45,435 results match your criteria reimbursement

Therapeutic review of cabotegravir/rilpivirine long-acting antiretroviral injectable and implementation considerations at an HIV specialty clinic.

Pharmacotherapy 2021 Jun 15. Epub 2021 Jun 15.

Indiana University Health, Indianapolis, Indiana, USA.

Cabotegravir/rilpivirine (CAB/RPV) was recently approved by the US Food and Drug Administration (FDA) as the first complete parenteral antiretroviral (ART) regimen for treatment of people living with HIV (PLWH). As a monthly intramuscular (IM) injection, this therapy constitutes a major departure from the traditional paradigm of oral therapy requiring (at least) daily administration that has defined HIV treatment for decades. Composed of a second-generation integrase inhibitor (INSTI) and nonnucleoside reverse transcriptase inhibitor (NNRTI), CAB/RPV has achieved high rates of sustained virologic suppression with a favorable safety profile for treatment-experienced PLWH following oral lead-in (OLI) during several clinical trials. Read More

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From hospital unit to intestinal failure center: Twenty years of history.

Clin Nutr 2021 Apr 27;40(6):3787-3792. Epub 2021 Apr 27.

Department of Clinical Nursing, Institute of Nursing and Midwifery, Faculty of Health Care, Jagiellonian University, Krakow, Poland.

Aim: Home parenteral nutrition (HPN) is one of the most demanding medical therapies as it is the only option for patients for intestinal failure (IF). No unequivocal policy on how to start and progress with HPN has ever been presented. The IF Center at the Stanley Dudrick's Memorial Hospital in Skawina is one of the biggest centers in Poland, celebrating its twentieth birthday last year. Read More

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Precision cancer medicine: What has translated into clinical use in Belgium?

Semin Cancer Biol 2021 Jun 12. Epub 2021 Jun 12.

Cancer Center, Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.

Rationale: In 2016, Belgium launched the Next Generation Sequencing (NGS) Roadbook, consisting in 10 Actions, across the health care system, to facilitate the uptake of NGS in routine clinical practice. We compiled feedback on deployment of the NGS Roadbook from governmental stakeholders and beneficiaries: health policy makers, insurance providers, pathologists, geneticists, and oncologists.

Main Findings: The Roadbook ensured the establishment of a Commission on Personalized Medicine and NGS testing guidelines. Read More

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Positioning the National Health Insurance for financial sustainability and Universal Health Coverage in Ghana: A qualitative study among key stakeholders.

PLoS One 2021 15;16(6):e0253109. Epub 2021 Jun 15.

Department of Health Policy Planning and Management, School of Public Health, University of Ghana, Legon, Accra.

Introduction: The National Health Insurance Scheme (NHIS) was introduced in 2003 to reduce "out-of-pocket" payments for health care in Ghana. Over a decade of its implementation, issues about the financial sustainability of this pro-poor policy remains a crippling fact despite its critical role to go towards Universal Health Coverage. We therefore conducted this study to elicit stakeholders' views on ways to improve the financial sustainability of the operations of NHIS. Read More

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Cost-Effectiveness Analysis of Adjuvant Therapy for BRAF-Mutant Resected Stage III Melanoma in Medicare Patients.

Ann Surg Oncol 2021 Jun 15. Epub 2021 Jun 15.

Department of Surgery, Division of Biological Sciences, The University of Chicago, Chicago, IL, USA.

Background: Adjuvant therapy for stage III melanoma improves several measures of patient survival. However, decisions regarding inclusion of adjuvant therapies in the formularies of public payers necessarily consider the cost-effectiveness of those treatments. The objective of this study is to evaluate the cost-effectiveness of four recently approved adjuvant therapies for BRAF-mutant stage III melanoma in the Medicare patient population. Read More

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[Mutational oncology of lung cancer: molecular markers, drugs, negotiation conditions and experiences in national reference centers.]

Recenti Prog Med 2021 Jun;112(6):419-437

Drugs and Health srl, Roma.

The gradual availability of genomic profiling tests and the "agnostic approvals" from FDA and EMA have opened the oncology mutational model phase, which complements and integrates the traditional hystological approach. The non-small-cell lung cancer (NSCLC) is characterized by many molecular alterations and represents the need of a change from the traditional diagnostic, therapeutic and organisational paradigms to the "mutational" ones. From the Italian National Healthcare System point of view, access and reimbursement of drugs based on the hystological model were managed thorugh the Italian Medicines Agency's (AIFA) monitoring registries and the managed entry agreements: risk-sharing, cost-sharing and payment by results. Read More

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Conditions and barriers for quality improvement work: a qualitative study of how professionals and health centre managers experience audit and feedback practices in Swedish primary care.

