7,925 results match your criteria Health affairs Project Hope[Journal]


Risk Adjustment In Medicare ACO Program Deters Coding Increases But May Lead ACOs To Drop High-Risk Beneficiaries.

Health Aff (Millwood) 2019 Feb;38(2):253-261

Andrew M. Ryan ( ) is the UnitedHealthcare Professor of Health Care Management in the Department of Health Management and Policy, University of Michigan School of Public Health.

The Medicare Shared Savings Program (MSSP) adjusts savings benchmarks by beneficiaries' baseline risk scores. To discourage increased coding intensity, the benchmark is not adjusted upward if beneficiaries' risk scores rise while in the MSSP. As a result, accountable care organizations (ACOs) have an incentive to avoid increasingly sick or expensive beneficiaries. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05407DOI Listing
February 2019
1 Read

Priorities In Patient Safety.

Health Aff (Millwood) 2019 Feb;38(2):330

Icahn School of Medicine at Mount Sinai New York, New York.

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http://dx.doi.org/10.1377/hlthaff.2018.05349DOI Listing
February 2019

Hospitals, Health IT, And More.

Authors:
Alan R Weil

Health Aff (Millwood) 2019 Feb;38(2):175

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http://dx.doi.org/10.1377/hlthaff.2019.00063DOI Listing
February 2019

Does Health Information Exchange Improve Patient Outcomes? Empirical Evidence From Florida Hospitals.

Health Aff (Millwood) 2019 Feb;38(2):197-204

Xuan Tan is a doctoral student in the Department of Information Systems and Business Analytics, College of Business, Florida International University.

Achieving widespread exchange of health information is a national health policy objective, for it is believed to boost treatment efficiency, reduce health care costs, and improve patient outcomes. We used state-level data for 2011-14 from Florida to examine the relationship between hospitals' participation in health information exchange (HIE) and quality and health outcomes. HIE participation was associated with a decrease in the probability of unplanned, thirty-day readmissions for acute myocardial infarction that was 1. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05447DOI Listing
February 2019

Covering All Californians: The Authors Reply.

Health Aff (Millwood) 2019 Feb;38(2):329-330

Los Angeles, California.

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http://dx.doi.org/10.1377/hlthaff.2018.05449DOI Listing
February 2019

Cystic Fibrosis And Ivacaftor Use: The Authors Reply.

Health Aff (Millwood) 2019 Feb;38(2):328

Boston Children's Hospital Boston, Massachusetts.

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http://dx.doi.org/10.1377/hlthaff.2018.05268DOI Listing
February 2019

Variation In Health Spending Growth For The Privately Insured From 2007 To 2014.

Health Aff (Millwood) 2019 Feb;38(2):230-236

John Van Reenen is the Gordon Y. Billard Professor in Management and Economics, Sloan School of Management, Massachusetts Institute of Technology, in Cambridge.

We examined the growth in health spending on people with employer-sponsored private insurance in the period 2007-14. Our analysis relied on information from the Health Care Cost Institute data set, which includes insurance claims from Aetna, Humana, and UnitedHealthcare. In the study period private health spending per enrollee grew 16. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05245DOI Listing
February 2019

In States That Border Mexico, Cesarean Rates Were Highest For Hispanic Women Living In Border Counties In 2015.

Health Aff (Millwood) 2019 Feb;38(2):276-286

Jesus Sigala is a graduate student in the Department of Economics, Applied Statistics, and International Business and is affiliated with the Southwest Institute for Health Disparities Research, College of Business, New Mexico State University.

Hispanic women living on the US-Mexico border have had higher cesarean delivery rates than other Hispanic women in the US. Using birth certificate and other data, we compared cesarean rates among Hispanic women living in US border counties with rates among other Hispanic women in border states during 2015. Using linear regression, we also determined which medical, hospital, and sociodemographic characteristics accounted for intercounty variations in rates. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05369DOI Listing
February 2019
1 Read

Hospital Prices Grew Substantially Faster Than Physician Prices For Hospital-Based Care In 2007-14.

