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Population Health Management

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https://read.qxmd.com/read/30942658/an-audit-and-feedback-intervention-to-improve-internal-medicine-residents-performance-on-ambulatory-quality-measures-a-randomized-controlled-trial
#1
Andrew S Hwang, Alex S Harding, Yuchiao Chang, Sandra M O'Keefe, Daniel M Horn, Adrienne L Clark
Audit and feedback is an effective method to improve attending physician performance. However, there are limited data on how audit and feedback impacts care provided by resident physicians. The authors conducted a 3-arm randomized clinical trial among internal medicine resident physicians to examine the impact of an audit and feedback intervention on ambulatory quality measures (AQMs). Residents in all 3 groups received an email containing the contact information of a population health coordinator and a list of AQMs (control)...
April 3, 2019: Population Health Management
https://read.qxmd.com/read/30939082/skin-cancer-prevention-evaluation-of-an-intervention-focused-on-primary-care
#2
José Francisco Millán-Cayetano, Nuria Delgado-Sánchez, Miguel Aguilar-Bernier, Francisco Rivas-Ruiz, Nuria Blázquez-Sánchez, Inés Fernández-Canedo, Magdalena de Troya-Martín
No abstract text is available yet for this article.
April 2, 2019: Population Health Management
https://read.qxmd.com/read/30907688/self-insured-employer-health-benefits-strategy-established-a-negative-cost-trend-while-improving-performance
#3
Steven E Goldberg, Maren S Fragala, Jay G Wohlgemuth
This case study describes the collaboration between a self-insured employee benefits team and a national health insurance provider to control costs while maintaining program quality and promoting population health. In 2015, Quest Diagnostics well exceeded the full-year expense target for their ∼60,000-life Group Health Insurance (GHI) program. Through proactive changes, physician executive leadership, health plan collaboration, disease-specific population health initiatives, and plan design, Quest GHI annual employer health care cost trend subsequently improved from a year-over-year trend of 5...
March 22, 2019: Population Health Management
https://read.qxmd.com/read/30897047/food-insecurity-associated-with-self-reported-falls-among-medicare-advantage-members
#4
David M Mosen, Matthew P Banegas, Nicole Friedman, Elizabeth Shuster, Neon Brooks
More than 3 million older US adults injure themselves by falling each year. Falls are a major cause of morbidity and mortality for this population, and account for nearly $30 billion in Medicare expenditures annually. Falls have been linked to frailty and vitamin D deficiency, both of which are linked to low nutrient intake and food insecurity. This retrospective, observational study is the first the authors know of to directly assess the relationship between food insecurity and falls. The study sample consisted of 26,525 Medicare Advantage members at Kaiser Permanente Northwest, a group model health maintenance organization, who had completed a quality of care survey between April 2013 and March 2017 and who maintained continuous enrollment in the 12 months prior to the survey date...
March 21, 2019: Population Health Management
https://read.qxmd.com/read/30864884/integrating-social-and-behavioral-determinants-of-health-into-population-health-analytics-a-conceptual-framework-and-suggested-road-map
#5
Zachary Predmore, Elham Hatef, Jonathan P Weiner
There is growing recognition that social and behavioral risk factors impact population health outcomes. Interventions that target these risk factors can improve health outcomes. This study presents a review of existing literature and proposes a conceptual framework for the integration of social and behavioral data into population health analytics platforms. The authors describe several use cases for these platforms at the patient, health system, and community levels, and align these use cases with the different types of prevention identified by the Centers for Disease Control and Prevention...
March 13, 2019: Population Health Management
https://read.qxmd.com/read/30855210/framework-for-evaluating-workplace-health-promotion-in-a-health-care-delivery-setting
#6
Ron Z Goetzel, Jeff Berko, Katherine McCleary, Enid Chung Roemer, Kimon Stathakos, Patricia R Flynn, Joseph Moscola, Gregg Nevola
This case study describes a multistage approach applied to evaluation of an employee wellness program at Northwell Health. The paper describes a framework that other large employers may adopt in their wellness program evaluations. Evaluators worked with Northwell to develop, tailor, and apply a structure-process-outcome framework aligned with the organization's specific goals. Analyses of structural, process, and outcome variables will provide Northwell with valuable information about strengths and weaknesses of its wellness program...
March 11, 2019: Population Health Management
https://read.qxmd.com/read/30855207/disability-benefits-and-change-in-prescription-opioid-dose
#7
Sarah Gebauer, Joanne Salas, Jeffrey F Scherrer, Sandra Burge, F David Schneider
Among chronic low back pain (CLBP) patients, workers' compensation is associated with longer term prescription opioid analgesic use (OAU). The aim was to study the association between receiving Social Security Disability Insurance (SSDI) benefits and course of OAU. This prospective cohort study utilized data from primary care patients diagnosed with non-cancer CLBP. The outcomes were morphine equivalent dose (MED) - categorized as no OAU, 1-50mg MED, or >50mg MED - and change in MED over time using mixed multinomial logistic regression models...
