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Cost-Benefit Analysis of Robotic vs. Laparoscopic Hepatectomy: A Propensity-Matched Retrospective Cohort Study of American College of Surgeons National Surgical Quality Improvement Program Database.

Am Surg 2021 Apr 16:31348211011124. Epub 2021 Apr 16.

Department of Surgery, Cooper University Hospital, Camden, NJ, USA.

Background: Robotic and laparoscopic hepatectomies having increased utilization as minimally invasive techniques are explored for hepatobiliary malignancies. Although the data on outcomes from these 2 approaches are emerging, the cost-benefit analysis of these approaches remains sparse. This study compares the costs associated with robotic vs. Read More

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Risk Factors for Infection and Revision Surgery following Patellar Tendon and Quadriceps Tendon Repairs: An Analysis of 3,442 Patients.

J Knee Surg 2021 Apr 14. Epub 2021 Apr 14.

Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia.

Disruption of the extensor mechanism is debilitating with surgical repair being the accepted treatment. The incidence of infection and reoperation after extensor mechanism repair are not well reported in the literature. Thus, the objective of the current study was to (1) determine the incidence of surgical site infection and reoperation within 1 year of primary extensor mechanism repair and (2) identify independent risk factors for infection and reoperation following patellar and quadriceps tendon repair. Read More

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Use of Functional Rhinoplasty in the Aging Nose: Medicare Database Analysis.

Facial Plast Surg Aesthet Med 2021 Apr 13. Epub 2021 Apr 13.

Department of Otolaryngology - Head and Neck Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA.

Nasal obstruction is a common clinical problem. It has become more recognized that the internal and external nasal valves are the areas of greatest resistance. There are changes with aging that can contribute to nasal valve compromise. Read More

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What's Wrong with this Picture? A Critical Review of Current CMS Coverage Criteria for CGM.

Diabetes Technol Ther 2021 Apr 12. Epub 2021 Apr 12.

Washington University in Saint Louis, 7548, 660 S. Euclid, Campus Box 8127, Saint Louis, Missouri, United States, 63130-4899;

Numerous studies have demonstrated the clinical value of CGM in type 1 diabetes (T1D) and type 2 diabetes (T2D) populations. However, the eligibility criteria for CGM coverage required by the Centers for Medicare & Medicaid Services (CMS) ignores conclusive evidence that supports CGM use in various diabetes populations that are currently deemed ineligible. This article discusses the limitations and inconsistencies of the CMS eligibility criteria relative to current scientific evidence and proposes workable solutions to address this issue and improve the safety and care of all individuals with diabetes. Read More

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Understanding the evolution of coverage policies for prophylaxis treatments of hemophilia A without inhibitors: a payer Delphi panel.

J Manag Care Spec Pharm 2021 Apr 12:1-13. Epub 2021 Apr 12.

PRECISIONheor, Los Angeles, CA.

The landscape for hemophilia A prophylaxis is rapidly expanding from factor VIII replacement therapy to include novel treatments such as nonfactor replacement therapies that may enhance coagulation (e.g., emicizumab) or inhibit anticoagulant pathways (e. Read More

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Financial Burden of Revision Hip and Knee Arthroplasty at an Orthopedic Specialty Hospital: Higher Costs and Unequal Reimbursements.

J Arthroplasty 2021 Mar 23. Epub 2021 Mar 23.

Department of Orthopedic Surgery, New England Baptist Hospital, Boston, MA.

Background: As demand for primary total joint arthroplasty (TJA) continues to grow, a proportionate increase in revision TJA (rTJA) is expected. It is essential to understand costs and reimbursement of rTJA as our country moves to bundled payment models. We aimed (1) to characterize implant and total hospital costs, (2) assess reimbursement, and (3) determine revenue for rTJA in comparison with primary TJA. Read More

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Trends in Emergency Department Utilization Among Women With Leiomyomas in the United States.

Obstet Gynecol 2021 Apr 8. Epub 2021 Apr 8.

Division of Reproductive Endocrinology and Infertility and the Division of Gynecology, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, and the Department of Emergency Medicine, Henry Ford Hospital, Detroit, Michigan.

Objective: To describe trends in emergency department (ED) visits in the United States with a primary diagnosis of leiomyomas, subsequent admissions, and associated charges.

Methods: The Healthcare Cost and Utilization Project Nationwide Emergency Department Sample database was used to retrospectively identify all ED visits from 2006 to 2017 among women aged 18-55 years with a primary diagnosis of leiomyomas as indicated by International Classification of Diseases (ICD) diagnosis codes. Trends in ED visits and subsequent admissions were analyzed and stratified by patient and hospital characteristics. Read More

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Service Availability in Assisted Living and Other Community-Based Residential Settings at the End of Life.