Health Aff (Millwood) 2019 Feb;38(2):184-189

John Van Reenen is the Gordon Y. Billard Professor in Management and Economics, Sloan School of Management, Massachusetts Institute of Technology, in Cambridge.

Evidence suggests that growth in providers' prices drives growth in health care spending on the privately insured. However, existing work has not systematically differentiated between the growth rate of hospital prices and that of physician prices. We analyzed growth in both types of prices for inpatient and hospital-based outpatient services using actual negotiated prices paid by insurers. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05424DOI Listing
February 2019

Medicare Advantage And Commercial Prices For Mental Health Services.

Health Aff (Millwood) 2019 Feb;38(2):262-267

Tamara Hayford is a principal analyst in the Health, Retirement, and Long-Term Analysis Division, Congressional Budget Office.

In 2014, insurers paid an average of 13-14 percent less for in-network mental health services in their commercial and Medicare Advantage plans than fee-for-service Medicare paid for identical services-despite paying up to 12 percent more than Medicare when the same services were provided by other physician specialties. However, patients went out of network more frequently for mental health services than for comparison services, which increased their average cost-sharing payments. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05226DOI Listing
February 2019

Homelessness And Health Care: What Is Being Funded?

Authors:

Health Aff (Millwood) 2019 Feb;38(2):324-325

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http://dx.doi.org/10.1377/hlthaff.2018.05500DOI Listing
February 2019

Access To E-Prescriptions And Related Technologies Before And After Hurricanes Harvey, Irma, And Maria.

Health Aff (Millwood) 2019 Feb;38(2):205-211

Max M. Sow is vice president of the Division of Business Intelligence at Surescripts.

Hurricanes Harvey, Irma, and Maria devastated parts of the US mainland and Puerto Rico during the 2017 hurricane season, causing loss of life and substantial damage and interrupting access to health care for many people in the hurricane impact zones. Using data on e-prescriptions and medication history transactions from a large health information network for the period August 2017-May 2018, we examined providers' access to these technologies across affected areas. Although e-prescribing and medication history transactions decreased considerably during each hurricane, transaction volumes returned to normal levels in the days immediately following Hurricanes Harvey and Irma in Texas and Florida. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05247DOI Listing
February 2019

Covering The Uninsured In California.

Authors:
Lucy Johns

Health Aff (Millwood) 2019 Feb;38(2):329

Health Care Planning and Policy San Francisco, California.

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http://dx.doi.org/10.1377/hlthaff.2018.05385DOI Listing
February 2019

Performance Of Safety-Net Hospitals In Year 1 Of The Comprehensive Care For Joint Replacement Model.

Health Aff (Millwood) 2019 Feb;38(2):190-196

Yue Li is a professor in the Department of Public Health Sciences, University of Rochester.

The Comprehensive Care for Joint Replacement (CJR) model introduced in 2016 aims to improve the quality and costs of care for Medicare beneficiaries undergoing hip and knee replacements. However, there are concerns that the safety-net hospitals that care for the greatest number of vulnerable patients may perform poorly in CJR. In this study we used Medicare's CJR data to evaluate the performance of 792 hospitals mandated to participate in the first year of CJR. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05264DOI Listing
February 2019
1 Read

Health Care Spending Slowed After Rhode Island Applied Affordability Standards To Commercial Insurers.

Health Aff (Millwood) 2019 Feb;38(2):237-245

Sanjay Basu is an assistant professor of medicine in the Center for Primary Care and Outcomes Research and the Center for Population Health Sciences, both in the Department of Medicine, Stanford University School of Medicine.

States are introducing regulations to slow health care spending growth, but which of these successfully reduce spending growth remains unclear. We studied Rhode Island's 2010 affordability standards, which imposed price controls-particularly inflation caps and diagnosis-based payments-on contracts between commercial insurers and hospitals and clinics and required commercial insurers to increase their spending on primary care and care coordination services. Using a difference-in-differences design, we compared spending among 38,001 commercially insured adults in Rhode Island to that among 38,001 matched adults in other states in the period 2007-16. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05164DOI Listing
February 2019

Qualifying Conditions Of Medical Cannabis License Holders In The United States.

