Health affairs (Project Hope)最新文献_第7页

Expanding Licensure Portability And Access To Care: Lessons Learned During COVID-19. 扩大许可证可移植性和获得医疗服务:2019冠状病毒病期间的经验教训。

IF 9.7

Health affairs (Project Hope) Pub Date : 2022-08-01 DOI: 10.1377/hlthaff.2022.00756

Humayun J Chaudhry

引用次数: 3

Billing And Insurance-Related Administrative Costs: A Cross-National Analysis. 帐单与保险相关的行政成本:一个跨国分析。

IF 9.7

Health affairs (Project Hope) Pub Date : 2022-08-01 DOI: 10.1377/hlthaff.2022.00241

Barak D Richman, Robert S Kaplan, Japees Kohli, Dennis Purcell, Mahek Shah, Igna Bonfrer, Brian Golden, Rosemary Hannam, Will Mitchell, Daniel Cehic, Garry Crispin, Kevin A Schulman

{"title":"Billing And Insurance-Related Administrative Costs: A Cross-National Analysis.","authors":"Barak D Richman, Robert S Kaplan, Japees Kohli, Dennis Purcell, Mahek Shah, Igna Bonfrer, Brian Golden, Rosemary Hannam, Will Mitchell, Daniel Cehic, Garry Crispin, Kevin A Schulman","doi":"10.1377/hlthaff.2022.00241","DOIUrl":"https://doi.org/10.1377/hlthaff.2022.00241","url":null,"abstract":"Billing and insurance-related costs are a significant source of wasteful health care spending in Organization for Economic Cooperation and Development nations, but these administrative burdens vary across national systems. We executed a microlevel accounting of these costs in different national settings at six provider locations in five nations (Australia, Canada, Germany, the Netherlands, and Singapore) that supplements our prior study measuring the costs in the US. We found that billing and insurance-related costs for inpatient bills range from a low of $6 in Canada to a high of $215 in the US for an inpatient surgical bill (purchasing power parity adjusted). We created a taxonomy of billing and insurance-related activities (eligibility, coding, submission, and rework) that was applied to data from the six sites and allows cross-national comparisons. Higher costs in the US and Australia are attributed to high coding costs. Much of the savings achieved in some nations is attributable to assigning tasks to people in lower-skill job categories, although most of the savings are due to more efficient billing and insurance-related processes. Some nations also reduce these costs by offering financial counseling to patients before treatment. Our microlevel approach can identify specific cost drivers and reveal national billing features that reduce coding costs. It illustrates a valuable pathway for future research in understanding and mitigating administrative costs in health care.","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"1098-1106"},"PeriodicalIF":9.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40684492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Alcohol-Attributable Deaths Help Drive Growing Socioeconomic Inequalities In US Life Expectancy, 2000-18. 2000-18年，酒精导致的死亡加剧了美国预期寿命的社会经济不平等。

IF 9.7

Health affairs (Project Hope) Pub Date : 2022-08-01 DOI: 10.1377/hlthaff.2021.01905

Charlotte Probst, Miriam Könen, Jürgen Rehm, Nikkil Sudharsanan

{"title":"Alcohol-Attributable Deaths Help Drive Growing Socioeconomic Inequalities In US Life Expectancy, 2000-18.","authors":"Charlotte Probst, Miriam Könen, Jürgen Rehm, Nikkil Sudharsanan","doi":"10.1377/hlthaff.2021.01905","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01905","url":null,"abstract":"Socioeconomic gaps in life expectancy have widened substantially in the United States since 2000. Yet the contribution of specific causes to these growing disparities remains unknown. We used death records from the National Vital Statistics System and population data from Current Population Surveys to quantify the contribution of alcohol-attributable causes of death to changes in US life expectancy between 2000 and 2018 by sex and socioeconomic status (as measured by educational attainment). During the study period, the gap in life expectancy between people with low (high school diploma or less) compared with high (college degree) levels of education increased by three years among men and five years among women. Between 2000 and 2010 declines in cardiovascular disease mortality among people with high education made major contributions to growing inequalities. In contrast, between 2010 and 2018 deaths from a cause with an alcohol-attributable fraction of 20 percent or more were a dominant driver of socioeconomic divergence. Increased efforts to implement cost-effective alcohol control policies will be essential for reducing health disparities.","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"1160-1168"},"PeriodicalIF":9.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9639704/pdf/nihms-1844450.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40684494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Hospital And Regional Characteristics Associated With Emergency Department Facility Fee Cash Pricing. 与急诊科设施收费现金定价相关的医院和地区特征。

