The American journal of managed care
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Driven by the growth of high deductibles and price transparency initiatives, patients are being encouraged to search for prices before seeking care, yet few do so. To understand why this is the case, we interviewed individuals who were offered access to a widely used price transparency website through their employer. ⋯ We found a disconnect between respondents' enthusiasm for price shopping and their reported use of a price transparency tool to shop for care. However, many did find the tool useful for other purposes, including checking their claims history. Addressing the barriers to price shopping identified by respondents can help inform ongoing and future price transparency initiatives.
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To replicate and extend a recently published analysis of the drivers of excess costs of opioid abuse. ⋯ Opioid abuse imposes a considerable economic burden on payers. Many abusers have complex healthcare needs and may require care beyond that which is required to treat opioid abuse. These results are robust and consistent across different data sources.
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To quantify how adherence mismeasurement affects the estimated impact of adherence on inpatient costs among patients with serious mental illness (SMI). ⋯ Measurement error due to claims-based adherence measures is worth addressing, alongside other more widely emphasized sources of bias in inference.
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Satisfaction with care is an important patient-centered domain of health system quality. However, satisfaction measures are costly to collect and not directly modifiable. Therefore, we assessed the relationships between veterans' satisfaction and measures of modifiable aspects of Veterans Health Administration (VHA) mental health care programs. ⋯ As the VHA strives to increase access to, and provision of, mental health care, policy makers and program managers should be aware that satisfaction with care, as it is currently measured, may not rise as more patients initiate treatment, unless continuity of care is maintained or enhanced.
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An Asthma Medication Ratio (AMR) of ≥0.50 has gained recognition as a metric related to improved asthma outcomes. The goals of this study were to evaluate asthma outcomes in relation to this threshold in Hispanic children with high-risk asthma and to compare the effectiveness of the Breathmobile (BM) program with usual care (UC), utilizing the AMR-related emergency department utilization (ED) rate. ⋯ View achievement of the AMR ≥0.50 as an informative metric in program evaluation and for healthcare organizations to measure the quality of care provided to high-risk patients with asthma.