Health Aff (Millwood) 2019 Feb;38(2):295-302

Rebecca L. Haffajee is an assistant professor of health management and policy, University of Michigan School of Public Health, in Ann Arbor.

The evidence for cannabis's treatment efficacy across different conditions varies widely, and comprehensive data on the conditions for which people use cannabis are lacking. We analyzed state registry data to provide nationwide estimates characterizing the qualifying conditions for which patients are licensed to use cannabis medically. We also compared the prevalence of medical cannabis qualifying conditions to recent evidence from the National Academies of Sciences, Engineering, and Medicine report on cannabis's efficacy in treating each condition. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05266DOI Listing
February 2019

Primary Care Office Visits For Acute Care Dropped Sharply In 2002-15, While ED Visits Increased Modestly.

Health Aff (Millwood) 2019 Feb;38(2):268-275

Stephen R. Pitts is an associate professor in the Department of Emergency Medicine, Emory University School of Medicine, and an associate professor in the Department of Epidemiology, Rollins School of Public Health, Emory University, both in Atlanta, Georgia.

The traditional model of primary care practices as the main provider of care for acute illnesses is rapidly changing. Over the past two decades the growth in emergency department (ED) visits has spurred efforts to reduce "inappropriate" ED use. We examined a nationally representative sample of office and ED visits in the period 2002-15. Read More

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http://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05184
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http://dx.doi.org/10.1377/hlthaff.2018.05184DOI Listing
February 2019
1 Read

Improving The Medicare Physician Fee Schedule: Make It Part Of Value-Based Payment.

Health Aff (Millwood) 2019 Feb;38(2):246-252

Paul B. Ginsburg ( ) is director of the University of Southern California (USC)-Brookings Schaeffer Initiative for Health Policy and the Leonard D. Schaeffer Chair in Health Policy Studies, Center for Health Policy, both at the Brookings Institution, in Washington, D.C., and a professor at the Price School of Public Policy and director of public policy at the Leonard D. Schaeffer Center for Health Policy and Economics, both at the University of Southern California, in Los Angeles.

Alternative Payment Models (APMs) can address the limitations inherent in fee-for-service payment to support new approaches to health care delivery that produce greater value. But the models being tested are directly layered on top of fee-for-service architecture, specifically the Medicare Physician Fee Schedule. Shoring up that architecture to produce greater value, in combination with APMs, should be considered an integral part of the movement to value-based payment. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05411DOI Listing
February 2019

For Women Living With HIV, A Trauma-Informed Approach To Care.

Authors:
Brian Rinker

Health Aff (Millwood) 2019 Feb;38(2):178-183

This article is part of a series on transforming health systems published with support from The Robert Wood Johnson Foundation. This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt, and build upon this work, for commercial use, provided the original work is properly cited. See https://creativecommons.org/licenses/by/4.0/ . Brian Rinker ( ) is an independent journalist in San Francisco, California.

At a San Francisco primary care clinic, trauma is recognized as a root cause of many health challenges. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05498DOI Listing
February 2019

Real-Time Patient Safety Surveillance Program.

Authors:
Asghar Shah

Health Aff (Millwood) 2019 Feb;38(2):330

Feinstein Institute for Biomedical Research Manhasset, New York.

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http://dx.doi.org/10.1377/hlthaff.2018.05410DOI Listing
February 2019

Managing Cancer Patients' Expectations Amid Hope And Hype.

Health Aff (Millwood) 2019 Feb;38(2):320-323

Joseph O. Jacobson ( ) is the chief quality officer at the Dana-Farber Cancer Institute and an associate professor of medicine at Harvard Medical School, both in Boston, Massachusetts. The patient's name in this essay was changed to protect her privacy.

How patients view oncologists-and how oncologists view themselves-„matters when difficult decisions must be made. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05259DOI Listing
February 2019

Telemedicine In Substance Use Disorder Treatment.

Authors:
David Barash

Health Aff (Millwood) 2019 Feb;38(2):331

GE Foundation Boston, Massachusetts.