IF 9.7

Health affairs (Project Hope) Pub Date : 2022-07-01 DOI: 10.1377/hlthaff.2022.00045

Morgan A Henderson, Morgane C Mouslim

引用次数: 8

Care Management For Patients With Type 2 Diabetes: The Roles Of Nurses, Pharmacists, And Social Workers. 2型糖尿病患者的护理管理:护士、药剂师和社会工作者的角色。

IF 9.7

Health affairs (Project Hope) Pub Date : 2022-07-01 Epub Date: 2022-06-27 DOI: 10.1377/hlthaff.2022.00227

Thomas S Bodenheimer, Rachel Willard-Grace

{"title":"Care Management For Patients With Type 2 Diabetes: The Roles Of Nurses, Pharmacists, And Social Workers.","authors":"Thomas S Bodenheimer, Rachel Willard-Grace","doi":"10.1377/hlthaff.2022.00227","DOIUrl":"https://doi.org/10.1377/hlthaff.2022.00227","url":null,"abstract":"Managing patients with type 2 diabetes takes time. Clinicians in primary care, where most diabetes visits take place, lack that time. Planned visits by diabetes care managers-nurses, pharmacists, social workers, and other team members-assist clinicians and are associated with improved glycemic control. Particularly effective is care management featuring nurses or pharmacists adjusting medications without prior physician approval. Care management programs need to pay close attention to inequities in diabetes care and outcomes. The widespread implementation of diabetes care management in primary care faces several barriers: lack of an adequate, diverse, trained care manager workforce; regulations limiting care managers' scope of practice; and financial models not supportive of care management. Wide-ranging policies are needed to address these barriers. In particular, payment reform is needed to stimulate the spread of diabetes care management: adding fee-for-service codes that adequately pay care managers for their work, adopting shared savings models that channel savings back to primary care, and increasing the percentage of health care spending dedicated to primary care. In this article we explore key questions around type 2 diabetes care management, review the published evidence, examine the barriers to its wider use, and describe policy solutions.","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"947-954"},"PeriodicalIF":9.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40404980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Local Supply Of Postdischarge Care Options Tied To Hospital Readmission Rates. 与医院再入院率相关的出院后护理选择的本地供应。

IF 9.7

Health affairs (Project Hope) Pub Date : 2022-07-01 DOI: 10.1377/hlthaff.2021.01991

Kevin N Griffith, David A Schwartzman, Steven D Pizer, Jacob Bor, Vijaya B Kolachalama, Brian Jack, Melissa M Garrido

{"title":"Local Supply Of Postdischarge Care Options Tied To Hospital Readmission Rates.","authors":"Kevin N Griffith, David A Schwartzman, Steven D Pizer, Jacob Bor, Vijaya B Kolachalama, Brian Jack, Melissa M Garrido","doi":"10.1377/hlthaff.2021.01991","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01991","url":null,"abstract":"The extent to which patients' risk for readmission after a hospitalization is influenced by local availability of postdischarge care options is not currently known. We used national, hospital-level data to assess whether the supply of postdischarge care options in hospitals' catchment areas was associated with readmission rates for Medicare patients after hospitalizations for acute myocardial infarction, heart failure, or pneumonia. Overall, readmission rates were negatively associated with per capita supply of primary care physicians (-0.16 percentage points per standard deviation) and licensed nursing home beds (-0.09 percentage points per standard deviation). In contrast, readmission rates were positively associated with per capita supply of nurse practitioners (0.09 percentage points per standard deviation). Our results suggest potential modifications to the Hospital Readmissions Reduction Program to account for local health system characteristics when assigning penalties to hospitals.","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"1036-1044"},"PeriodicalIF":9.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9342702/pdf/nihms-1824838.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40480014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Health Care Spending Effectiveness: Estimates Suggest That Spending Improved US Health From 1996 To 2016. 医疗保健支出有效性:估计表明1996年至2016年的支出改善了美国人的健康状况。

