J Am Board Fam Med
-
Despite major efforts to transition to a new physician payment system under the Medicare Access and CHIP Reauthorization Act (MACRA), little is known about how well practices are prepared. This study aimed to understand how small and medium-sized primary care practices in the Heart of Virginia Healthcare (https://www.vahealthinnovation.org/hvh/) perceive their quality incentives under MACRA. ⋯ This study highlights a dilemma in which independent practices are proactively attempting to prepare for MACRA's requirements, yet they continue to have major challenges. Practices are under extreme pressure to comply with reimbursement regulations, which may force some practices joining a health system or merging with another practice or completely closing the practices. Policy makers should assess the unintended consequences of payment reform policies on independent practices and provide support in transitioning to a new payment system.
-
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States (US), with West Virginia bearing a disproportionate disease burden. Complex COPD cases can be difficult to manage during a standard primary care provider (PCP) visit, and pharmacological treatment regimens should be individually tailored to each patient. ⋯ An interdisciplinary, team-based approach was effective for improving the health of COPD patients in an Appalachian academic primary care practice.
-
This issue of the Journal contains some exceptional research articles. A few are truly "must-reads," including a fascinating look at the relationship between having a usual source of care and telomere length. Glucosamine/chrondroitin supplementation seems to be helpful for more than just arthritis pain. ⋯ This issue also features 5 articles addressing how family physicians can combat the opioid epidemic. Three articles highlight research on diabetes and another 3 on breast cancer. Payment reform, dermoscopy, and telemedicine are among many other topics covered.
-
The purpose of this study is to examine the patterns of patient teach-back experience (also known as "interactive communication loop") and determine its association with risk for diabetic complications and hospitalization, and health expenditures among individuals with diabetes. ⋯ Teach-back could be an effective communication strategy that has potential to improve health outcomes, resulting in savings in diabetes care.
-
Adults with communication disabilities (CDs) experience poor health and health care outcomes. Few studies have examined behavioral health outcomes among this population. We compare the behavioral health of adults with CDs to their peers without such disabilities. ⋯ Adults with CDs experience poorer behavioral health and health care outcomes compared with persons without CDs. Barriers to identification and treatment related to CDs must be addressed for persons with CDs.