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ACOs With Risk-Bearing Experience Are Likely Taking Steps to Reduce Low-Value Medical ServicesExperience with risk-based contracting best predicts active engagement of accountable care organizations in reducing low-value medical services, mainly through physician education and encouraging shared decision making.
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Scaling Lean in Primary Care: Impacts on System PerformanceLean redesigns in primary care improved workflow efficiencies, physician productivity, and overall satisfaction among patients, physicians, and staff, with no adverse effects on clinical quality.
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Pilot of Urgent Care Center Evaluation for Acute Coronary SyndromeA formal protocol for urgent care center evaluation of potential acute coronary syndrome safely precluded emergency department visits among 84% of those eligible.
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Scalable Hospital at Home With Virtual Physician Visits: Pilot StudyResults suggest that this scalable model of Hospital at Home is safe, feasible, highly satisfactory, and may be associated with substantial reductions in hospital readmissions.
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Claims-Based Risk Model for First Severe COPD ExacerbationA health insurance claims-based risk assessment tool to predict patients’ first severe chronic obstructive pulmonary disease exacerbation has been developed and validated.
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False-Positive Mammography and Its Association With Health Service UseThis study demonstrated that a false-positive mammogram was associated with increases in outpatient visits, but not provider referrals, for 1 year post mammogram.
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Preventive/Office Visit Patient Knowledge and Their Insurance Information Gathering PerceptionsPatients have an incomplete understanding of what constitutes no-cost preventive care services. Ease of obtaining information from insurance companies can significantly affect whether patients are charged correctly.
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Patients With Diabetes in Pay-for-Performance Programs Have Better Physician Continuity of Care and SurvivalPatients with diabetes who participate in a pay-for-performance program had higher continuity of care index (COCI) scores, and those with high COCI scores had higher survival rates.
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Patient Ratings of Veterans Affairs and Affiliated HospitalsThe mean online patient rating for Veterans Affairs hospitals was higher (3.70 ± 1.3 out of 5) than the rating for affiliated hospitals (3.19 ± 1.3; P = .003).
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Use of Well-Child Visits in High-Deductible Health PlansWhen preventive care was exempt from the deductible, well-child visits did not change for children switching from traditional plans to high-deductible plans.
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CAH Staff Perceptions of a Clinical Information System ImplementationThis study examines staff perceptions of patient care quality and the processes before and after implementation of a comprehensive clinical information system in 7 critical access hospitals.
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Office Manager and Nurse Perspectives on Facilitators of Adult ImmunizationFactors significantly associated with adult vaccination rates in primary care practices were patients’ age, race, scheduled well-visit length, and nurses’ vaccination status.
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Are Obese Patients Assisted in Losing Weight?In obese patients, we assessed the lack of advice to lose weight and its association with cardiovascular risk using the REGICOR chart (adaption of Framingham).
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Clinical Outcomes and Healthcare Use Associated With Optimal ESRD StartsOptimal end-stage renal disease (ESRD) starts were associated with lower 12-month morbidity, mortality, and inpatient and outpatient utilization in an integrated healthcare delivery system.
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Medicare's Bundled Payments for Care Improvement Initiative: Expanding Enrollment Suggests Potential for Large ImpactExpanding and more representative participation in Medicare's Bundled Payments for Care Improvement initiative suggests potential for large impact, pending the results of risk-bearing participants.
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Considerations for Optimal Management of Patients With Pulmonary Arterial Hypertension: A Multi-Stakeholder Roundtable DiscussionStakeholders, including national and regional managed care decision makers and providers, met to discuss the clinical background, health economics, and management strategies for pulmonary arterial hypertension (PAH) at a roundtable meeting on December 10, 2016, in Dallas, Texas.
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Cost-Effectiveness of Combinatorial Pharmacogenomic Testing for Treatment-Resistant Major Depressive Disorder PatientsUsing a state-transition probability analysis, this study assessed the long-term outcomes and economic implications of combinatorial pharmacogenomic testing for managing patients with major depressive disorder who were nonresponsive to treatments.
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Are Benefits From Diabetes Self-Management Education Sustained?Conventional individualized diabetes self-management education resulted in sustained improvement in self-efficacy and diabetes distress. Short-term improvements in A1C, nutrition, and physical activity were not sustained.
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Care Fragmentation and Emergency Department Use Among Complex Patients With DiabetesFragmentation of care to specialists may be associated with higher rates of emergency department visits among patients with chronic illness.
