The American journal of managed care
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To assess whether discharging hospitals' self-reported care transition activities (CTAs) were associated with transitional care management (TCM) claims following discharge to the community and whether CTAs and TCM were associated with better patient outcomes. ⋯ Beyond recent increases in provider TCM compensation and relaxed billing restrictions, hospitals should be encouraged to increase CTA and to enhance care transitions to improve patient outcomes and lower spending.
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Text messaging could be effective for determining patient eligibility for lung cancer screening (LCS). We explored people's willingness to share their tobacco use history via text message among diverse groups. ⋯ Text messaging showed promise for evaluating smoking history and for simplifying the process of identifying LCS-eligible individuals. However, achieving equity in identifying eligibility for LCS requires the implementation of multimodal strategies.
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Despite chronic obstructive pulmonary disease (COPD) being a leading cause of death in the US, there are few COPD measures in current quality programs. The objective of this study was to assess the validity and applicability of the COPD treatment ratio (CTR) as a surrogate marker of COPD exacerbation risk for use in quality measurement. CTR is defined as the ratio of COPD maintenance medications to all COPD medications (maintenance and rescue). ⋯ Study results substantiated CTR as a valid measure of COPD exacerbation risk and support the use of CTR in quality improvement to drive evidence-based care for individuals with COPD.
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Patients with type 2 diabetes (T2D) are at high risk for developing chronic kidney disease (CKD). The onset of incident CKD may complicate glycemic control among these patients. This study aimed to characterize antihyperglycemic medication use after incident CKD onset among patients with T2D to inform disease management. ⋯ Treatment of T2D was considerably heterogenous by HbA1C level and CKD severity in patients with incident CKD. Current agents may not sufficiently fulfill the unmet need of T2D management in patients with CKD.
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The high costs of cancer care can cause significant harm to patients and society. Prostate cancer, the leading nonskin malignancy in men, is responsible for the second-highest out-of-pocket (OOP) payments among all malignancies. Multiple first-line treatment options exist for metastatic castration-resistant prostate cancer (mCRPC); although their costs vary substantially, comparative effectiveness data are limited. There is little evidence of how gross payments made by insurers and OOP payments made by patients differ by treatment and health plan type and how these payment differences relate to utilization. ⋯ The extent to which patient OOP payments for drugs reflect differences in gross payments made by insurers varies across health insurance plan types. However, even though OOP payments for the same treatment differ across plan types, treatment choice is not significantly different across type of health insurance after controlling for patient characteristics.