Patient characteristics associated with frequent telehealth utilization in 2022: Evaluation of a national virtual integrated medical and behavioral health practice within the United States.

Objectives: As permanent telehealth policies are considered in the United States (U.S.), it is important to understand who uses telehealth most often following the pandemic.

Association Between Antibiotic Receipt and Provider Rating Within a National Telemedicine Practice.

This retrospective cohort study estimated the association between prescription receipt and provider 5-star rating for adult visits with upper respiratory infections in a national telemedicine practice with active antibiotic stewardship initiatives. The odds of a 5-star rating were higher for visits with an antibiotic or nonantibiotic prescription and longer visits.

Adults' willingness to report sexual orientation and gender identity when registering for a digital health application: A cross-sectional quantitative study.

The collection of patient sexual orientation and gender identity information is crucial in identifying and addressing disparities in healthcare access, quality, and outcomes for sexual and gender minority individuals. While some studies have explored patients' willingness to disclose this information in specific settings, little is known about response rates in digital health applications. In light of the growing use of digital health, including virtual care, we sought to determine whether adults would respond to optional sexual orientation and gender identity fields during registration for a digital health application offered through their employer-provided benefits.

Patient-reported Outcomes Among Vulnerable Populations in the Medicare Bundled Payments for Care Improvement Initiative.

Background: The Centers for Medicare & Medicaid Services Bundled Payments for Care Improvement (BPCI) initiative tested whether episode-based payment models could reduce Medicare payments without harming quality. Among patients with vulnerabilities, BPCI appeared to effectively reduce payments while maintaining the quality of care. However, these findings could overlook potential adverse patient-reported outcomes in this population.

Bundled Payment Episodes Initiated by Physician Group Practices: Medicare Beneficiary Perceptions of Care Quality.

Background: The Bundled Payments for Care Improvement (BPCI) initiative incentivizes participating providers to reduce total Medicare payments for an episode of care. However, there are concerns that reducing payments could reduce quality of care.

Objective: To assess the association of BPCI with patient-reported functional status and care experiences.

Medicare's Bundled Payments For Care Improvement Initiative Maintained Quality Of Care For Vulnerable Patients.

The Bundled Payments for Care Improvement (BPCI) initiative established four models to test whether linking payments for an episode of care could reduce Medicare payments while maintaining or improving quality. Evaluations concluded that model 2, the largest, generally lowered payments without reducing quality for the average beneficiary, but these global results could mask adverse findings among vulnerable subpopulations. We analyzed changes in emergency department visits, unplanned hospital readmissions, and all-cause mortality within ninety days of hospital discharge among beneficiaries with one or more of three vulnerable characteristics-dementia, dual eligibility for Medicare and Medicaid, and recent institutional care-in 105,458 beneficiary episodes in the period October 2013-December 2016.

Association Between Hospital Participation in a Medicare Bundled Payment Initiative and Payments and Quality Outcomes for Lower Extremity Joint Replacement Episodes.

Importance: Bundled Payments for Care Improvement (BPCI) is a voluntary initiative of the Centers for Medicare & Medicaid Services to test the effect of holding an entity accountable for all services provided during an episode of care on episode payments and quality of care.

Objective: To evaluate whether BPCI was associated with a greater reduction in Medicare payments without loss of quality of care for lower extremity joint (primarily hip and knee) replacement episodes initiated in BPCI-participating hospitals that are accountable for total episode payments (for the hospitalization and Medicare-covered services during the 90 days after discharge).

Design, Setting, And Participants: A difference-in-differences approach estimated the differential change in outcomes for Medicare fee-for-service beneficiaries who had a lower extremity joint replacement at a BPCI-participating hospital between the baseline (October 2011 through September 2012) and intervention (October 2013 through June 2015) periods and beneficiaries with the same surgical procedure at matched comparison hospitals.

Autism occurrence by MMR vaccine status among US children with older siblings with and without autism.

Importance: Despite research showing no link between the measles-mumps-rubella (MMR) vaccine and autism spectrum disorders (ASD), beliefs that the vaccine causes autism persist, leading to lower vaccination levels. Parents who already have a child with ASD may be especially wary of vaccinations.

Objective: To report ASD occurrence by MMR vaccine status in a large sample of US children who have older siblings with and without ASD.

Injuries among children with autism spectrum disorder.

Objective: We compared risk of injury among children with autism spectrum disorder (ASD) to those without ASD, adjusting for demographic and clinical characteristics.

Methods: We used claims data from 2001 to 2009 from a commercial health plan in the United States. A validated ASD case identification algorithm identified 33,565 children (ages 0-20 years) with ASD and 138,876 children without.

Psychotropic medication use and polypharmacy in children with autism spectrum disorders.

Objective: The objectives of this study were to examine rates and predictors of psychotropic use and multiclass polypharmacy among commercially insured children with autism spectrum disorders (ASD).

Methods: This retrospective observational study used administrative medical and pharmacy claims data linked with health plan enrollment and sociodemographic information from 2001 to 2009. Children with ASD were identified by using a validated ASD case algorithm.