March 11, 2019: Population Health Management
https://read.qxmd.com/read/30801238/association-of-resilience-and-social-networks-with-pain-outcomes-among-older-adults
#8
Shirley Musich, Shaohung S Wang, Luke Slindee, Sandra Kraemer, Charlotte S Yeh
Depression, stress, and poor sleep have been associated with increased pain among older adults; positive resources, such as resilience and social networks, may help to buffer the impacts of these negative attributes on pain outcomes. The primary objective was to determine the relative effects of positive resources and negative attributes on pain outcomes among older adults with diagnosed back pain, osteoarthritis, and rheumatoid arthritis. The stratified study sample was identified from older adults ages ≥65 years...
February 25, 2019: Population Health Management
https://read.qxmd.com/read/30688559/community-characteristics-and-regional-variations-in-diabetes-prevalence-in-texas-counties
#9
Juha Baek, Jusung Lee, Ohbet Cheon
Diabetes has become a critical population health issue in the United States. Although researchers have focused on diabetes prevalence at the individual level, few studies address community contexts of diabetes prevalence at the county level. The objective of this study is to explore the association between community characteristics and diabetes prevalence in 254 counties in Texas. Using 3 countywide data sets in 2012, the authors measured county-level community characteristics, including social, environmental, and health behavior factors, and examined how these county-level factors are associated with diabetes prevalence...
January 28, 2019: Population Health Management
https://read.qxmd.com/read/30668228/evaluating-the-impact-of-year-long-augmented-diabetes-self-management-support
#10
Benjamin M Bluml, Leslie E Kolb, Ruth Lipman
This was a randomized controlled study to test a scalable intervention model addressing the need for ongoing diabetes support. The study included individuals receiving care in a Federally Qualified Health Center (FQHC) with HbA1c >8. The aim of this project was to determine whether augmenting diabetes self-management education (DSME) with support for an economically vulnerable population might better meet patient needs and reduce morbidity and premature mortality. The intervention utilized pre and post comparisons and was designed to test the efficacy of a telephonic diabetes support intervention to increase patient engagement in self-care and with the health care system as a means to improve clinical outcomes...
January 22, 2019: Population Health Management
https://read.qxmd.com/read/30668222/automation-and-simplification-drivers-of-innovative-collection-and-use-of-patient-reported-outcomes-data
#11
Jason M Guattery, Jimmy Johnson, Ryan P Calfee
The aim was to develop an electronic data capture (EDC) system to capture patient-reported outcome (PRO) measures successfully by automating processes identified as barriers to implementation. Clinical success, research impact, and patient acceptance of this system were evaluated during a pilot and a follow-up period 2 years later. During the pilot, there were 44,831 eligible visits. Capture rate was 99.0% (44,374 visits) and completion rate was 99.4% (44,108 visits). Capture rate was 99.4% and completion rate was 95...
January 22, 2019: Population Health Management
https://read.qxmd.com/read/30917095/retraction-of-using-the-healthy-days-measure-to-assess-factors-associated-with-poor-health-related-quality-of-life-for-patients-with-metastatic-breast-lung-or-colorectal-cancer-enrolled-in-a-medicare-advantage-health-plan-by-casebeer-aw-et-al-popul-health-manag
#12
https://read.qxmd.com/read/30648928/effect-of-patient-care-coordination-on-hospital-encounters-and-related-costs
#13
Ellen D Breckenridge, Bobbie Kite, Rebecca Wells, Tenaya M Sunbury
Given high costs of hospital encounters, providers have increasingly turned to patient-centered health care programs to improve cost-effectiveness and population health for patients with high needs. Yet, evidence is mixed about program effectiveness. This pre-post comparative analysis assessed whether the number of hospital encounters and related costs decreased for patients who received care coordination services funded through Texas's 1115(a) Medicaid waiver incentive-based payment model, under which providers created new programs to improve care quality, population health, and cost-effectiveness...
January 16, 2019: Population Health Management
https://read.qxmd.com/read/30628868/comparative-effectiveness-of-metformin-dosage-uptitration-versus-adding-another-antihyperglycemic-medication-on-glycemic-control-in-type-2-diabetes-patients-failing-initial-metformin-monotherapy-a-retrospective-cohort-study
#14
Rohan Mahabaleshwarkar, Tsai-Ling Liu, Holly Mulder
Metformin is recommended as first-line treatment for type 2 diabetes (T2D). A disadvantage of metformin is the possibility of gastrointestinal adverse effects in some patients. Many T2D patients are not able to achieve/maintain glycemic control from initial metformin treatment and receive treatment intensification by means of metformin dosage uptitration or addition of a T2D drug. This retrospective study evaluated the comparative effectiveness of these 2 treatment intensification strategies. The study cohort included T2D patients at a US integrated health care system who: were initiated on metformin monotherapy (MM) during January 2009 - September 2013; had an uncontrolled HbA1c (≥7%) after at least 90 days of MM; and received metformin dosage uptitration or an additional T2D medication within 6 months of the uncontrolled HbA1c reading...