BMC Fam Pract 2021 Jun 14;22(1):113. Epub 2021 Jun 14.

Lund University School of Economics & Management, Lund, Sweden.

Background: High quality primary care is expected to be the basis of many health care systems. Expectations on primary care are rising as societies age and the burden of chronic disease grows. To stimulate adherence to guidelines and quality improvement, audit and feedback to professionals is often used, but the effects vary. Read More

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Preferences for long-term care insurance in China: Results from a discrete choice experiment.

Soc Sci Med 2021 Jun 5;281:114104. Epub 2021 Jun 5.

Heidelberg Institute of Global Health, Heidelberg University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Germany.

Rapid population aging has led countries to consider the introduction of long-term care insurance (LTCI) as an essential component of a comprehensive social health protection package. Limited evidence, however, exists on people's preferences for such insurance products, especially in countries where their availability is still restricted. Using a discrete choice experiment (DCE), we investigated preferences, willingness to pay, and heterogeneity in preferences for attributes of a social LTCI among community members in China. Read More

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Gun Violence and Firearm Injuries in West Michigan: Targeting Prevention.

West J Emerg Med 2021 May 19;22(3):488-497. Epub 2021 May 19.

University of Michigan, Department of Urology, Ann Arbor, Michigan.

Introduction: Firearm-related deaths and injuries are ongoing public health issues in the United States. We reviewed a series of gun violence- and firearm-related injuries treated at a multi-campus community healthcare system in West Michigan to better understand the demographic and clinical characteristics of these injuries. We also studied hospital charges, and payers responsible, in an effort to identify stakeholders and opportunities for community- and hospital-based prevention. Read More

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Case Report: Clinical Experience With Avelumab in Patients With Metastatic Merkel Cell Carcinoma and Brain Metastases Treated in Europe.

Front Oncol 2021 28;11:672021. Epub 2021 May 28.

Candiolo Cancer Institute, FPO - IRCCS, Candiolo, Italy.

Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer that can metastasize rapidly. In patients with metastatic MCC (mMCC), brain metastases are uncommon but are associated with poor prognosis; furthermore, there is limited published literature regarding treatment of these patients, and no specific regimens are currently recommended by guidelines. Avelumab, an anti-programmed death ligand 1 monoclonal antibody, was the first approved treatment for patients with mMCC. Read More

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A Clinical Decision-Making Framework for the Use of Video Gaming as a Therapeutic Modality.

Front Neurol 2021 28;12:610095. Epub 2021 May 28.

School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.

Virtual reality and video gaming offer modulation of more exercise and motor learning parameters simultaneously than other modalities; however, there is a demonstrated need for resources to facilitate their effective use clinically. This article presents a conceptual framework to guide clinical-decision making for the selection, adaptation, modulation, and progression of virtual reality or gaming when used as a therapeutic exercise modality, and two cases as exemplars. This framework was developed by adapting the steps of theory derivation, whereby concepts and parent theories are brought together to describe a new structure or phenomenon of interest. Read More

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Contemporary pure laparoscopic vs robotic assisted laparoscopic radical nephrectomy: Is the transition worth it?

J Endourol 2021 Jun 13. Epub 2021 Jun 13.

Washington University in Saint Louis School of Medicine, 12275, Urologic Surgery, 4960 Children's place, Saint Louis, Missouri, United States, 63110.

Introduction The proportion of robotic procedures continues to rise. The literature reinforces that robotic procedures take longer and are often more costly. We compared cost and peri-operative outcomes of laparoscopic radical nephrectomy (LRN) and robotic assisted radical nephrectomy (RARN) at our high-volume center. Read More

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Monitoring outpatient antibiotic utilization using reimbursement and retail sales data: a population-based comparison in France, 2012-17.

J Antimicrob Chemother 2021 Jun 13. Epub 2021 Jun 13.

Université de Paris, Epidemiology and Statistics Research Center-CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology research team, F-75004, Paris, France.

Objectives: To assess whether a retail sales database could be used to monitor antibiotic utilization in the outpatient setting at the national level.

Methods: We extracted 2012-17 outpatient antibiotic extrapolated retail sales (IQVIA's Xponent) and reimbursement data from the National Health Insurance (SNDS) in metropolitan France. We compared estimates of antibiotic use and consumption [number of antibiotic drug deliveries (DrID) and defined daily doses (DID) per 1000 inhabitants per day]. Read More

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The impact of additional payments on functional decline among long-term care health facility residents in Japan.

Age Ageing 2021 Jun 11. Epub 2021 Jun 11.

Department of Clinical Epidemiology and Health Economics, School of Public Health, Graduate School of Medicine, University of Tokyo, Tokyo City, Japan.

Background: Additional payment approach has been one of the most important incentives in long-term care (LTC) systems for the past 20 years in Japan.

