JAMA internal medicine
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JAMA internal medicine · Sep 2017
Randomized Controlled TrialEffects of an Intervention to Reduce Hospitalizations From Nursing Homes: A Randomized Implementation Trial of the INTERACT Program.
Medicare payment initiatives are spurring efforts to reduce potentially avoidable hospitalizations. ⋯ Training and support for INTERACT implementation as carried out in this study had no effect on hospitalization or ED visit rates in the overall population of residents in participating NHs. The results have several important implications for implementing quality improvement initiatives in NHs.
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JAMA internal medicine · Sep 2017
Randomized Controlled TrialImproving Adherence to Long-term Opioid Therapy Guidelines to Reduce Opioid Misuse in Primary Care: A Cluster-Randomized Clinical Trial.
Prescription opioid misuse is a national crisis. Few interventions have improved adherence to opioid-prescribing guidelines. ⋯ A multicomponent intervention improved guideline-concordant care but did not decrease early opioid refills.
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JAMA internal medicine · Sep 2017
Physician Reimbursement in Medicare Advantage Compared With Traditional Medicare and Commercial Health Insurance.
Nearly one-third of Medicare beneficiaries are enrolled in a Medicare Advantage (MA) plan, yet little is known about the prices that MA plans pay for physician services. Medicare Advantage insurers typically also sell commercial plans, and the extent to which MA physician reimbursement reflects traditional Medicare (TM) rates vs negotiated commercial prices is unclear. ⋯ Traditional Medicare's administratively set rates act as a strong anchor for physician reimbursement in the MA market, although MA plans succeed in negotiating lower prices for other health care services for which TM overpays. Reforms that transition the Medicare program toward some premium support models could substantially affect how physicians and other clinicians are paid.