2025
Vulnerability Index Approach to Identify Pharmacy Deserts and Keystone Pharmacies
Mathis W, Berenbrok L, Kahn P, Appolon G, Tang S, Hernandez I. Vulnerability Index Approach to Identify Pharmacy Deserts and Keystone Pharmacies. JAMA Network Open 2025, 8: e250715. PMID: 40080019, PMCID: PMC11907307, DOI: 10.1001/jamanetworkopen.2025.0715.Peer-Reviewed Original ResearchConceptsNational Council for Prescription Drug ProgramsPharmacy desertsSmall rural areasCross-sectional studyPharmacy accessCensus tractsPopulation-based cross-sectional studyRural areasLow-income areasHealth equityPrescription drug programPharmacy servicesMedication dispensingCommunity pharmaciesMain OutcomesTargeted policy interventionsPharmacy dataPrimary exposureSignificant disparitiesNearest pharmacyReimbursement ratesAt-riskPharmacyPublic healthPoint-of-care testing
2024
Trends in Medicare Reimbursement and Service Volume of Vitreoretinal Procedures: 2000 to 2021
Li E, Adelman R. Trends in Medicare Reimbursement and Service Volume of Vitreoretinal Procedures: 2000 to 2021. Journal Of VitreoRetinal Diseases 2024, 9: 31-36. PMID: 39539838, PMCID: PMC11556364, DOI: 10.1177/24741264241292743.Peer-Reviewed Original ResearchVitreoretinal proceduresStatistically significant decreasePanretinal photocoagulation treatmentInflation-adjusted Medicare reimbursementSignificant decreaseSpearman correlationMedicare Part B National Summary Data FilesScleral bucklingEvaluate time trendsIntravitreal injectionPhotocoagulation treatmentNational reimbursement ratesSpearman correlation coefficientPractice patternsPatient coverageMedicare Physician Fee ScheduleStatistical significancePhysician fee scheduleMedicare reimbursementSignificant declineReimbursement ratesInjectionReimbursement trendsTime trendsIntravitrealPayment Innovation in Emergency Care: A Case for Global Clinician Budgets
Pines J, Black B, Cirillo L, Kachman M, Nikolla D, Moghtahderi A, Oskvarek J, Rahman N, Venkatesh A, Venkat A. Payment Innovation in Emergency Care: A Case for Global Clinician Budgets. Annals Of Emergency Medicine 2024, 84: 305-312. PMID: 38691065, DOI: 10.1016/j.annemergmed.2024.04.002.Peer-Reviewed Original ResearchClinician groupsClinical workloadEmergency departmentPopulation health programsUS emergency departmentsClinician staffingPopulation healthWorkforce attritionEmergency careHealth programsGovernment payorsED capacityHospital incentivesHospital boardsImprove equityClinician servicesLow reimbursementImprove qualityFinancial incentivesReimbursement ratesFunding modelsReimbursementGlobal budgetState-level legislationFinancial pressures
2022
Medicare Utilization and Reimbursement Variation Between Rural and Urban Otolaryngologists
Patel R, Torabi S, Kayastha D, Kuan E, Manes R. Medicare Utilization and Reimbursement Variation Between Rural and Urban Otolaryngologists. Otolaryngology 2022, 168: 528-535. PMID: 35852873, DOI: 10.1177/01945998221113550.Peer-Reviewed Original ResearchConceptsMedicare patientsRetrospective cross-sectional studyPatient's comorbidity profileHealthcare Common Procedure Coding System codesNumber of patientsCross-sectional studyReimbursement variationComorbidity profilesPatient populationRisk scoreMedicare Provider UtilizationLarge urban settingUrban settingsOlder ageMore Medicare patientsPhysician populationPatientsPhysiciansComplexity of proceduresHCPCS codesProvider UtilizationReimbursement ratesOtolaryngologyRural practiceMedicare utilizationMedicare Reimbursement in Hand and Upper Extremity Procedures: A 20-Year Analysis
Weiss S, Gilbert G, Gentile P, Gaughan J, Miskiel S, Pagliaro A, Ramirez R, Fuller D. Medicare Reimbursement in Hand and Upper Extremity Procedures: A 20-Year Analysis. Hand 2022, 19: 175-179. PMID: 38149769, PMCID: PMC10786100, DOI: 10.1177/15589447221096708.Peer-Reviewed Original ResearchConceptsCenters for Medicare & Medicaid ServicesUS dollarsConsumer price indexPhysician feesUpper extremity proceduresConstant US dollarsPhysician reimbursementMonetary dataMedicare physician feesExtremity proceduresFinancial databaseCurrent Procedural Terminology</i>InflationUpper extremity surgical proceduresLinear regressionReimbursement ratesMedicaid ServicesMedicare reimbursement ratesOrthopedic handFeesSurgical proceduresMedicare reimbursementMedicareReimbursementPhysicians
