The Experts below are selected from a list of 108 Experts worldwide ranked by ideXlab platform
Rami Doukky - One of the best experts on this subject based on the ideXlab platform.
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impact of Insurance Carrier prior authorization and socioeconomic status on appropriate use of spect myocardial perfusion imaging in private community based office practice
Clinical Cardiology, 2015Co-Authors: Rami Doukky, Kathleen Hayes, Nathan Frogge, Noreen Nazir, Fareed M Collado, Kim A WilliamsAbstract:Background The impact of health Insurance Carrier and socioeconomic status (SES) on the adherence to appropriate use criteria (AUC) for radionuclide myocardial perfusion imaging (MPI) is unknown. Hypothesis Health Insurance Carrier's prior authorization and patient's SES impact adherence to AUC for MPI in a fee-for-service setting. Methods We conducted a prospective cohort study of 1511 consecutive patients who underwent outpatient MPI in a multi-site, office-based, fee-for-service setting. The patients were stratified according to the 2009 AUC into appropriate/uncertain appropriateness and inappropriate use groups. Insurance status was categorized as Medicare (does not require prior authorization) vs commercial (requires prior authorization). Socioeconomic status was determined by the median household income in the ZIP code of residence. Results The proportion of patients with Medicare was 33% vs 67% with commercial Insurance. The rate of inappropriate use was higher among patients with commercial Insurance vs Medicare (55% vs 24%; P < 0.001); this difference was not significant after adjusting for confounders known to impact AUC determination (odds ratio: 1.06, 95% confidence interval: 0.62-1.82, P = 0.82). The mean annual household income in the residential areas of patients with inappropriate use as compared to those with appropriate/uncertain use was $72 000 ± 21 000 vs $68 000 ± 20 000, respectively (P < 0.001). After adjusting for covariates known to impact AUC determination, SES (top vs bottom quartile income area) was not independently predictive of inappropriate MPI use (odds ratio: 0.9, 95% confidence interval: 0.53-1.52, P = 0.69). Conclusions Insurance Carriers prior authorization and SES do not seem to play a significant role in determining physicians adherence to AUC for MPI.
Gus J Slotman - One of the best experts on this subject based on the ideXlab platform.
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in the superobese weight loss and resolution of obesity comorbidities after biliopancreatic bypass and or duodenal switch vary according to health Insurance Carrier medicaid vs medicare vs private Insurance vs self pay in 1681 bariatric outcomes long
American Journal of Surgery, 2016Co-Authors: Janette P Gomez, Michael A Davis, Gus J SlotmanAbstract:Abstract Background Differences in Medicaid vs Medicare vs Private vs Self-Pay duodenal switch (DS) results are unknown. This study identified DS outcomes variations by health Insurance. Methods Data from 1,681 DS patients were analyzed retrospectively: Medicaid (n = 138), Medicare (n = 313), Private Insurance (n = 1,171), and Self-Pay (n = 59). General linear models included baseline and postoperative data and were modified for dichotomous variables. Results Hypertension, obstructive sleep apnea, abdominal hernia, diabetes, and 9 other hepatobiliary, and somatic conditions were lowest in Private ( P P P P Conclusions Outcomes after DS vary by health Insurance. These findings may facilitate management of DS patients.
Kim A Williams - One of the best experts on this subject based on the ideXlab platform.
