The American journal of managed care
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A final rule has been issued that increases Medicare fee-for-service payment rates for individuals experiencing homelessness. This rule provides new, incentivized opportunities to better screen for and document homelessness among patients in acute inpatient settings. With greater identification of homeless patients, there may be increased needs to develop comprehensive discharge plans that involve coordination with housing providers and social service agencies to prevent the high repeated use of acute care found among many homeless patients.
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To analyze US commercial insurance payments associated with COVID-19 as a function of severity and duration of disease. ⋯ COVID-19 payments for S/C cases were more than 10-fold greater than those of moderate cases and further increased by nearly $95,000 in S/C cases with PCC vs a DOD of fewer than 4 weeks.
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Evaluation of a collaborative model between managed care and affordable housing on acute care costs.
This study evaluated a collaborative service model between the largest Medicaid managed care organization (MCO) in Texas, Superior HealthPlan, and the affordable housing provider Prospera Housing Community Services. ⋯ These findings provide needed evidence of the clinical and economic value of forming multisector collaborative models between MCOs and other community providers.
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Randomized Controlled Trial Pragmatic Clinical Trial
Scaling care coordination through digital engagement: stepped-wedge trial assessing readmissions.
Transitions of care are pivotal, vulnerable times as patients are discharged from the hospital. Telephonic care coordination is standard care, but labor intensive. We implemented a patient postdischarge digital engagement (PDDE) program to scale coordination. We hypothesized that PDDE could reduce readmissions for low-risk patients and supplement care coordination for medium- and high-risk patients. ⋯ Our study expanded resource-limited care coordination by offering low-risk patients a service they were unable to receive previously while having no impact on readmission. PDDE efficiently provided additional touch points between patients and providers.
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Counseling and education on Medicare coverage options are available through the federal State Health Insurance Assistance Program (SHIP), but little is known about the population that SHIP reaches. ⋯ These results suggest that there are areas where in-person SHIP service expansion or other additional navigation support may be warranted.