The Experts below are selected from a list of 11733 Experts worldwide ranked by ideXlab platform
Ateev Mehrotra - One of the best experts on this subject based on the ideXlab platform.
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direct to consumer telehealth may increase access to care but does not decrease spending
Health Affairs, 2017Co-Authors: Scott J Ashwood, Ateev Mehrotra, David W Cowling, Lori UscherpinesAbstract:The use of direct-to-consumer telehealth, in which a patient has access to a Physician via telephone or videoconferencing, is growing rapidly. A key attraction of this type of telehealth for health plans and employers is the potential savings involved in replacing Physician Office and emergency department visits with less expensive virtual visits. However, increased convenience may tap into unmet demand for health care, and new utilization may increase overall health care spending. We used commercial claims data on over 300,000 patients from three years (2011–13) to explore patterns of utilization and spending for acute respiratory illnesses. We estimated that 12 percent of direct-to-consumer telehealth visits replaced visits to other providers, and 88 percent represented new utilization. Net annual spending on acute respiratory illness increased $45 per telehealth user. Direct-to-consumer telehealth may increase access by making care more convenient for certain patients, but it may also increase utilizat...
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a comparison of care at e visits and Physician Office visits for sinusitis and urinary tract infection
JAMA Internal Medicine, 2013Co-Authors: Ateev Mehrotra, Suzanne Paone, Daniel G Martich, Steven M Albert, Grant J ShevchikAbstract:Internet capabilities create the opportunity for eVisits, in which Physicians and patients interact virtually instead of face-to-face. In an eVisit, a patient logs into her secure personal health record internet portal and answers a series of questions about her condition. This written information is sent to the Physician, who makes a diagnosis, orders necessary care, puts a note in the patient’s electronic medical record (EMR), and replies to the patient via the secure portal within several hours. eVisits are offered by numerous health systems and are commonly reimbursed by health plans.1,2 eVisits typically focus on care for acute conditions, such as minor infections. There are several potential advantages of eVisits, including convenience and efficiency (avoiding travel and time) and lower costs.3 Further, eVisits can be provided by the patient’s primary care Physician (PCP) instead of a Physician at an emergency department or urgent care center. The main concerns about eVisits center on quality issues: whether Physicians can make accurate diagnoses without a face-to-face interview or physical exam,4 whether use of tests and follow-up visits is appropriate, and whether antibiotics might be overprescribed. No studies have characterized the differences between eVisits and Office visits. To fill this knowledge gap, we compared the care at eVisits and Office visits for two conditions--sinusitis and urinary tract infection (UTI).
Brent K. Hollenbeck - One of the best experts on this subject based on the ideXlab platform.
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Effects of the Medicare Modernization Act on Spending for Outpatient Surgery.
Health Services Research, 2017Co-Authors: John M. Hollingsworth, Mary K. Oerline, Chandy Ellimoottil, Lindsey A. Herrel, Brent K. HollenbeckAbstract:OBJECTIVES To examine the effects of Medicare's revised ambulatory surgery center (ASC) payment schedule on overall payments for outpatient surgery. DATA SOURCES Twenty percent sample of national Medicare beneficiaries. STUDY DESIGN We conducted a pre-post study of Medicare beneficiaries who underwent outpatient surgery in a hospital outpatient department (HOPD), ASC, or Physician Office between 2004 and 2011. Specifically, we used multivariable regression to compare temporal trends in outpatient surgery before and after implementation of Medicare's revised payment schedule in 2008, which reduced ASC facility payments to roughly two-thirds that of HOPDs. Our outcome measures included overall Medicare payments, utilization rates, per beneficiary spending, and average episode payments for outpatient surgery. PRINCIPAL FINDINGS Between the last quarters of 2007 and 2008, overall Medicare payments for outpatient surgery grew by $334 million-an amount nearly three times higher than would have been expected without the policy change (p
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medicare payments for outpatient urological surgery by location of care
The Journal of Urology, 2012Co-Authors: John M. Hollingsworth, Christopher S Saigal, Rodney L Dunn, Seth A Strope, Brent K. HollenbeckAbstract:Purpose: The cost implications associated with offloading outpatient surgery from hospitals to ambulatory surgery centers and the Physician Office remain poorly defined. Therefore, we determined whether payments for outpatient surgery vary by location of care.Materials and Methods: Using national Medicare claims from 1998 to 2006, we identified elderly patients who underwent 1 of 22 common outpatient urological procedures. For each procedure we measured all relevant payments (in United States dollars) made during the 30-day claims window that encompassed the procedure date. We then categorized payment types (hospital, Physician and outpatient facility). Finally, we used multivariable regression to compare price standardized payments across hospitals, ambulatory surgery centers and the Physician Office.Results: Average total payments for outpatient surgery episodes varied widely from $200 for urethral dilation in the Physician Office to $5,688 for hospital based shock wave lithotripsy. For all but 2 proced...
Jose Ignacio Santospreciado - One of the best experts on this subject based on the ideXlab platform.
