managed Care - January 1, 2014 Category: Health Management Authors: Bayer FJ, Galusha D, Slade M, Chu IM, Taiwo O, Cullen MR Tags: Am J Manag Care Source Type: research

Challenges and Opportunities for Integrating Preventive Substance-Use-Care Services in Primary Care through the Affordable Care Act.
Abstract Undertreated or untreated substance use disorders (SUD) remain a pervasive, medically-harmful public health problem in the United States, particularly in medically underserved and low-income populations lacking access to appropriate treatment. The need for greater access to SUD treatment was expressed as policy in the Final Rule on standards related to essential health benefits, required to be covered through the 2010 Affordable Care Act (ACA) health insurance exchanges. SUD treatment services have been included as an essential health benefit, in a manner that complies with the Mental Health Parity and Ad...
Source: Journal of Health Care for the Poor and Underserved - March 5, 2014 Category: Global & Universal Authors: Ghitza UE, Tai B Tags: J Health Care Poor Underserved Source Type: research

Assessment of Levels of Hospice Care Coverage Offered to Commercial Managed Care Plan Members in California: Implications for the California Health Insurance Exchange.
Abstract The implementation of the Affordable Care Act that provides for the expansion of affordable insurance to uninsured individuals and small businesses, coupled with the provision of mandated hospice coverage, is expected to increase the enrollment of the terminally ill younger population in hospice care. We surveyed health insurance companies that offer managed care plans in the 2014 California health insurance exchange and large hospice agencies that provided hospice care to privately insured patients in 2011. Compared with Medicare and Medicaid hospice benefits, hospice benefits for privately insured patie...
Source: The American Journal of Hospice and Palliative Care - March 10, 2014 Category: Palliative Care Authors: Chung K, Jahng J, Petrosyan S, Yim V Tags: Am J Hosp Palliat Care Source Type: research

Do Experiences Consistent With a Medical-Home Model Improve Diabetes Care Measures Reported by Adult Medicaid Patients?
CONCLUSIONS: Features consistent with higher medical-home performance are associated with improvements in patient-reported diabetes care process measures, even in this low socioeconomic status setting. The patient-centered medical-home model may help in caring for people with type 2 diabetes. PMID: 24947789 [PubMed - as supplied by publisher]
Source: Diabetes Care - June 19, 2014 Category: Endocrinology Authors: Stevens GD, Shi L, Vane C, Peters AL Tags: Diabetes Care Source Type: research

The Affordable Care Act As New-Business Creator
The following post ran yesterday, March 19 on Health Populi. While there’s little evidence that the short-term impact of the Affordable Care Act has limited job growth or driven most employers to drop health insurance plans, the ACA has spawned a “cottage industry” of health companies since 2010, according to PwC. As the ACA turned five years of age, the PwC Health Research Institute led by Ceci Connolly identified at least 90 newcos addressing opportunities inspired by the ACA: Supporting telehealth platforms between patients and providers, such as Vivre Health Educating consumers, such as the transparency provider...
Source: Disruptive Women in Health Care - March 20, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Access Choice Consumer Health Care Cost Coverage Policy Health Reform Innovation Source Type: blogs

Emergency department use: a reflection of poor primary care access?
Conclusions Correlating data from 3 sources, we suggest that the expansion of insurance under the Affordable Care Act may not be sufficient to reduce ED use for nonurgent conditions. PMID: 25880489 [PubMed - in process]
Source: The American Journal of Managed Care - April 18, 2015 Category: Health Management Authors: Weisz D, Gusmano MK, Wong G, Trombley J Tags: Am J Manag Care Source Type: research

Consumer Engagement through Patient Portals and Innovative Care Delivery Models
The upcoming Connected Health Summit: Engaging Consumers, September 9-10 in San Diego, will examine the growth of the connected health market through analysis of new devices, technologies, and integrated platforms and its consumer-oriented focus. 2014, the first year of the conference, was a significant year in the evolution of this market. A record number of ACOs formed to deliver accountable care, and it was also the maiden year for health insurance exchanges, which are now attracting more private insurers as the current healthcare model solidifies. Large CE companies, including Apple, Google, and Samsung, officially ent...
Source: Disruptive Women in Health Care - July 15, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Consumer Health Care Events Source Type: blogs

