Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Automated text messaging is a promising approach to monitor patients after hospital discharge and avert readmissions; however, it is not known to what extent patients would engage with this type of program and whether engagement may vary based on patients' characteristics. Using data from a 30-day postdischarge texting program at a large university hospital, we examined engagement over time (operationalized as response rate to text messages) and patient characteristics associated with engagement. ⋯ Patients who were male (p < .05), were Black/African American (p < .001), had lower health literacy (p < .01), or had not recently logged into the patient portal (p < .001), all had lower response rates. Results support closer examinations of patient engagement in hospital-based texting programs and who is positioned to benefit.
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Medicare previously announced plans for new billing reforms for inpatient visits that are shared by physicians and advanced practice providers (APPs) whereby the clinician spending the most time on the patient visit would bill for the visit. ⋯ Physician and APP collaborative care models are increasingly evolving to independent visits often driven by workloads, financial drivers, and local regulations such as medical staff rules and hospital bylaws. Understanding which staffing models produce optimal patient, clinician, and organizational outcomes should inform billing policies rather than the reverse.