J Palliat Med 2021 Apr 7. Epub 2021 Apr 7.

Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Community-based residential settings (e.g., assisted living facilities and retirement communities), are increasing, where vulnerable older adults are living as they age and die. Read More

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Bereavement Support Services in a National Sample of Hospices: A Content Analysis.

Omega (Westport) 2021 Apr 6:30222821997602. Epub 2021 Apr 6.

115980University of Maryland School of Social Work, Baltimore, MD, United States.

Although the Medicare Hospice Benefit mandates that hospices offer bereavement support services to families for at least 1 year following the death of a patient, it does not stipulate which services they should offer. As a result, little is known about what bereavement support services hospices provide, especially on a national scale. The current study recruited a national sample of hospice representatives who responded to an open-ended question that asked, "What types of bereavement support services does your hospice provide to families?" Seventy-six viable responses were recorded and content analyzed. Read More

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Projections of the Impact to Arthroplasty Surgeons With Changes to the 2021 Medicare Physician Fee Schedule-A Looming Crisis of Access to Care?

J Arthroplasty 2021 Mar 11. Epub 2021 Mar 11.

Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA.

Background: The Centers for Medicare and Medicaid Services 2021 Physician Fee Schedule (PFS) includes increases in office reimbursement but decreases in the valuation of total hip arthroplasty and total knee arthroplasty and the conversion factor. The purpose of this study was to determine the financial impact of these changes on arthroplasty surgeons.

Methods: We queried data for 35 arthroplasty surgeons within our practice from 10/2019 to 10/2020 and captured all office and arthroplasty-related surgical procedure codes. Read More

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Transplant Administration- A Survey of the Roles and Responsibilities of Kidney and Pancreas Medical Directors of U.S Transplant Centers.

Clin Transplant 2021 Apr 2:e14305. Epub 2021 Apr 2.

Centura Transplant, Denver, CO, USA.

The current American Society of Transplantation (AST) accredited transplant fellowship programs in the U.S. provide no structured formal training in leadership and administration which is essential for successfully running a transplant program. Read More

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Current and Future Status of Merit-Based Incentive Payment Systems.

Urol Clin North Am 2021 May 12;48(2):259-268. Epub 2021 Mar 12.

The Icahn School of Medicine at Mount Sinai, New York, NY, USA.

The Quality Payment Program was established by the Medicare Access and CHIP Reauthorization Act (MACRA) legislation in response to repeated efforts to create a permanent so-called doc fix in response to the failures of the sustainable growth formula. This article examines the history leading up to MACRA, the current pathways associated with the Quality Payment Program, and future expectation both from the Centers for Medicare and Medicaid Services, stakeholders, and patients. Read More

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The Association of Nursing Home Characteristics and Quality With Adverse Events After a Hospitalization.

J Am Med Dir Assoc 2021 Mar 27. Epub 2021 Mar 27.

University of Massachusetts Medical School, Worcester, MA, USA; Meyers Primary Care Institute, Worcester, MA, USA.

Background/objectives: We previously found high rates of adverse events (AEs) for long-stay nursing home residents who return to the facility after a hospitalization. Further evidence about the association of AEs with aspects of the facilities and their quality may support quality improvement efforts directed at reducing risk.

Design: Prospective cohort analysis. Read More

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Operative times in primary total hip arthroplasty will remain stable up to the year 2027: prediction models based on 85,808 cases.

Eur J Orthop Surg Traumatol 2021 Mar 30. Epub 2021 Mar 30.

Center for Hip Preservation, Department of Orthopaedic Surgery, Orthopaedic and Rheumatologic Institute, Cleveland Clinic, 9500 Euclid Avenue, Mailcode A41, Cleveland, OH, 44195, USA.

Purpose: Recently, the Centers for Medicare and Medicaid have announced the decision to review "potentially misvalued" Current Procedural Terminology codes, including those for primary total hip arthroplasty (THA). While recent studies have suggested that THA operative times have remained stable in recent years, there is an absence of information regarding how operative times are expected to change in the future. Therefore, the purpose of our analysis was to produce 2- and 10-year prediction models developed from contemporary operative time data. Read More

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Cancer diagnoses and survival rise as 65-year-olds become Medicare-eligible.

Cancer 2021 Mar 29. Epub 2021 Mar 29.

Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California.

Background: A Medicare effect has been described to account for increased health care utilization occurring at the age of 65 years. The existence of such an effect in cancer care, where it would be most likely to reduce mortality, has been unclear.

