JAMA internal medicine
-
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.
-
JAMA internal medicine · Sep 2017
A Research Agenda for Communication Between Health Care Professionals and Patients Living With Serious Illness.
Poor communication by health care professionals contributes to physical and psychological suffering in patients living with serious illness. Patients may not fully understand their illness, prognosis, and treatment options or may not receive medical care consistent with their goals. Despite considerable research exploring the role of communication in this setting, many questions remain, and a clear agenda for communication research is lacking. ⋯ Our findings highlight the urgent need to improve quality of communication between health care professionals and patients living with serious illness through a broad range of research that covers communication skills, tools, patient education, and models of care.
-
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.
-
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.