The American journal of managed care
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The 2010 Patient Protection and Affordable Care Act included a provision to promote the formation of Accountable Care Organizations (ACOs). These organizations will be eligible to share in the savings to Medicare if they are able to reduce costs and provide high-quality care. The law allows a wide variety of organizations to become ACOs, even networks of providers that are small compared with major integrated delivery networks. ⋯ The potential for shared savings may be too small to justify the additional costs and regulatory burdens of becoming an ACO. In addition, the incentives to physicians may be inadequate to encourage behavior that reduces cost while maintaining quality. The article reviews the proposed regulations and discusses the prospects for success of ACOs.
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Comparative Study
Economic model for emergency use authorization of intravenous peramivir.
To develop 3 computer simulation models to determine the potential economic effect of using intravenous (IV) antiviral agents to treat hospitalized patients with influenza-like illness, as well as different testing and treatment strategies. ⋯ Our study supports the use of IV antiviral treatment for hospitalized patients with influenza-like illness.
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Randomized Controlled Trial
Electronic health record feedback to improve antibiotic prescribing for acute respiratory infections.
To examine whether the Acute Respiratory Infection (ARI) Quality Dashboard, an electronic health record (EHR)-based feedback system, changed antibiotic prescribing. ⋯ The ARI Quality Dashboard was not associated with an overall change in antibiotic prescribing for ARIs, although when used, it was associated with improved antibiotic prescribing. EHR-based quality reporting, as part of "meaningful use," may not improve care in the absence of other changes to primary care practice.
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Comparative Study
Cost-effectiveness of 70-gene MammaPrint signature in node-negative breast cancer.
To evaluate the cost-effectiveness of 70-gene MammaPrint signature (Agendia Inc, Huntington Beach, CA) vs Adjuvant! Online software (AS) (http://www.adjuvantonline.com) in patients 60 years or younger with early-stage breast cancer. ⋯ A 70-gene signature is likely to be a cost-effective strategy to guide adjuvant chemotherapy treatment in younger patients with early-stage breast cancer.
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Comparative Study
Using electronic prescribing transaction data to estimate electronic health record adoption.
To determine whether electronic prescribing transaction data can be used to accurately and efficiently track national and regional electronic health record (EHR) adoption in order to evaluate progress toward national goals and identify and address regional disparities. ⋯ Surescripts transactional data may allow for the ongoing identification of regional trends and assist policy makers in identifying and mitigating emerging disparities in EHR adoption. Further analysis is needed to ensure that Surescripts data continue to correlate with NAMCS results for 2009-2010.