Methods: Patients aged 61 to 69 years who were diagnosed with lung, breast, colon, or prostate cancer from 2004 to 2016 were identified with the Surveillance, Epidemiology, and End Results database and were dichotomized on the basis of eligibility for Medicare (61-64 vs 65-69 years). Read More

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Influenza vaccination rates and location for receiving the influenza vaccination among older adult Medicare beneficiaries.

J Am Pharm Assoc (2003) 2021 Feb 27. Epub 2021 Feb 27.

Objectives: The objectives of this study were to (1) assess the trends in older adult influenza vaccination rates and (2) locations at which U.S. older adults received influenza vaccinations for the 2008-2009 to 2017-2018 influenza seasons, and (3) compare the estimates of influenza vaccination rates and locations with the estimates from other sources reported previously. Read More

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February 2021

Impact of iStent Micro-Bypass Shunt on Medicare Part B Glaucoma Surgical Expenditure.

Ophthalmol Glaucoma 2021 Mar-Apr;4(2):131-138. Epub 2020 May 22.

Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut. Electronic address:

Purpose: To examine the impact of the iStent (Glaukos) on the recent glaucoma surgical expenditure for Medicare Part B beneficiaries.

Design: Retrospective, observational, population-based analysis.

Participants: All applicable cases in the Centers for Medicare and Medicaid Services Part B Summary Data Files. Read More

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Inflation-Adjusted Medicare Reimbursement for Revision Hip Arthroplasty: Study Showing Significant Decrease from 2002 to 2019.

J Bone Joint Surg Am 2021 Mar 25. Epub 2021 Mar 25.

Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.

Background: Investigations into reimbursement trends for primary and revision arthroplasty procedures have demonstrated a steady decline over the past several years. Revision total hip arthroplasty (rTHA) due to infection (rTHA-I) has been associated with higher resource utilization and complexity, but long-term inflation-adjusted data have yet to be compared between rTHA-I and rTHA due to aseptic complications (rTHA-A). The present study was performed to analyze temporal reimbursement trends regarding rTHA-I procedures compared with those for rTHA-A procedures. Read More

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Trends in the utilization and reimbursement of coronary revascularization in the United States Medicare population from 2010 to 2018.

Catheter Cardiovasc Interv 2021 Mar 24. Epub 2021 Mar 24.

Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.

Objective: To determine utilization and reimbursement trends of coronary revascularization procedures in the US Medicare population from 2000 to 2018.

Background: US Medicare population is increasing, and coronary revascularization decreased in the 2000s.

Methods: This is a population-based, cross sectional study of US Medicare beneficiaries from 2010 to 2018. Read More

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Utilization and Availability of Advanced Imaging in Patients With Acute Ischemic Stroke.

Circ Cardiovasc Qual Outcomes 2021 Mar 24:CIRCOUTCOMES120006989. Epub 2021 Mar 24.

Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston. (Y.K., S.L., R.A., V.L.-R., S.I.S., A.C., L.D.M., S.A.S.).

Background: Recent clinical trials have established the efficacy of endovascular stroke therapy and intravenous thrombolysis using advanced imaging, particularly computed tomography perfusion (CTP). The availability and utilization of CTP for patients and hospitals that treat acute ischemic stroke (AIS), however, is uncertain.

Methods: We performed a retrospective cross-sectional analysis using 2 complementary Medicare datasets, full sample Texas and 5% national fee-for-service data from 2014 to 2017. Read More

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Total Margin-Controlled Excision is Superior to Standard Excision for Keratinocyte Carcinoma on the Nose: A Veterans Affairs Nested Cohort Study.

Ann Surg Oncol 2021 Mar 19. Epub 2021 Mar 19.

Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Background: Keratinocyte carcinoma (KC), including basal and squamous cell carcinoma, is the most common human malignancy. Limited real-world data have compared surgical outcome or cost between total margin-controlled excision (TMCE) and standard excision (SE), the two most common treatments for invasive KC. We compared reconstruction, margin status, and cost between TMCE and SE for KC on the nose at a Veterans Affairs (VA) healthcare system. Read More

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What is the societal economic cost of poor oral health among older adults in the United States? A scoping review.

Gerodontology 2021 Mar 14. Epub 2021 Mar 14.

Department of Epidemiology and Health Promotion, College of Dentistry, New York University, New York, NY, USA.

Objective: To assess the state of the literature in the United States quantifying the societal economic cost of poor oral health among older adults.

Background: Proponents of a Medicare dental benefit have argued that addressing the growing need for dental care among the US older adult population will decrease costs from systemic disease and other economic costs due to oral disease. However, it is unclear what the current economic burden of poor oral health among older adults is in the United States. Read More

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Economic impact of orthopaedic care for non-fatal gunshot wounds: analysis of a public health crisis.