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http://dx.doi.org/10.1377/hlthaff.2018.05435DOI Listing
February 2019

Trends In Coverage For Disease-Modifying Therapies For Multiple Sclerosis In Medicare Part D.

Health Aff (Millwood) 2019 Feb;38(2):303-312

Dennis N. Bourdette is a professor in and chair of the Department of Neurology, Oregon Health and Science University.

The high cost of multiple sclerosis (MS) disease-modifying therapies can negatively affect access for patients through increased payer restrictions and higher out-of-pocket spending. Our objective was to describe changes in pharmacy benefit coverage and cost-sharing amounts for MS disease-modifying therapies in the Medicare Part D program, using enrollment-weighted Prescription Drug Plan Formulary files for the period 2007-16. Among therapies available throughout the study period, the rate of prior authorization use increased from 61-66 percent of plans to 84-90 percent. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05357DOI Listing
February 2019
2 Reads

Impact Of The Priority Review Voucher Program On Drug Development For Rare Pediatric Diseases.

Health Aff (Millwood) 2019 Feb;38(2):313-319

Aaron S. Kesselheim is an associate professor of medicine at Harvard Medical School and director of the Program on Regulation, Therapeutics, and Law in the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School.

Only an estimated 5 percent of rare pediatric diseases have a treatment, although collectively they affect more than ten million children in the US. To stimulate drug development for rare pediatric diseases, Congress expanded the priority review voucher (PRV) program in 2012. A pediatric PRV, which can be sold to another manufacturer, requires the FDA to provide priority six-month review rather than the standard ten-month review to another drug of the company's choosing. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05330DOI Listing
February 2019

Immeasurable Time Bias In Exposure to Ivacaftor.

Health Aff (Millwood) 2019 Feb;38(2):328

University of Florida Gainesville, Florida.

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http://dx.doi.org/10.1377/hlthaff.2018.05175DOI Listing
February 2019

Health System Approaches Are Needed To Expand Telemedicine Use Across Nine Latin American Nations.

Health Aff (Millwood) 2019 Feb;38(2):212-221

Alejandro Arrieta is an assistant professor in the Department of Health Policy and Management, Robert Stempel College of Public Health and Social Work, Florida International University.

Doctors are unequally distributed across different regions in virtually all Latin American countries, which results in limited access to consistent health services. Telemedicine may address such challenges. This study profiles current levels of telemedicine use and assesses forces driving that use for nine Latin American countries (Argentina, Chile, Colombia, Costa Rica, Guatemala, Mexico, Panama, Peru, and Uruguay). Read More

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http://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05274
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http://dx.doi.org/10.1377/hlthaff.2018.05274DOI Listing
February 2019
3 Reads
4.966 Impact Factor

Real-Time Patient Safety: The Authors Reply.

Health Aff (Millwood) 2019 Feb;38(2):331

Pascal Metrics Washington, D.C.

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http://dx.doi.org/10.1377/hlthaff.2018.05453DOI Listing
February 2019

Priorities In Patient Safety: The Authors Reply.

Health Aff (Millwood) 2019 Feb;38(2):330

Baylor College of Medicine Houston, Texas.

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http://dx.doi.org/10.1377/hlthaff.2018.05376DOI Listing
February 2019
4.966 Impact Factor

Educating Caregivers To Provide Safe Care.

Health Aff (Millwood) 2019 Feb;38(2):328-329

Healthcare Systems Engineering Institute Boston, Massachusetts.

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http://dx.doi.org/10.1377/hlthaff.2018.05474DOI Listing
February 2019

A Transitioning Epidemic: How The Opioid Crisis Is Driving The Rise In Hepatitis C.

Health Aff (Millwood) 2019 Feb;38(2):287-294

Rosalie L. Pacula is a senior economist at the RAND Corporation in Santa Monica, California.