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prevalence of respiratory virus in symptomatic children in private Physician Office settings in five communities of the state of veracruz mexico
BMC Research Notes, 2015Co-Authors: Rosa Maria Wongchew, Marco A Espinoza, Blanca Taboada, Fernando E Aponte, Maria A Ariasortiz, Jesus Mongemartinez, Ruben Rodriguezvazquez, Fidel Diazhernandez, Fernando Zaratevidal, Jose Ignacio SantospreciadoAbstract:Acute respiratory tract infections are the leading cause of morbidity and mortality in children worldwide. Many studies have described the frequency of viruses in hospitalized patients, but studies describing the prevalence of viruses in the community setting are limited, particularly in developing countries, where most of the deaths from serious respiratory diseases occur. The aim of this study was to evaluate the diversity of respiratory viruses in the community setting using molecular diagnostic tools, as well as the clinical characteristics of respiratory viral infections in the general pediatric practice in Mexico. Children with respiratory tract infections attending private pediatric practices during a 10-month period in five cities of the state of Veracruz were included. Nasal swabs were taken and processed by a multiplex detection kit for 15 respiratory viruses. 525 children were included from July 2011 to May 2012; 44% were female, mean age was 45 months. The 3 most frequent clinical diagnosis were: rhinopharyngitis 68%, pharyngitis 18%, and 3.3% influenza-like illness. 71.5% of the samples were positive for virus. The five most frequent pathogens were respiratory syncycitial virus in 18.3% of the children, rhinovirus in 17.5%, influenza A 9.1%, adenovirus 7.2%, and enterovirus 3.4%, although all 15 viruses were detected; there were viral coinfections in 14.1%, and 28.5% of the samples were negative. A large proportion of respiratory infections in the community setting in Mexico was associated to viruses. Although testing for common respiratory pathogens in children with acute respiratory tract infections may lead to a better understanding of the role of viral pathogens in, and eventually to improvement in the management of, individual patients, additional prospective studies are required to study the need of routinely using such tests in general pediatric practices in resource-limited countries.
Lori Uscherpines - One of the best experts on this subject based on the ideXlab platform.
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direct to consumer telehealth may increase access to care but does not decrease spending
Health Affairs, 2017Co-Authors: Scott J Ashwood, Ateev Mehrotra, David W Cowling, Lori UscherpinesAbstract:The use of direct-to-consumer telehealth, in which a patient has access to a Physician via telephone or videoconferencing, is growing rapidly. A key attraction of this type of telehealth for health plans and employers is the potential savings involved in replacing Physician Office and emergency department visits with less expensive virtual visits. However, increased convenience may tap into unmet demand for health care, and new utilization may increase overall health care spending. We used commercial claims data on over 300,000 patients from three years (2011–13) to explore patterns of utilization and spending for acute respiratory illnesses. We estimated that 12 percent of direct-to-consumer telehealth visits replaced visits to other providers, and 88 percent represented new utilization. Net annual spending on acute respiratory illness increased $45 per telehealth user. Direct-to-consumer telehealth may increase access by making care more convenient for certain patients, but it may also increase utilizat...
Anthony Masaquel - One of the best experts on this subject based on the ideXlab platform.
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chemotherapy treatment patterns by site of care soc a comparison of the Physician Office versus hospital outpatient setting
Journal of Clinical Oncology, 2015Co-Authors: Sari Hopson, Andrew M. Howe, Stephen Stemkowski, Jeffrey Patton, Art Small, Adrianne Waldman Casebeer, Brian Barnett, Anthony MasaquelAbstract:e17670 Background: First line chemotherapy regimens for a variety of cancer types have been found to differ by site of care. This is the first study to explore differences in treatment patterns bet...
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Baseline demographic characteristics and treatment patterns by cancer site of care: Physician Office versus hospital outpatient.
Journal of Clinical Oncology, 2014Co-Authors: Andrew M. Howe, Stephen Stemkowski, Sari Hopson, Joseph Dye, Jeffrey Patton, Anthony Masaquel, Art SmallAbstract:e17536 Background: Chemotherapy infusion costs among different oncology sites of care may be due to patient demographic and utilization differences. We compared baseline demographic, clinical and healthcare (HC) costs between patients receiving chemotherapy or biologic infusions at independent Physician Office (PO) and hospital outpatient (HO) cancer treatment centers in the US. Methods: Claims data from Humana’s Commercial and Medicare health plan during 2007-2013 were used to identify continuously enrolled patients who received infusion therapy within 120 days post diagnosis for early stage breast (esBC), metastatic breast (mBC), metastatic colorectal (mCRC), metastatic lung (mLC) cancers, non-Hodgkin’s Lymphoma (NHL) or chronic lymphocytic leukemia (CLL). Site of care codes were used to categorize patients by infusion therapy location. Patient demographic, cancer clinical characteristics and HC costs at baseline (6 month pre-index infusion) were summarized in each cohort. Results: A total of 19,589 pat...