Objective: To estimate the effect of additional payments on functional decline in long-term care health facility (LTCHF) residents of Japan.

Design: A 24-month retrospective cohort study. Read More

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Determining Cost-Optimal Next-Generation Sequencing Panels for Rare Disease and Pharmacogenomics Testing.

Clin Chem 2021 Jun 13. Epub 2021 Jun 13.

Strand Life Sciences, Bengaluru, India.

Background: Multi-gene panel sequencing using next-generation sequencing (NGS) methods is a key tool for genomic medicine. However, with an estimated 140 000 genomic tests available, current system inefficiencies result in high genetic-testing costs. Reduced testing costs are needed to expand the availability of genomic medicine. Read More

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Coverage with evidence development schemes for medical devices in Europe: characteristics and challenges.

Eur J Health Econ 2021 Jun 12. Epub 2021 Jun 12.

Centre for Health Economics, University of York, York, UK.

Objectives: Medical devices are potentially good candidates for coverage with evidence development (CED) schemes, as clinical data at market entry are often sparse and (cost-)effectiveness depends on real-world use. The objective of this research was to explore the diffusion of CED schemes for devices in Europe, and the factors that favour or hamper their utilization.

Methods: We conducted structured interviews with 25 decision-makers from 22 European countries to explore the characteristics of existing CED programmes for devices, and how decision makers perceived 13 pre-identified challenges associated with initiating and operating CED schemes for devices. Read More

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How does artificial intelligence in radiology improve efficiency and health outcomes?

Pediatr Radiol 2021 Jun 12. Epub 2021 Jun 12.

Department of Medical Imaging, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.

Since the introduction of artificial intelligence (AI) in radiology, the promise has been that it will improve health care and reduce costs. Has AI been able to fulfill that promise? We describe six clinical objectives that can be supported by AI: a more efficient workflow, shortened reading time, a reduction of dose and contrast agents, earlier detection of disease, improved diagnostic accuracy and more personalized diagnostics. We provide examples of use cases including the available scientific evidence for its impact based on a hierarchical model of efficacy. Read More

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Value-Based Purchasing Programs (VBPs): Are the Quality Measures Used "Fit for Purpose"?

Am J Med Qual 2021 Jun 10. Epub 2021 Jun 10.

Independent Healthcare Consultant, Monkton, MD Part-Time Associate Professor, Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD.

Quality measurement is an intrinsic component of value-based purchasing, yet the quality measures currently in use for Value-Based Purchasing Programs (VBPs) are generally derived from a potpourri of measures originally built for other purposes. Only a handful of VBPs have definitively shown savings or expanded nationally. We suggest that to shift the health care reimbursement system in the United States to paying for value, quality measures used in VBPs should be vetted as "fit for purpose. Read More

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Current practices in the instruction of lifestyle medicine in medical curricula.

Patient Educ Couns 2021 Jun 2. Epub 2021 Jun 2.

College of Medicine, University of Central Florida, Orlando, USA.

Objective: A review of current practices of educational interventions for lifestyle medicine was performed to inform the design of interventions with long-term goals of improving patient outcomes.

Methods: Systematic review of PubMed, MedEdPORTAL, and Cochrane using keywords "lifestyle medicine," "education," "medical students," and "medical school" was done by 3 independent reviewers. Location, learner, curricular hours, focus, outcomes, and impact are reported. Read More

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Test it earlier, result it faster, makes us stronger: how rapid viral diagnostics enable therapeutic success.

Curr Opin Virol 2021 Jun 8;49:111-116. Epub 2021 Jun 8.

Department of Laboratory Medicine and Pathology, University of Washington Medical Center, Seattle, WA, United States; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States. Electronic address:

The COVID-19 pandemic has entailed simultaneous revolutions in virology diagnostics, clinical trials management, and antiviral therapy and vaccinology. Over the past year, SARS-CoV-2 diagnostic testing has moved from highly centralized laboratories to at-home and even over the-counter. This transition has been lionized for its potential public health impact via isolation, but has been less examined for its effect on individual health and therapeutics. Read More

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A Fast-track Pathway for Emergency General Surgery at an Academic Medical Center.

J Surg Res 2021 Jun 8;267:1-8. Epub 2021 Jun 8.

Department of Surgery, University of Massachusetts Medical School, Worcester, Massachusetts. Electronic address:

Background: Fast Track Pathways (FTP) directed at reducing length of stay (LOS) and overall costs are being increasingly implemented for emergency surgeries. The purpose of this study is to evaluate implementation of a FTP for Emergency General Surgery (EGS) at an academic medical center (AMC).

