The American journal of managed care
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Despite widespread efforts to reduce emergency department (ED) visits, patients newly diagnosed with cancer often use the ED for commonly anticipated acute care needs. Existing delivery innovations to reduce ED use are underused, and reasons for this are not understood. Patients who recently visited the ED may provide insights into these patterns of care. ⋯ Even robust education programs for patients with cancer may have difficulty conveying the availability of innovative clinical services. Patient perspectives on avoidable ED visits may differ from policy makers' definitions.
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This study describes the use of data-based feedback, such as human papillomavirus (HPV) vaccination rates, to advance HPV vaccination uptake in pediatric and family medicine clinics. ⋯ Clinical staff seldom receive feedback about HPV vaccination in primary care.
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Provider directory inaccuracies have important implications for care navigation and access as well as ongoing regulatory efforts. We assessed the extent to which identified provider directory inaccuracies persisted across 7 specialties (cardiology, dermatology, endocrinology, gastroenterology, neurology, obstetrics-gynecology, primary care) and 5 carriers in the Pennsylvania Affordable Care Act insurance marketplace. ⋯ A large number of provider directory inaccuracies persist well beyond the 90-day expectation mandated by federal regulations, raising substantial concerns about compliance. These inaccuracies may impose substantial barriers to patient access and may render existing assessments of network adequacy ineffective.
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To compare rates and analyze health facility determinants of emergency department visits and hospitalizations for ambulatory care-sensitive conditions (ACSCs) among Medicaid patients by geographical location. ⋯ Our evaluation revealed more than 13-fold variation in acute care utilization for ACSCs between Medicaid counties within the same state. Proximity to urgent care facilities and density of rural health clinics were major explanatory variables for these variations, underscoring the importance of local health infrastructure in reducing acute care utilization for ACSCs.
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Private negotiated facility fees at hospitals are on average double the ambulatory surgery center facility fees for common outpatient procedures.