The American journal of managed care
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Randomized Controlled Trial
Effect of a patient activation intervention on hypertension medication optimization: results from a randomized clinical trial.
To examine the effect of a patient activation intervention with financial incentives to promote switching to a thiazide in patients with controlled hypertension using calcium channel blockers (CCBs). ⋯ This low-cost, low-intensity patient activation intervention resulted in increased rates of switching to a thiazide in those whose hypertension was controlled using another medication, suggesting that such interventions may be used to overcome medication optimization challenges, including clinical inertia.
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Value co-creation focuses on customer participation and co-creates value with suppliers. Patients' support and cooperation can improve the quality of medical care. Value creation is closely related to participants' behavior. The DART (Dialogue, Access, Risk assessment, Transparency) model is widely used in commercial research because it defines and classifies value co-creation behavior clearly and systematically. However, there is little research using the DART model in the field of health care. This study aimed to develop and evaluate the psychometric properties of a scale measuring patient value co-creation behavior based on the DART model. ⋯ The scale exhibited acceptable reliability and validity and could serve as an evaluation tool for patient value co-creation behavior.
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To quantify the proportion of health plan spending on services for which surprise billing is common-provided by radiologists, anesthesiologists, pathologists, emergency physicians, emergency ground ambulances, and emergency outpatient facilities-and estimate the potential impact of proposed policies to address surprise billing on health insurance premiums. ⋯ Addressing surprise billing could substantially affect commercial insurance premiums.
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To determine whether implementation of patient-centered oncology standards in 5 medical oncology practices improved patient experiences and quality and reduced emergency department (ED) and hospital use. ⋯ This pilot of patient-centered oncology care showed improved quality but no impact on hospitalizations/ED use and mixed results for patient experiences. Findings are consistent with early evaluations of primary care patient-centered medical homes.
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Some managed care companies are testing rideshare services as an approach to providing transportation to health care for Medicaid enrollees. The objective of this study was to assess whether more rideshare transportation to health care was associated with improved self-reported ride experiences and fewer late/failed passenger pickups for Medicaid enrollees. ⋯ This study suggests that rideshare to health care programs can meet similar goals of quality compared with traditional NEMT services but may have implications for health care access for Medicaid enrollees. Future evaluations need to include the perspectives of enrollees and explore potential differences among different Medicaid subpopulations.