January 10, 2019: Population Health Management
https://read.qxmd.com/read/30614761/systematic-review-of-community-paramedicine-and-ems-mobile-integrated-health-care-interventions-in-the-united-states
#15
Abbey Gregg, Joshua Tutek, Matthew D Leatherwood, William Crawford, Richard Friend, Martha Crowther, Robert McKinney
Emergency medical services (EMS) in the United States are frequently used for nonurgent medical needs. Use of 911 and the emergency department (ED) for primary care-treatable conditions is expensive, inefficient, and undesirable for patients and providers. The objective is to describe the outcomes from community paramedicine (CP) and mobile integrated health care (MIH) interventions related to the Quadruple Aim. Three electronic databases were searched for peer-review literature on CP-MIH interventions in the United States...
January 7, 2019: Population Health Management
https://read.qxmd.com/read/30589614/identifying-older-patients-at-high-risk-for-emergency-department-visits-and-hospitalization
#16
Brooke E Salzman, Rachel V Knuth, Amy T Cunningham, Marianna D LaNoue
Hospitalizations are costly, potentially hazardous for older patients, and sometimes preventable. With Medicare's implementation of hospital penalties for 30-day readmissions on certain index conditions, health care organizations have prioritized addressing those issues that lead to avoidable hospitalizations. Little is known about the utility and feasibility of using standardized tools to identify adults at risk for hospitalizations in primary care. In this study, the goal was to determine, from a sample of 60 adults aged 65 and older, whether the Probability of Repeat Admission (PRA), the Vulnerable Elders Survey (VES-13), or a provider estimate of likelihood of hospitalization could identify patients at high risk for emergency department (ED) visits or hospitalization at 6 and 12 months, while being feasible to administer in a primary care setting...
December 27, 2018: Population Health Management
https://read.qxmd.com/read/30589613/reducing-emergency-department-visits-among-dual-eligible-patients-via-a-comprehensive-wellness-assessment
#17
Barbara Guerard, Vincent Omachonu, Bisakha Sen
The objective was to assess whether a Comprehensive Wellness Assessment (CWA) is associated with reduced emergency department (ED) visits for Special Needs Program (SNP) enrollees with diabetes. This retrospective panel study used a Medicare Advantage plan's administrative claims data for 2010-2017 and pooled member-month observations. Multivariate regression and individual fixed-effects regression models were estimated. The outcome was ED visits measured as binary and continuous outcomes. Data were derived from claims data that included at least 1 ICD-9 or 10 code between January 2010 and December 2017...
December 27, 2018: Population Health Management
https://read.qxmd.com/read/30570425/building-a-culture-of-health-and-well-being-at-merck
#18
Cathryn E Gunther, Virginia Peddicord, Joseph Kozlowski, Yi Li, Danielle Menture, Raymond Fabius, Sharon Glave Frazee, Peter J Nigro
There is increasing evidence that a healthy and safe workforce can provide a competitive business advantage. This article shares the efforts and experience of a large global employer as it builds on existing corporate wellness and safety programs to develop a corporate culture of health and well-being. Starting with a comprehensive review of the current state of employee health and culture, a small team established the business case, aligned strategic partners, created an implementation plan, and engaged the C-Suite...
December 19, 2018: Population Health Management
https://read.qxmd.com/read/30562144/primary-care-and-public-health-collaboration-reports-a-qualitative-review-of-integration-aims-participants-and-success-determinants
#19
Kimberly L McVicar, Lana V Ivanitskaya, Don W Bradley, Jose T Montero
This qualitative review of 57 published case reports aimed to analyze primary care and public health integration efforts in 45 states to summarize collaboration aims, participants, and systemic, organizational, and interactional success determinants. Chronic disease management, maternal and child health, and wellness and health promotion were the most commonly reported aims of collaboration between primary care and public health entities in the United States. Typical participants were government public health structures, health delivery systems, communities, academia, state professional medical associations, and employers and businesses...
December 18, 2018: Population Health Management
https://read.qxmd.com/read/30562143/using-the-healthy-days-measure-to-assess-factors-associated-with-poor-health-related-quality-of-life-for-patients-with-metastatic-breast-lung-or-colorectal-cancer-enrolled-in-a-medicare-advantage-health-plan
#20
Adrianne Waldman Casebeer, Dana Drzayich Antol, Sari Hopson, Raya Khoury, Andrew Renda, Aparna Parikh, Alisha Stein, Todd Michael, Stephen Stemkowski, Mikele Bunce
This study investigated factors associated with patient-reported health-related quality of life (HRQoL) using the Centers for Disease Control and Prevention's Healthy Days tool for patients with Medicare Advantage undergoing treatment for metastatic breast, lung, and colorectal cancer. In 2015, a total of 6390 patients were mailed surveys regarding factors that may influence their HRQoL, including cancer-related symptoms and patient-reported medication adherence. HRQoL was measured as the number of physically and mentally unhealthy days experienced in the past 30 days and summed for the total number of unhealthy days...
December 18, 2018: Population Health Management
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