2021
Office versus Institutional Operative Hysteroscopy: An Economic Model
Munro MG, Kasiewicz JL, Desai VB. Office versus Institutional Operative Hysteroscopy: An Economic Model. Journal Of Minimally Invasive Gynecology 2021, 29: 535-548. PMID: 34933096, DOI: 10.1016/j.jmig.2021.12.008.Peer-Reviewed Original ResearchConceptsNet revenueHealth system costsEconomic modelInstitutional settingsSet of vendorsSystem costPrice informationList priceInstitutional environmentRevenueGeneric supplyTotal health system costsMonthly proceduresInherent expenseReimbursement ratesCost modelingCostPractice revenueModeling exerciseAmbulatory surgical centerPurpose-built systemPrices
2016
Impact of laboratory cost display on resident attitudes and knowledge about costs
Long T, Bongiovanni T, Dashevsky M, Halim A, Ross JS, Fogerty RL, Silvestri MT. Impact of laboratory cost display on resident attitudes and knowledge about costs. Postgraduate Medical Journal 2016, 92: 592-596. PMID: 27033861, DOI: 10.1136/postgradmedj-2015-133851.Peer-Reviewed Original ResearchConceptsLaboratory ordersAcademic medical centerCost awarenessMedicare reimbursement ratesProportion of residentsPreintervention periodPostintervention periodMedical CenterHealthcare costsImaging testsMost physiciansOrthopedic surgeryWeb-based surveyInternal medicineDiagnostic testsCost displayEmergency medicineReimbursement ratesPediatricsPhysiciansMedicineEntry screensCommon laboratoryResidentsSurgerySurvey of Patient Insurance Status on Access to Specialty Foot and Ankle Care Under the Affordable Care Act
Kim CY, Wiznia DH, Roth AS, Walls RJ, Pelker RR. Survey of Patient Insurance Status on Access to Specialty Foot and Ankle Care Under the Affordable Care Act. Foot & Ankle International 2016, 37: 776-781. PMID: 27026727, DOI: 10.1177/1071100716642015.Peer-Reviewed Original ResearchConceptsTotal ankle arthroplastyAnkle arthroplastyAnkle surgeonsPrimary care referralsPatient insurance statusAppointment success rateCare referralAffordable Care ActInsurance statusInsurance typePrognostic studiesPatientsAnkle careLevel IIBlueCrossFictitious patientArthroplastyReferralMedicaidReimbursement ratesSurgeonsCare ActSuccess rateMedicareAppointments
2009
The impact of Medicaid coverage and reimbursement on access to diagnostic mammography
Schuur JD, Shah A, Wu Z, Forman HP, Gross CP. The impact of Medicaid coverage and reimbursement on access to diagnostic mammography. Cancer 2009, 115: 5566-5578. PMID: 19728371, PMCID: PMC3723693, DOI: 10.1002/cncr.24637.Peer-Reviewed Original ResearchConceptsMedicaid reimbursement ratesTimely appointmentsDiagnostic mammographyReimbursement ratesState Medicaid reimbursement ratesStandardized patientsSame clinical vignettesMedicaid reimbursementLow socioeconomic statusMedicare reimbursement ratesThird available appointmentLow Medicaid reimbursementInsurance statusInsurance typeBreast cancerMedicaid coverageAbnormal mammogramsAvailable appointmentClinical servicesMedicaidSocioeconomic statusMammography facilitiesMedicare reimbursementMammographyMedicare
2008
Modeling the Potential Impact of a Prescription Drug Copayment Increase on the Adult Asthmatic Medicaid Population
Bae SJ, Paltiel AD, Fuhlbrigge AL, Weiss ST, Kuntz KM. Modeling the Potential Impact of a Prescription Drug Copayment Increase on the Adult Asthmatic Medicaid Population. Value In Health 2008, 11: 110-118. PMID: 18237365, PMCID: PMC3476042, DOI: 10.1111/j.1524-4733.2007.00219.x.Peer-Reviewed Original ResearchMeSH KeywordsAdrenal Cortex HormonesAdultAge FactorsAnti-Asthmatic AgentsAsthmaCost SharingDrug PrescriptionsHealth Services AccessibilityHumansInsurance, Pharmaceutical ServicesMassachusettsMedicaidModels, EconometricNebulizers and VaporizersOutcome Assessment, Health CareState Health PlansTreatment RefusalUnited StatesConceptsFrequent acute exacerbationsAcute exacerbationCopayment increaseHealth outcomesPrescription drug copaymentsLikely health outcomesDrug nonadherenceCorticosteroid useAdult asthmaticsAcute eventDrug utilizationMedicaid populationDrug copaymentsMedicaid beneficiariesPrescription drugsCopaymentsReimbursement ratesFinancial burdenExacerbationTarget populationFirst yearNet savingsOutcomesPharmacyCommonwealth of Massachusetts
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