Methods: The study included 165 patients at an AMC between 2016 and 2018 who underwent laparoscopic appendectomy (LA), laparoscopic cholecystectomy (LC), or laparoscopic inguinal hernia repair (LI). Read More

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Trends in Patch Testing in the Medicare Part B Fee-for-Service Population.

Dermatitis 2021 Jun 9. Epub 2021 Jun 9.

From the University of Minnesota Medical School Biostatistical Design and Analysis Center, Clinical and Translational Science Institute Division of Healthy Policy and Management, School of Public Health, University of Minnesota Department of Dermatology, University of Minnesota, Minneapolis Veterans Affairs Health Care System Departments of Medicine Dermatology, University of Minnesota Departments of Medicine Dermatology, Minneapolis Veterans Affairs Health Care System, MN.

Background: Patch testing is a vital component of the workup for allergic contact dermatitis. There are limited data on changes of patch testing use among Medicare providers, as well as patch testing reimbursement rates.

Objective: The aim of the study was to evaluate trends in the use of patch testing among various Medicare providers and Medicare patch testing reimbursement. Read More

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Musculoskeletal Urgent Care Centers Restrict Access for Patients with Medicaid Insurance Based on Policy and Location.

Clin Orthop Relat Res 2021 06 11. Epub 2021 Jun 11.

D. Wiznia, Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA.

Background: As the urgent care landscape evolves, specialized musculoskeletal urgent care centers (MUCCs) are becoming more prevalent. MUCCs have been offered as a convenient, cost-effective option for timely acute orthopaedic care. However, a recent "secret-shopper" study on patient access to MUCCs in Connecticut demonstrated that patients with Medicaid had limited access to these orthopaedic-specific urgent care centers. Read More

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Equal Pay for Equal Screening: Impact of Patient and Provider Gender on Reimbursement for Screening Colonoscopy.

Dig Dis Sci 2021 Jun 10. Epub 2021 Jun 10.

Division of Digestive Diseases, Rush University Medical Center, 1725 W Harrison St Suite 207, Chicago, IL, 60612, USA.

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Gender Differences in Colonoscopy: Implications for Clinical Practice and Female Gastroenterologists.

Dig Dis Sci 2021 Jun 10. Epub 2021 Jun 10.

Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, USA.

Background And Aims: Performing colonoscopy can be technically challenging in female patients. Female patients may prefer having a female endoscopist. This preference, coupled with the fact that there are fewer female endoscopists, may result in gender differences in colonoscopy practice. Read More

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The association between hospital care transition planning and timely primary care follow-up.

J Rural Health 2021 Jun 10. Epub 2021 Jun 10.

College of Business, Healthcare Administration, University of Houston Clear Lake, Houston, Texas, USA.

Purpose: To determine whether Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Care Transitions (CTM-3) Scores were associated with timely (14-day) primary care provider (PCP) follow-up visits, and to look for disparities across various types of urban and rural hospitals.

Methods: Data were obtained for 3,299 hospitals: 2,000 urban, 544 micropolitan prospective payment system (PPS), 109 micropolitan critical access hospital (CAH), 252 noncore rural PPS, and 394 noncore rural CAH. HCAPPS data were drawn from CMS Hospital Compare (2015). Read More

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Commentary on Avalone et al.: "Reimbursement for Telepsychiatry: Permanent Changes Are Needed".

Peter Yellowlees

Psychiatr Serv 2021 Jun;72(6):724-725

Department of Psychiatry and Behavioral Sciences, University of California Davis Health, Sacramento.

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Analysis of Postpartum Uptake of Long-Acting Reversible Contraceptives Before and After Implementation of Medicaid Reimbursement Policy.

Matern Child Health J 2021 Jun 9. Epub 2021 Jun 9.

Department of Gynecology and Obstetrics, Jane Fonda Center for Adolescent Reproductive Health, Emory University School of Medicine, 46 Armstrong Street SE, Atlanta, GA, 30303, USA.

Objectives: The postpartum period is a time of high unmet contraception need. Providing long-acting reversible contraception (LARC), particularly in the immediate postpartum period, is one strategy to meet contraceptive needs. This practice may also prevent unintended and short interpregnancy interval pregnancies. Read More

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Distributed education enables distributed economic impact: the economic contribution of the Northern Ontario School of Medicine to communities in Canada.

Health Econ Rev 2021 Jun 9;11(1):20. Epub 2021 Jun 9.

Professor of Rural Health, and Founding Dean Emeritus, Northern Ontario School of Medicine, 935 Ramsey Lake Road, Greater Sudbury, Ontario, P3E 2C6, Canada.

Background: Medical schools with distributed or regional programs encourage people to live, work, and learn in communities that may be economically challenged. Local spending by the program, staff, teachers, and students has a local economic impact. Although the economic impact of DME has been estimated for nations and sub-national regions, the community-specific impact is often unknown. Read More

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