The American journal of managed care
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Editorial Comment
Baffled by NAFLD: the horse might be out of the barn but should not take us for a ride.
As awareness of nonalcoholic fatty liver disease (NAFLD) rises, it is essential to develop and implement a rigorously determined approach to identify patients who will, or will not, benefit from diagnostic evaluation.
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On November 25, 2020, CMS announced the creation of an Acute Hospital Care at Home program to reimburse qualifying hospital-at-home models. As we increasingly adopt the Acute Hospital Care at Home program and similar home-based services, it is crucial to better define the value of these programs and their appropriate reimbursement rates. We provide a framework centered around cost, quality, and equity to help accomplish this task. ⋯ It is also worthwhile to consider personal, societal, technical, and allocative value when determining the value and subsequent reimbursement rates of hospital-at-home programs. With careful patient selection, the hospital-at-home model has the potential to significantly benefit a subset of patients. To create sustainable reimbursement mechanisms for hospital-at-home programs, we first need a better definition of the value provided by this model of care.
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To evaluate the impact of pharmacist-delivered medication safety reviews (MSRs) on total medical expenditures, hospitalizations, emergency department (ED) visits, and mortality in Medicare Part D beneficiaries, whose plan was a participant of the Enhanced Medication Therapy Management model. ⋯ MSRs were effective at improving annual health care costs, hospitalizations, ED visits, and mortality in Medicare beneficiaries targeted according to MRS.
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Patients with chronic respiratory failure resulting from chronic obstructive pulmonary disease (COPD-CRF) have limited treatment options and poor health outcomes. We examined the effect of noninvasive ventilation at home (NIVH) treatment on all-cause mortality, hospitalizations, and emergency department (ED) visits. ⋯ Patients with COPD-CRF who received NIVH had statistically significant reductions in hospitalizations and ED visits compared with patients not treated with NIVH. Further research is needed to examine the effect of NIVH on mortality.
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Observational Study
Association of the MedWise Risk Score with health care outcomes.
Older patients are especially vulnerable to drug-related problems due to multiple prescription drugs, which increases their risk of drug-drug interactions and adverse drug events (ADEs). This study aimed to examine outcomes associated with the MedWise Risk Score (MRS) in a Medicare Part D population, including total medical expenditures, ADEs, falls, mortality, emergency department (ED) visits, hospital admissions, and length of stay (LOS). ⋯ This study shows that MRS was associated with health outcomes and therefore could be used to identify patients at increased risk of negative outcomes based primarily on their medication regimens.