The hepatitis C virus is responsible for more deaths in the United States than any other infectious disease, and hepatitis C infections have been rising at an alarming rate since 2010. We evaluated the role of the opioid epidemic and, in particular, the 2010 introduction of an abuse-deterrent version of OxyContin. The OxyContin reformulation led some users of the drug to switch to heroin, which could have exposed them to the hepatitis C virus. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05232DOI Listing
February 2019
2 Reads

Explaining The Slowdown In Medical Spending Growth Among The Elderly, 1999-2012.

Health Aff (Millwood) 2019 Feb;38(2):222-229

Allison B. Rosen is an associate professor in the Department of Quantitative Health Sciences, University of Massachusetts Medical School, in Worcester.

We examined trends in per capita spending for Medicare beneficiaries ages sixty-five and older in the United States in the period 1999-2012 to determine why spending growth has been declining since around 2005. Decomposing spending by condition, we found that half of the spending slowdown was attributable to slower growth in spending for cardiovascular diseases. Spending growth also slowed for dementia, renal and genitourinary diseases, and aftercare for people with acute illnesses. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05372DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366852PMC
February 2019

Court Rules Individual Mandate, Entire ACA Unconstitutional.

Authors:
Katie Keith

Health Aff (Millwood) 2019 Feb 14;38(2):176-177. Epub 2019 Jan 14.

Katie Keith ( ) is a principal at Keith Policy Solutions, LLC; an appointed consumer representative to the National Association of Insurance Commissioners; and an adjunct professor at the Georgetown University Law Center. [Published online January 14, 2019.] Readers can find more detail and updates on health reform on Health Affairs Blog ( http://healthaffairs.org/blog/ ).

The holiday season brought a potentially fatal blow to the Affordable Care Act, but enrollment remained steady, and the law remains in place. Read More

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http://www.healthaffairs.org/doi/10.1377/hlthaff.2019.00024
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http://dx.doi.org/10.1377/hlthaff.2019.00024DOI Listing
February 2019
4 Reads

How Telehealth Stopped A Contagious Outbreak At A School.

Health Aff (Millwood) 2018 Dec;37(12):2092-2095

Cynthia M. Zettler-Greeley ( ) is assistant director of research and evaluation at the Center for Health Delivery Innovation, Nemours Children's Health System, in Jacksonville, Florida. She worked with Peggy McGrath, a critical care nurse at Morning Star Catholic School, in Orlando, Florida, to write this essay. The student's name has been changed to protect her privacy.

A school-based telehealth program helps identify a disease outbreak before it gets out of hand. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05181DOI Listing
December 2018

Know Your HIV Status.

Authors:
Tom Kenyon

Health Aff (Millwood) 2018 Dec;37(12):2104

Tom Kenyon is CEO and chief medical officer of Project HOPE, in Millwood, Virginia.

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http://dx.doi.org/10.1377/hlthaff.2018.05136DOI Listing
December 2018

Telehealth.

Authors:
Alan R Weil

Health Aff (Millwood) 2018 Dec;37(12):1915

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http://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05262
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http://dx.doi.org/10.1377/hlthaff.2018.05262DOI Listing
December 2018
4 Reads

Charting A Pathway To Better Health.

Authors:
T R Goldman

Health Aff (Millwood) 2018 Dec;37(12):1918-1922

This article is part of a series on transforming health systems published with support from The Robert Wood Johnson Foundation. This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt, and build upon this work, for commercial use, provided the original work is properly cited. See https://creativecommons.org/licenses/by/4.0/ . T. R. Goldman ( ) is a Washington, D.C.-based freelance journalist.

In Toledo and other communities nationwide, a new approach to care coordination is reaching patients where they live. Read More

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http://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05166
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http://dx.doi.org/10.1377/hlthaff.2018.05166DOI Listing
December 2018
2 Reads

School Safety: The Author Replies.

Authors:
Tony S Reed

Health Aff (Millwood) 2018 Dec;37(12):2101

Temple University Hospital Philadelphia, Pennsylvania.

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http://dx.doi.org/10.1377/hlthaff.2018.05222DOI Listing
December 2018

Safety For Children In School.

Authors:
Erin Miller

Health Aff (Millwood) 2018 Dec;37(12):2100-2101

Colorado Children's Campaign Denver, Colorado.