IF 9.7

Health affairs (Project Hope) Pub Date : 2022-07-01 DOI: 10.1377/hlthaff.2021.01515

Marcia R Weaver, Jonah Joffe, Michael Ciarametaro, Robert W Dubois, Abe Dunn, Arjun Singh, Gianna W Sparks, Lauryn Stafford, Christopher J L Murray, Joseph L Dieleman

{"title":"Health Care Spending Effectiveness: Estimates Suggest That Spending Improved US Health From 1996 To 2016.","authors":"Marcia R Weaver, Jonah Joffe, Michael Ciarametaro, Robert W Dubois, Abe Dunn, Arjun Singh, Gianna W Sparks, Lauryn Stafford, Christopher J L Murray, Joseph L Dieleman","doi":"10.1377/hlthaff.2021.01515","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01515","url":null,"abstract":"Health care spending effectiveness is the ratio of an increase in spending per case of illness or injury to an increase in disability-adjusted life-years (DALYs) averted per case. We report US spending-effectiveness ratios, using comprehensive estimates of health care spending from the Disease Expenditure Project and DALYs from the Global Burden of Disease Study 2017. We decomposed changes over time to estimate spending per case and DALYs averted per case, controlling for changes in population size, age-sex structure, and incidence or prevalence of cases. Across all causes of health care spending and disease burden, median spending was US$114,339 per DALY averted between 1996 and 2016. Twelve of thirty-four causes with the highest spending or highest burden had median spending that was less than $100,000 per DALY averted. Using decomposition results, we calculated an outcome-adjusted health care price index by assigning a dollar value to DALYs averted per case. When we used $100,000 as the dollar value per DALY averted, prices increased by 4 percent more than the broader economy; when we used $150,000 per DALY averted, relative prices fell by 13 percent, meaning that much of the growth in health care spending over time has purchased health improvements.","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"994-1004"},"PeriodicalIF":9.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40571156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

A New Way To Support Frequent Emergency Department Visitors. 支持急诊科频繁访客的新方法

IF 9.7

Health affairs (Project Hope) Pub Date : 2022-07-01 DOI: 10.1377/hlthaff.2022.00680

David Tuller

引用次数: 1

How Phantom Networks And Other Barriers Impede Progress On Mental Health Insurance Reform. 幻影网络和其他障碍如何阻碍精神健康保险改革的进展。

IF 9.7

Health affairs (Project Hope) Pub Date : 2022-07-01 DOI: 10.1377/hlthaff.2022.00541

Howard H Goldman

引用次数: 1

Catastrophic Spending On Insulin In The United States, 2017-18. 2017-18年，美国在胰岛素上的灾难性支出。

IF 9.7

Health affairs (Project Hope) Pub Date : 2022-07-01 DOI: 10.1377/hlthaff.2021.01788

Baylee F Bakkila, Sanjay Basu, Kasia J Lipska

{"title":"Catastrophic Spending On Insulin In The United States, 2017-18.","authors":"Baylee F Bakkila, Sanjay Basu, Kasia J Lipska","doi":"10.1377/hlthaff.2021.01788","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01788","url":null,"abstract":"Insulin is considered an essential medicine for people with diabetes, but its price has doubled during the past decade, posing substantial financial barriers to patients in the US. In this article we describe out-of-pocket spending on insulin and consider risk factors that could contribute to the likelihood of a person experiencing catastrophic spending, defined as spending more than 40 percent of their postsubsistence family income on insulin alone. Using nationally representative data from the 2017 and 2018 Medical Expenditure Panel Surveys, we examined out-of-pocket spending on insulin among people who filled at least one insulin prescription. Among Americans who use insulin, 14.1 percent reached catastrophic spending over the course of one year, representing almost 1.2 million people. Nearly two-thirds of patients who experienced catastrophic spending on insulin were Medicare beneficiaries. Catastrophic spending was 61 percent less likely among Medicaid beneficiaries than among Medicare beneficiaries, suggesting that factors other than income, such as different types of insurance coverage, may influence catastrophic insulin spending. Policy reform is needed to curb out-of-pocket spending, especially for Medicare beneficiaries and people with low incomes, who appear to be particularly vulnerable to catastrophic spending.","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"1053-1060"},"PeriodicalIF":9.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40571152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5