The American journal of managed care
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Comparative Study
Racial differences in switching, augmentation, and titration of lipid-lowering agents by Medicare/Medicaid dual-eligible patients.
The goal of this study was to examine prescription fill patterns of lipid-lowering agents among Medicare/ Medicaid dual-eligible patients by ethnicity. ⋯ These results suggest that African Americans may be receiving less aggressive treatment than other patients, which in turn may explain why many studies find that African Americans are less likely to reach lipid goals. These treatment disparities merit further study, because they may impact dual-eligible patients moving into Medicare Part D plans.
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Despite substantial enthusiasm among insurers and federal policy makers for pay-for-performance incentives, little is known about the current scope of these incentives or their influence on the delivery of care. To assess the scope and magnitude of pay-for-performance (P4P) incentives among physician groups and to examine whether such incentives are associated with quality improvement initiatives. ⋯ P4P incentives are now common among physician groups in Massachusetts, and these incentives most commonly reward higher clinical quality or lower utilization of care. Although the scope and magnitude of incentives are still modest for many groups, we found an association between P4P incentives and the use of quality improvement initiatives.
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Randomized Controlled Trial
Reducing the number of emergency department visits and costs associated with anxiety: a randomized controlled study.
To demonstrate the economic effects of an intervention for members discharged from the emergency department (ED) with anxiety diagnoses. ⋯ The case management-based intervention effectively reduced psychiatric ED recidivism and costs for members discharged from the ED with an anxiety diagnosis, without significantly affecting psychiatric outpatient visit costs.
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To examine the impact of geographic variation on racial differences in 7 of 15 Health Plan Employer Data and Information Set (HEDIS) measures that assess the quality of the Medicare managed care program (also known as Medicare+Choice). ⋯ Removing within-region racial variation while ignoring geographic differences will not equalize the experiences of black and white elders. Rather, both racial and geographic components of healthcare quality must be addressed if the Medicare managed care program is to provide care of equal quality to all elders regardless of race.