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impact of Insurance Carrier prior authorization and socioeconomic status on appropriate use of spect myocardial perfusion imaging in private community based office practice
Clinical Cardiology, 2015Co-Authors: Rami Doukky, Kathleen Hayes, Nathan Frogge, Noreen Nazir, Fareed M Collado, Kim A WilliamsAbstract:Background The impact of health Insurance Carrier and socioeconomic status (SES) on the adherence to appropriate use criteria (AUC) for radionuclide myocardial perfusion imaging (MPI) is unknown. Hypothesis Health Insurance Carrier's prior authorization and patient's SES impact adherence to AUC for MPI in a fee-for-service setting. Methods We conducted a prospective cohort study of 1511 consecutive patients who underwent outpatient MPI in a multi-site, office-based, fee-for-service setting. The patients were stratified according to the 2009 AUC into appropriate/uncertain appropriateness and inappropriate use groups. Insurance status was categorized as Medicare (does not require prior authorization) vs commercial (requires prior authorization). Socioeconomic status was determined by the median household income in the ZIP code of residence. Results The proportion of patients with Medicare was 33% vs 67% with commercial Insurance. The rate of inappropriate use was higher among patients with commercial Insurance vs Medicare (55% vs 24%; P < 0.001); this difference was not significant after adjusting for confounders known to impact AUC determination (odds ratio: 1.06, 95% confidence interval: 0.62-1.82, P = 0.82). The mean annual household income in the residential areas of patients with inappropriate use as compared to those with appropriate/uncertain use was $72 000 ± 21 000 vs $68 000 ± 20 000, respectively (P < 0.001). After adjusting for covariates known to impact AUC determination, SES (top vs bottom quartile income area) was not independently predictive of inappropriate MPI use (odds ratio: 0.9, 95% confidence interval: 0.53-1.52, P = 0.69). Conclusions Insurance Carriers prior authorization and SES do not seem to play a significant role in determining physicians adherence to AUC for MPI.
Andrew J Satin - One of the best experts on this subject based on the ideXlab platform.
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implementation of a multicenter shoulder dystocia injury prevention program
Seminars in Perinatology, 2017Co-Authors: Linda Szymanski, Christine Arnold, Arthur J Vaught, Susan Lamantia, Theresa Harris, Andrew J SatinAbstract:Abstract Although the evidence for supporting the effectiveness of many patient safety practices has increased in recent years, the ability to implement programs to positively impact clinical outcomes across multiple institutions is lagging. Shoulder dystocia simulation has been shown to reduce avoidable patient harm. Neonatal injury from shoulder dystocia contributes to a significant percentage of liability claims. We describe the development and the process of implementation of a shoulder dystocia simulation program across five academic medical centers and their affiliated hospitals united by a common Insurance Carrier. Key factors in successful roll out of this program included the following: involvement of physician and nursing leadership from each academic medical center; administrative and logistic support from the insurer; development of consensus on curriculum components of the program; conduct of gap and barrier analysis; financial support from insurer to close necessary gaps and mitigate barriers; and creation of dashboards and tracking performance of the program.
G Ebel - One of the best experts on this subject based on the ideXlab platform.
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can we monitor socioeconomic inequalities in health a survey of u s health departments data collection and reporting practices
Public Health Reports, 1997Co-Authors: Nancy Krieger, J T Chen, G EbelAbstract:Objective. To evaluate the potential for and obstacles to routine monitoring of socioeconomic inequalities in health using U.S. vital statistics and disease registry data, the authors surveyed current data collection and reporting practices for specific socioeconomic variables. Methods. In 1996 the authors mailed a self-administered survey to all of the 55 health department vital statistics offices reporting data to the National Center for Health Statistics (NCHS) to determine what kinds of socioeconomic data they collected on birth and death certificates and in cancer, AIDS, and tuberculosis (TB) registries and what kinds of socioeconomic data were routinely reported in health department publications. Results. Health departments routinely obtained data on occupation on death certificates and in most cancer registries. They collected data on educational level for both birth and death certificates. None of the databases collected information on income, and few obtained data on employment status, health Insurance Carrier, or receipt of public assistance. When socioeconomic data were collected, they were usually not included in published reports (except for mothers educational level in birth certificate data). Obstacles cited to collecting and reporting socioeconomic data included lack of resources and concerns about the confidentiality and accuracy of data. All databases, however, included residential addresses, suggesting records could be geocoded and linked to Census-based socioeconomic data. Conclusions. U.S. state and Federal vital statistics and disease registries should routinely collect and publish socioeconomic data to improve efforts to monitor trends in and reduce social inequalities in health.