The American journal of managed care
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Observational Study
Targeting a high-risk group for fall prevention: strategies for health plans.
Although Medicare has implemented incentives for health plans to reduce fall risk, the best way to identify older people at high risk of falling and to use screening results to target fall prevention services remains unknown. We evaluated 4 different strategies using a combination of administrative data and patient-reported information that health plans could easily obtain. ⋯ The combination of administrative data and a simple screening item can be used by health plans to target patients at high risk for future fall-related injuries.
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Observational Study
Socioeconomic disparities across ethnicities: an application to cervical cancer screening.
Our aim is to investigate socioeconomic disparities in cervical cancer screening utilization among and between ethnic groups in the United States. ⋯ Uptake of cervical cancer screening is common in the United States, with large socioeconomic disparities also evident. Those from lower socioeconomic or uninsured groups who are most likely to have, and to die from, cervical cancer, are least likely to use preventive screening. Disparities differ across ethnic groups and are greatest amongst white women. Incorporating organized screening may serve to improve both the systems efficiency and address disparities between and within groups.
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To determine if Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) are meeting public reporting requirements related to shared savings plans, to quantitate the composition of shared savings distribution plans, and to investigate whether early ACO success is associated with specific plan or ACO characteristics. ⋯ Just over one-half of MSSP ACOs report detailed shared savings distribution plans online, and these plans vary widely. There appears to be no single shared savings distribution plan determinate of ACO success. Continued investigation of predictors for generating savings is needed to inform future shared savings models.
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The typical focus in discussions of healthcare spending is on direct medical costs such as physician reimbursement. The indirect costs of healthcare-patient opportunity costs associated with seeking care, for example-have not been adequately quantified. We aimed to quantify the opportunity costs for adults seeking medical care for themselves or others. ⋯ In the United States, opportunity costs associated with ambulatory medical care are substantial. Accounting for patient opportunity costs is important for examining US healthcare system efficiency and for evaluating methods to improve the efficient delivery of patient-centered care.