The American journal of managed care
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The authors interrogate elements of routine medical practice in New York City to argue for reforms of hospital culture through relational trust-building capabilities of community health workers.
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Observational Study
Implementation and cost validation of a real-time benefit tool.
To assess the accuracy of a real-time benefit tool (RTBT) that is compliant with the standards of the National Council for Prescription Drug Programs (NCPDP) in a large academic medical center. ⋯ Current standards established by NCPDP yield accurate patient out-of-pocket estimates and could serve as a national standard for all Part D sponsors.
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CMS created the Oncology Care Model (OCM) to increase the delivery of cost-efficient cancer care, but in linking medical oncologist compensation to total costs of care, the model also prompted concerns about reductions in radiation therapy utilization. We compare practices that participated in the model with those that did not through its launch to estimate whether radiation therapy utilization was reduced under the OCM. ⋯ Despite the potential incentives for medical oncologists to reduce radiation therapy utilization, we found no evidence that such reduction occurred.
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To assess long-term adherence to oral hypoglycemic agents (OHAs) and determine if adherence affects total health care expenditures of reactive vs preventive services. ⋯ Increasing adherence provides an opportunity to improve CMS quality ratings. Our finding that adherence does not affect the financial burden of disease might be explained by the increased costs of preventive medication and increased comorbidity burden of these patients. Low adherence to OHAs encourages clinicians to be more proactive in ensuring that prescription medications are refilled regularly. By emphasizing equitable diabetes education and tailoring quality initiatives that minimize racial disparities, adherence can be better achieved.
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To evaluate the effectiveness of a pilot smoking cessation service in an emergency department (ED) clinical observation unit. ⋯ Given the small sample and high number of uncontactable patients, more research is needed to assess whether the trend toward increasing point-prevalence abstinence rate over time and the trend toward decreasing median number of cigarettes smoked are observed in a larger sample.