The importance of identification when measuring performance in addiction treatment.

Identifying and effectively treating individuals with substance use disorders (SUDs) is an important priority for state Medicaid programs, given the enormous toll that SUDs take on individuals, their families, and their communities. In this paper, we describe how the Healthcare Effectiveness Data and Information Set (HEDIS) measure "Identification of Alcohol and Other Drug Services" can be used, along with eligible population prevalence rates, to expand states' ability to track how well their Medicaid programs identify enrollees with SUDs and link them with treatment (measured by initiation and engagement performance measures). We use the 2009 Medicaid MAX data on utilization and enrollment along with information from the National Survey of Drug Use and Health (NSDUH) to obtain state-level estimates of alcohol and drug abuse and dependence among Medicaid beneficiaries for 7 illustrative states.

Use of Inpatient Behavioral Health Services by Children and Adolescents With Private Insurance Coverage.

Objective: This study examined trends in hospitalizations of youths for behavioral health conditions in acute care hospital nonpsychiatric beds, acute care hospital psychiatric and detoxification beds, and specialty psychiatric hospitals.

Methods: Using data on hospitalizations for behavioral health conditions in 2009 (N=21,805) and 2014 (N=27,550) from the MarketScan Commercial Claims and Encounters database, this study examined the percentage of youths (ages two to 18) with one or more hospitalizations, by demographic characteristic and bed type, and the behavioral health diagnoses for which patients were hospitalized.

Results: The greatest increase in hospitalizations of youths occurred in acute care hospital psychiatric and detoxification beds.

Prevalence and screening for anaemia in mild to moderate Crohn's disease and ulcerative colitis in the United States, 2010-2014.

Background And Aims: Anaemia affects up to 74% patients with Crohn's disease (CD) and ulcerative colitis (UC) and is correlated with decreased quality of life. The European Crohn's and Colitis Organisation (ECCO) recommends at least annual screening for iron-deficiency anaemia. We aimed to determine the prevalence of anaemia, frequency of anaemia screening and factors associated with anaemia in a retrospective study of mild to moderate inflammatory bowel disease (IBD) in the USA.

MULTIMODAL IMAGING AND HISTOLOGIC CORRELATION OF ISOLATED METASTASIS OF PROSTATE ADENOCARCINOMA TO THE CHOROID.

Purpose: To provide correlative clinical-multimodal imaging-histopathologic findings of isolated prostatic choroidal metastasis.

Methods: Ophthalmologic examination, fluorescein angiogram, spectral-domain optical coherence tomography, fundus autofluorescence, computerized tomography, magnetic resonance imaging, positive emission tomography, CSF analysis, serologies, tissue pathology with immunohistochemistry, and examination of relevant literature.

Results: A 76-year-old man with a history of prostate adenocarcinoma was referred for 2 months of unilateral blurry vision.

Effect of Direct-to-Consumer Advertising on Asthma Medication Sales and Healthcare Use.

Rationale: The United States is one of only two countries that permit direct-to-consumer advertising (DTCA) of prescription drugs, and many questions remain regarding its effects.

Objectives: To quantify the association between asthma-related DTCA, pharmacy sales, and healthcare use.

Methods: This was an ecological study from 2005 through 2009 using linked data from Nielsen (DTCA television ratings), the IMS Health National Prescription Audit (pharmacy sales), and the MarketScan Commercial Claims data (healthcare use) for 75 designated market areas in the United States.

Establishing the feasibility of measuring performance in use of addiction pharmacotherapy.

This paper presents the rationale and feasibility of standardized performance measures for use of pharmacotherapy in the treatment of substance use disorders (SUD), an evidence-based practice and critical component of treatment that is often underused. These measures have been developed and specified by the Washington Circle, to measure treatment of alcohol and opioid dependence with FDA-approved prescription medications for use in office-based general health and addiction specialty care. Measures were pilot tested in private health plans, the Veterans Health Administration (VHA), and Medicaid.

Psychiatric and medical comorbidities, associated pain, and health care utilization of patients prescribed buprenorphine.