Ann Transl Med 2021 Feb;9(3):210

Department of Orthopedic Surgery, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, USA.

Background: The purpose of this study was to perform an epidemiological evaluation and an economic analysis of 90-day costs associated with non-fatal gunshot wounds (GSWs) to the extremities, spine and pelvis requiring orthopaedic care in the United States.

Methods: A retrospective epidemiological review of the Medicare national patient record database was conducted from 2005 to 2014. Incidence, fracture location and costs associated where evaluated. Read More

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February 2021

Plasma ω-3 and ω-6 PUFA Concentrations and Risk of Atrial Fibrillation: The Multi-Ethnic Study of Atherosclerosis.

J Nutr 2021 Mar 9. Epub 2021 Mar 9.

Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA.

Background: Current literature examining the prospective relation of circulating omega-3 (n-3) and omega-6 (n-6) PUFAs and atrial fibrillation (AF) is limited to predominantly white populations.

Objectives: We investigated the association of circulating n-3 and n-6 PUFAs with incident AF in participants from the Multi-Ethnic Study of Atherosclerosis.

Methods: A total of 6229 participants (mean age = 62 y; 53% female; 39% white, 27% black, 22% Hispanic, and 12% Chinese) who were free of baseline AF and with plasma phospholipid PUFAs measured at baseline using GC were prospectively followed for the development of AF. Read More

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Role and Growth of Independent Medicare-Billing Otolaryngologic Advanced Practice Providers.

Otolaryngol Head Neck Surg 2021 Mar 9:194599821994820. Epub 2021 Mar 9.

Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA.

Objective: To evaluate the role and growth of independently billing otolaryngology (ORL) advanced practice providers (APPs) within a Medicare population.

Study Design: Retrospective cross-sectional study.

Setting: Medicare Provider Utilization and Payment Data: Physician and Other Supplier Data Files, 2012-2017. Read More

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US Antiarrhythmic Drug Treatment for Patients With Atrial Fibrillation: An Insurance Claims-Based Report.

J Am Heart Assoc 2021 Mar 9;10(6):e016792. Epub 2021 Mar 9.

Creighton University School of Medicine and CHI Heart Institute Omaha NE.

Background Current American Heart Association/American College of Cardiology/Heart Rhythm Society guidelines and European Society of Cardiology guidelines recommend antiarrhythmic drugs (AADs) for maintenance of sinus rhythm in patients with atrial fibrillation. We assessed the concordance between healthcare provider real-world practice and current guidelines with respect to first-line AAD rhythm management. Methods and Results Administrative claims data from the deidentified Optum Clinformatics Data Mart database were used. Read More

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Cost-effectiveness analysis of radiotherapy techniques for whole breast irradiation.

PLoS One 2021 8;16(3):e0248220. Epub 2021 Mar 8.

Medical Physics Program, Department of Physics and Astronomy, Louisiana State University, Baton Rouge, Louisiana, United States of America.

Background: The current standard of care (SOC) for whole breast radiotherapy (WBRT) in the US is conventional tangential photon fields. Advanced WBRT techniques may provide similar tumor control and better normal tissue sparing, but it is controversial whether the medical benefits of an advanced technology are significant enough to justify its higher cost.

Objective: To analyze the cost-effectiveness of six advanced WBRT techniques compared with SOC. Read More

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Resuming Elective Surgery during Covid-19: Can Inpatient Hospitals Collaborate with Ambulatory Surgery Centers?

Plast Reconstr Surg Glob Open 2021 Feb 18;9(2):e3442. Epub 2021 Feb 18.

Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, Mich.

Little is known about the volume and scope of surgical procedures performed in ambulatory surgery centers (ASCs) and the resources that ASCs may provide to assist local health systems. The purpose of this study was to evaluate elective surgical procedures in the inpatient and outpatient ASC setting using currently available administrative claims data.

Methods: We used the 2019 Medicare Point of Service (POS) file to evaluate the geographic distribution of Medicare-certified ASCs in the U. Read More

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February 2021

Value of Dermatology Nights at a student-run free clinic.

Proc (Bayl Univ Med Cent) 2020 Oct 26;34(2):260-261. Epub 2020 Oct 26.

Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, Texas.

The Free Clinic at Lubbock Impact is a student-run free clinic affiliated with the Texas Tech University Health Sciences Center in Lubbock, Texas. Every Wednesday, the clinic provides free health services to the uninsured patient population of Lubbock and the surrounding West Texas regions. In addition to the weekly essential primary care services, "Dermatology Night" is held once a month for patients in need of dermatologic care. Read More

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October 2020