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http://dx.doi.org/10.1377/hlthaff.2018.05213DOI Listing
December 2018

Managed Competition.

Authors:
Brian Prestwich

Health Aff (Millwood) 2018 Dec;37(12):2100

University of California Los Angeles Los Angeles, California.

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http://dx.doi.org/10.1377/hlthaff.2018.05073DOI Listing
December 2018

Managed Competition: The Author Replies.

Authors:
Alain Enthoven

Health Aff (Millwood) 2018 Dec;37(12):2100

Stanford University Stanford, California.

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http://dx.doi.org/10.1377/hlthaff.2018.05230DOI Listing
December 2018

Use Of Telemedicine For ED Physician Coverage In Critical Access Hospitals Increased After CMS Policy Clarification.

Health Aff (Millwood) 2018 Dec;37(12):2037-2044

Amanda Bell is a quality and innovation officer at Avera eCARE.

There is a chronic shortage of physicians to cover emergency departments (EDs) in critical access hospitals. A 2013 memorandum from the Centers for Medicare and Medicaid Services clarified that a telemedicine physician could fulfill the regulatory requirements for physician backup when advanced practice providers were at telemedicine-equipped critical access hospital EDs but local physicians were not. In a sample of nineteen hospitals, coverage schedules in 2016 showed that seven had begun the use of tele-ED physician backup for advanced practice providers, decreasing local physician coverage in their EDs. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05103DOI Listing
December 2018

Telehealth In Health Centers: Key Adoption Factors, Barriers, And Opportunities.

Health Aff (Millwood) 2018 Dec;37(12):1967-1974

Suma Nair is director of the Office of Quality Improvement, Bureau of Primary Health Care, HRSA.

Telehealth services have the potential to improve access to care, especially in rural or urban areas with scarce health care resources. Despite the potential benefits, telehealth has not been fully adopted by health centers. This study examined factors associated with and barriers to telehealth use by federally funded health centers. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05125DOI Listing
December 2018

Quality Of Care For Acute Respiratory Infections During Direct-To-Consumer Telemedicine Visits For Adults.

Health Aff (Millwood) 2018 Dec;37(12):2014-2023

Kristin N. Ray ( ) is an assistant professor in the Department of Pediatrics, University of Pittsburgh School of Medicine, in Pennsylvania.

In direct-to-consumer telemedicine, physicians treat patients through real-time audiovisual conferencing for common conditions such as acute respiratory infections. Early studies had mixed findings on the quality of care provided during direct-to-consumer telemedicine and were limited by small sample sizes and narrow geographic scopes. Using claims data for 2015-16 from a large national commercial insurer, we examined the quality of antibiotic management in adults with acute respiratory infection diagnoses at 38,839 direct-to-consumer telemedicine visits, compared to the quality at 942,613 matched primary care visits and 186,016 matched urgent care visits. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05091DOI Listing
December 2018

Virtual Visits Partially Replaced In-Person Visits In An ACO-Based Medical Specialty Practice.

Health Aff (Millwood) 2018 Dec;37(12):2045-2051

Sandhya K. Rao is senior medical director for population health management at Partners Healthcare and an assistant professor of medicine at Harvard Medical School, both in Boston.

Specialty care contributes significantly to total medical expenditures, for which accountable care organizations (ACOs) are responsible. ACOs have sought to replace costly in-person visits with lower-cost alternatives such as virtual visits (videoconferencing with physicians). In fee-for-service environments, virtual visits appear to add to in-person visits instead of replacing them. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05105DOI Listing
December 2018

Home Telemonitoring In Heart Failure: A Systematic Review And Meta-Analysis.

Health Aff (Millwood) 2018 Dec;37(12):1983-1989

Andrzej Kozikowski is a senior analyst in the Division of Health Services Research and an assistant professor in the Department of Medicine, Northwell Health, in Manhasset.