This study describes the comorbidities and health care utilization of individuals treated with buprenorphine using the 2007-2009 MarketScan Research Databases. Buprenorphine recipients had a high prevalence of comorbidities associated with chronic pain, including back problems (42%), connective tissue disease (24-27%), and nontraumatic joint disorders (20-23%). Approximately 69% of recipients filled prescriptions for opioid agonist medications in the 6 months before buprenorphine initiation.

Mental health spending by private insurance: implications for the mental health parity and addiction equity act.

Objective: The study developed information on behavioral health spending and utilization that can be used to anticipate, evaluate, and interpret changes in health care spending following implementation of the Mental Health Parity and Addiction Equity Act (MHPAEA).

Methods: Data were from the Thomson Reuters' MarketScan database of insurance claims between 2001 and 2009 from large group health plans sponsored by self-insured employers. Annual rates in growth of total health spending and behavioral health spending and the contribution of behavioral health spending to growth in spending for all diseases were determined.

What every hospitalist should know about the post-bariatric surgery patient.

Obesity is a growing worldwide epidemic, increasingly addressed through surgical options for weight loss. Benefits of these operations, such as weight loss and improvement or reversal of obesity-related comorbidities, are well established; however, postoperative complications do occur. This article will evaluate common causes for hospital admissions in the post-bariatric surgery population as they relate to the hospitalist who is often responsible for their care.

Revised cost estimates of Medicaid recipients with serious mental illness and HIV-AIDS.

Objective: The aim of this brief report is to provide accurate 1996 baseline cost estimates for persons with co-occurring HIV and serious mental illness by revising original figures previously reported by the authors.

Methods: Data were examined for 23,729 adults who were enrolled in Medicaid in 1996. A comparison of utilization and cost of services was done for four groups: serious mental illness and HIV-AIDS, serious mental illness only, HIV-AIDS only, and neither condition.

Healthcare utilization of individuals with opiate use disorders: an analysis of integrated medicaid and state mental health/substance abuse agency data.

Data from the Substance Abuse and Mental Health Services Administration's Integrated Database (IDB) were used to examine the service use patterns of individuals with possible opiate use disorders in Washington State. Results indicate that regardless of Medicaid enrollment status, individuals who received mental health (MH) or substance abuse (SA) services only through state agencies received no inpatient substance abuse service. Furthermore, when compared with individuals who received at least one MH/SA service through Medicaid, those who received services only through the state agencies were less likely to have received any MH services and were more likely to have received residential SA services.

Treatment with antidepressant medications in private health plans.

This study analyzed 2002 MarketScan data from a convenience sample of enrollees with private health insurance from the largest U.S. firms to examine utilization, expenditures, and factors associated with antidepressant prescriptions.

Mental health services for children in large, employer-based health plans, 1999.

This study examines 1999 data from Medstat's MarketScan database of privately insured employees of US firms and their dependents. Of enrolled children and adolescents ages 2-18, 6.6% had claims for mental health services.

Children's mental health services in fee-for-service Medicaid.

This study analyzed annual service use and payment data for children in racial/ ethnic subgroups in Medicaid Programs of four States, and compared service use of youth treated with mental health or substance abuse (MH/SA) conditions to youth without such conditions. In addition to geographic variation in rates (6.2 to 10.

Use of mental health and substance abuse services among high-cost Medicaid enrollees.

Users of mental health and substance abuse (MH/SA) services were examined among nonelderly high-cost Medicaid enrollees in 10 states in 1995. Although MH/SA service users constitute 11% of all Medicaid enrollees, they make up nearly a third of high-cost enrollees. Adults account for two thirds of this high-cost MH/SA group, and most frequently qualify for Medicaid through disability-related eligibility categories.

Prevalence and costs of major depression among elderly claimants with diabetes.

Objective: To compare the odds of major depression among Medicare claimants with and without diabetes and to test whether annual medical payments are greater for those with both diabetes and major depression than for those with diabetes alone.

Research Design And Methods: This retrospective analysis relies on claims data from the 1997 Medicare 5% Standard Analytic Files. Using these data, we statistically determined whether the odds of major depression are greater among elderly claimants with diabetes after controlling for age, race/ethnicity, and sex.