Can We Tame The Wild West of Health Care Pricing?
By TORBEN NIELSEN Health care pricing is like the Wild West and it is only a matter of time before it catches up with us. In July, the Centers for Medicare & Medicaid Services (CMS) confirmed what many consumers, employers and health plans already knew: there is no cost and quality standard in the American health care system. Improving our system starts with driving payers and consumers to high value providers. But first, we must know who is charging what. Price transparency tools offer that important information, enabling people to actually comparison shop for their health care services. In early July, CMS released a ...
Source: The Health Care Blog - August 27, 2015 Category: Consumer Health News Authors: Matthew Holt Tags: Health 2.0 Matthew Holt THCB The Business of Health Care Cost transparency Healthsparq Torben Nielsen Source Type: blogs

Social Determinants Impact Health More Than Health Care
Today’s post first ran on Health Populi on November 9. The factors of where people are born, live, work and age — social determinants — shape human health more than health care. Yet in the U.S. much more resource per capita is funneled into healthcare services than into social ones. Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity was published by The Kaiser Commission on Medicaid and the Uninsured in November 2015, calling attention to the opportunity and wisdom of baking health into all public policy. The social determinants of health (SDOH) include economic stability, t...
Source: Disruptive Women in Health Care - November 24, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Consumer Health Care Health Reform Innovation Mental Health Source Type: blogs

The cost conundrum: financing the business of health care insurance.
This article examines the rapid growth of health care expenditures by analyzing the extent of this financial boom as well some of the reasons why health care financing has become so expensive. It also explores how the market concentration of insurance companies has led to growing insurer profits, fewer insurance providers, and less market competition. Based on economic data primarily from the Government Accountability Office, the Kaiser Family Foundation, and the American Medical Associa tion, it has become clear that this country needs more competitive rates for the business of health insurance. Because of the unique dyna...
Source: Journal of Health Care Finance - December 2, 2015 Category: Health Management Tags: J Health Care Finance Source Type: research

What Would a Health Care Mutual Look Like?
By MARC-DAVID MONK, MD For a few years I’ve been fantasizing about what a healthcare insurance/ delivery mutual would look like.  I’ve yet to see one but I like the idea a lot. Here’s the idea behind a mutual:  A mutual structure means that the company is owned by its clients or policyholders.  Since a mutual’s customers are also its owners, they get to share in any surpluses though they are mostly reinvested in the business. Wikipedia has a nice writeup on the fundamentals of mutuals: A mutual exists with the purpose of raising funds from its membership or customers (collectively called its members), which ca...
Source: The Health Care Blog - January 5, 2016 Category: Consumer Health News Authors: John Irvine Tags: The Business of Health Care Health Care Mutual Source Type: blogs

Consumers Take Better Preventive Care of Pets Than Themselves, CIGNA Finds
The post below first ran January 18 on Health Populi. Nine in 10 pet owners know when their dog or cat is due for their shots. Eight in 10 women know the frequency with which they get manicures and pedicures. 80% of men know the mileage between old changes. But only 50% of family health care decision makers know their blood pressure, and only 20% know their biometric numbers like cholesterol and BMI. Americans are great at doing preventive care for their pets and automobiles; but not so much for their own bodies and health, finds the report CIGNA Preventive Care Research, a survey of 1,000 U.S. consumers between 25 and 75...
Source: Disruptive Women in Health Care - January 19, 2016 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Access Consumer Health Care Patients Source Type: blogs

Effects of continuity of care on emergency department utilization in children with asthma.
CONCLUSIONS: High continuity of ambulatory asthma care can decrease asthma-specific ED utilization risk in children with newly diagnosed asthma in Taiwan. We suggest that providers and the government reinforce the use of follow-up care and education for high-risk groups to improve the continuity of ambulatory asthma care. PMID: 26799202 [PubMed - as supplied by publisher]
Source: The American Journal of Managed Care - January 23, 2016 Category: Health Management Authors: Huang ST, Wu SC, Hung YN, Lin IP Tags: Am J Manag Care Source Type: research

Factors related to continuing care and interruption of P4P program participation in patients with diabetes.
CONCLUSIONS: Taiwan's diabetes P4P program increased continuing care participation in patients with diabetes. The rate of interruption of P4P program participation among enrolled patients with diabetes, at 44.33%, should be a focus of improvement for Taiwan's health authorities. PMID: 26799201 [PubMed - as supplied by publisher]
Source: The American Journal of Managed Care - January 23, 2016 Category: Health Management Authors: Yen SM, Kung PT, Sheen YJ, Chiu LT, Xu XC, Tsai WC Tags: Am J Manag Care Source Type: research

National estimates of price variation by site of care.
CONCLUSIONS: Our study shows that price differentials by site of care exist at a national level, and that they are increasing over time. PMID: 26978238 [PubMed - in process]
Source: The American Journal of Managed Care - March 17, 2016 Category: Health Management Authors: Higgins A, Veselovskiy G, Schinkel J Tags: Am J Manag Care Source Type: research