We conducted a meta-analysis of twenty-six randomized controlled trials that tested the effectiveness of home telemonitoring in patients with heart failure for reducing mortality and hospital use. We used the PICOT framework as a tool to address an important variable not previously studied: the timing or duration of monitoring. Specifically, we found that home telemonitoring decreased the odds of all-cause mortality and heart failure-related mortality at 180 days but not at 365 days. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05087DOI Listing
December 2018

Are State Telehealth Policies Associated With The Use Of Telehealth Services Among Underserved Populations?

Health Aff (Millwood) 2018 Dec;37(12):2060-2068

Preeti Iyer was a data analyst intern in the Health Care Affairs Unit, Association of American Medical Colleges, in Washington, D.C., when this work was conducted. She is currently a third-year computer science student at Princeton University, in New Jersey.

Using four years of data from a nationally representative consumer survey, we examined trends in telehealth usage over time and the role state telehealth policies play in telehealth use. Telehealth use increased dramatically during the period 2013-16, with new modalities such as live video, live chat, texting, and mobile apps gaining traction. The rate of live video communication rose from 6. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05101DOI Listing
December 2018

Reduced Cost Of Specialty Care Using Electronic Consultations For Medicaid Patients.

Health Aff (Millwood) 2018 Dec;37(12):2031-2036

Bridget Teevan is a public health epidemiologist in the Rhode Island Department of Health, in Providence. She was a research associate at the Weitzman Institute, Community Health Center Inc., at the time this work was conducted.

Specialty care accounts for a significant and growing portion of year-over-year Medicaid cost increases. Some referrals to specialists may be avoided and managed more efficiently by using electronic consultations (eConsults). In this study a large, multisite safety-net health center linked its primary care providers with specialists in dermatology, endocrinology, gastroenterology, and orthopedics via an eConsult platform. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05124DOI Listing
December 2018

Electronic Visits For Common Acute Conditions: Evaluation Of A Recently Established Program.

Health Aff (Millwood) 2018 Dec;37(12):2024-2030

Vanessa Diaz ( ) is a professor in the College of Medicine, Medical University of South Carolina.

Asynchronous interactions between patients and providers through patient portals (called e-visits in this article) have the potential to increase access to care and reduce the time requirements for some office visits. We performed a retrospective chart review for nonemergent acute care of adults in the period December 2015-July 2017 at the Medical University of South Carolina. Most patients in the 1,565 e-visits were female (80. Read More

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http://dx.doi.org/10.1377/hlthaff.2018.05122DOI Listing
December 2018
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Population-Level Estimates Of Telemedicine Service Provision Using An All-Payer Claims Database.

Health Aff (Millwood) 2018 Dec;37(12):1931-1939

Jean M. Abraham is the Wegmiller Professor in the Division of Health Policy and Management, School of Public Health, University of Minnesota.

In recent years state and federal policies have encouraged the use of telemedicine by formalizing payments for it. Telemedicine has the potential to expand access to timely care and reduce costs, relative to in-person care. Using information from the Minnesota All Payer Claims Database, we conducted a population-level analysis of telemedicine service provision in the period 2010-15, documenting variation in provision by coverage type, provider type, and rurality of patient residence. Read More

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http://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05116
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http://dx.doi.org/10.1377/hlthaff.2018.05116DOI Listing
December 2018
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Expansion Of Telestroke Services Improves Quality Of Care Provided In Super Rural Areas.

Health Aff (Millwood) 2018 Dec;37(12):2005-2013

Matthew D. Ritchey is a senior scientist in the Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention.

Telestroke is a telemedicine intervention that facilitates communication between stroke centers and lower-resourced facilities to optimize acute stroke management. Using administrative claims data, we assessed trends in telestroke use among fee-for-service Medicare beneficiaries with acute ischemic stroke and the association between providing telestroke services and intravenous tissue plasminogen activator (IV tPA) and mechanical thrombectomy use, mortality, and medical expenditures, by urban versus rural county of residence in the period 2008-15. The proportion of ischemic stroke cases receiving telestroke increased from 0. Read More

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http://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05089
Publisher Site
http://dx.doi.org/10.1377/hlthaff.2018.05089DOI Listing
December 2018
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