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The Unintended Consequences of Medicare’s Wage Index Adjustment on Device-Intensive Hospital ProceduresThe authors found an association between Medicare’s wage index adjustment and the differential use of labor-intensive surgical procedures and medical device–intensive minimally invasive clinical procedures across the United States.
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Testing Novel Patient Financial Incentives to Increase Breast Cancer ScreeningThis study tested 3 financial incentives encouraging breast cancer screening (mammograms) among women deemed overdue. None were effective overall; "person-centered" incentives worked in the most recently screened subgroup.
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Challenges of Fracture Risk Assessment in Asian and Black WomenDifferences in bone density and FRAX fracture risk scores among Black and Asian women yield greater discordance in fracture risk estimation compared with White women.
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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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Diabetes and Employment Productivity: Does Diabetes Management Matter?Diabetes itself affected working and wages more than control of blood sugar levels in a Mexican American population.
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Effect of Medication Dosing Frequency on Adherence in Chronic DiseasesMedication adherence is important in chronic disease management. This systematic review demonstrates that dosing frequency has important effects on medication adherence.
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Methodological Effects on the Measurement of Repeat HospitalizationsThe rates of potentially preventable readmissions vary across measurement methodologies which explains inconsistencies in previous studies. Results suggest measurement of readmissions incentivizes inefficient behavior.
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Ambulatory Care Visits for Pap Tests, Abnormal Pap Test Results, and Cervical Cancer Procedures in the United StatesThe pre-HPV vaccination burden of ambulatory care visits and procedures related to cervical cancer screening is assessed, with projected effects of HPV vaccination and testing.
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Building Health IT Capacity to Improve HIV Infection Health OutcomesMassachusetts is integrating HIV surveillance and leveraging electronic health record clinical data into their electronic disease case management system to enhance monitoring the HIV continuum of care.
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Choosing Wisely Clinical Decision Support Adherence and Associated Inpatient OutcomesThis analysis examines the associations between adherence to Choosing Wisely recommendations embedded into clinical decision support alerts and 4 measures of resource use and quality.
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Can Electronic Health Records Help Improve Patients' Understanding of Medications?Patients' problems in understanding of new and existing medications were evaluated to design a primary care electronic health record quality improvement study.
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Self-monitoring of Blood Glucose Levels in Patients With Type 2 Diabetes Mellitus Not Taking Insulin: A Meta-analysisA meta-analysis of 9 RCTs found little benefit in self-monitoring of blood glucose levels on A1C outcomes in patients with diabetes mellitus not taking insulin.
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Quality Metrics for Oncology in a Value-Based Reimbursement WorldCMS has developed the Oncology Care Model (OCM) to provide physician practices that furnish chemotherapy treatment the option of payment arrangements that include financial and performance accountability for episodes of care for cancer patients. This article presents an overview of the model and guidelines that can help meet the quality and performance measures for OCM participation.
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A 10-Step Program to Successfully Reduce Low-Value CareThe frequency of low-value care can be reduced by a respectful, data-driven process anchored in nonjudgmental communication and explicit core values.
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Community Navigators Reduce Hospital Utilization in Super-UtilizersSuper-utilizers place a significant clinical and financial burden on the healthcare system. The authors investigated the effectiveness of community navigators in reducing hospital utilization and costs.
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Adaptation of an Asthma Management Program to a Small ClinicThe authors adapted a successful large-scale, specialist-run asthma management program to an existing multi-specialty clinic utilizing existing resources and achieving similar outcomes.
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Can Primary Care Physicians Accurately Predict the Likelihood of Hospitalization in Their Patients?This study demonstrates that the predictive accuracy of primary care physicians’ assessment of future hospitalization risk is comparable to commonly used quantitative risk stratification instruments.
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Delivering Vaccines: A Case Study of the Distribution System of Vaccines for ChildrenDuring implementation of the Vaccine Management Business Improvement Project, providers experienced longer delivery delays and a higher probability of a Vaccines for Children stockout.
