Clinical and healthcare use outcomes after cessation of long term opioid treatment due to prescriber workforce exit: quasi-experimental difference-in-differences study.

Objective: To examine the association between prescriber workforce exit, long term opioid treatment discontinuation, and clinical outcomes.

Design: Quasi-experimental difference-in-differences study SETTING: 20% sample of US Medicare beneficiaries, 2011-18.

Participants: People receiving long term opioid treatment whose prescriber stopped providing office based patient care or exited the workforce, as in the case of retirement or death (n=48 079), and people whose prescriber did not exit the workforce (n=48 079).

Tiered Physician Network Plans and Patient Choices of Specialist Physicians.

Importance: Tiered physician network (TPN) health plans sort physicians into tiers based on their cost and quality, and patients pay lower copays for visits with physicians in the lower-cost and better-quality tiers. When the plans are first introduced, they lead patients to seek care from higher-value physicians.

Objectives: To examine whether TPNs are associated with patient choice of physician when the plans have been in place for 8 to 12 years and whether there are inequities in patient out-of-pocket costs associated with inequities in access to physicians in lower-copay tiers.

Association of County-Level Prescriptions for Hydroxychloroquine and Ivermectin With County-Level Political Voting Patterns in the 2020 US Presidential Election.

This cross-sectional study examines whether an association exists between US county-level prescription rates of hydroxychloroquine and ivermectin and how people voted in the 2020 US presidential election.

Out-of-Pocket Spending for Asthma-Related Care Among Commercially Insured Patients, 2004-2016.

Background: Out-of-pocket (OOP) health care costs can cause financial burden and deferred care for many Americans. Little is known about OOP spending for asthma-related care among the commercially insured.

Objectives: To analyze OOP spending for asthma-related care overall, across types of care, and by income.

Association of eConsult Implementation With Access to Specialist Care in a Large Urban Safety-Net System.

Importance: Accessing specialty care continues to be a persistent problem for patients who use safety-net health systems. To address this access barrier, hospital systems have begun to implement electronic referral systems using eConsults, which allow clinicians to submit referral requests to specialty clinics electronically and enable specialty reviewers to resolve referrals, if appropriate, through electronic dialogue without an in-person visit.

Objective: Measure the effect of implementing an eConsult program on access to specialty care.

Admission Practices And Cost Of Care For Opioid Use Disorder At Residential Addiction Treatment Programs In The US.

The use of acute, short-term residential care for opioid use disorder has grown rapidly, with policy makers advocating to increase the availability of "treatment beds." However, there are concerns about high costs and misleading recruitment practices. We conducted an audit survey of 613 residential programs nationally, posing as uninsured cash-paying individuals using heroin and seeking addiction treatment.

Abrupt Discontinuation of Long-term Opioid Therapy Among Medicare Beneficiaries, 2012-2017.

Background: With mounting pressure to reduce opioid use, concerns exist about abrupt withdrawal of treatment for the millions of Americans using long-term opioid therapy (LTOT). However, little is known about how patients are tapered from LTOT nationally.

Objective: Measure national patterns of LTOT discontinuation and adherence to recommended tapering speed.

Association of Peer Comparison Emails With Electronic Health Record Documentation of Cancer Stage by Oncologists.

Importance: Systematically capturing cancer stage is essential for any serious effort by health systems to monitor outcomes and quality of care in oncology. However, oncologists do not routinely record cancer stage in machine-readable structured fields in electronic health records (EHRs).

Objective: To evaluate whether a peer comparison email intervention that communicates an oncologist's performance on documenting cancer stage relative to that of peer physicians was associated with increased likelihood that stage was documented in the EHR.

Therapies Offered at Residential Addiction Treatment Programs in the United States.

This study uses simulated patient calls to a random sample of US residential addiction treatment facilities to investigate the availability of opioid agonist treatment (buprenorphine-naloxone) and nonpharmacologic therapies (eg, CBT) for opioid use disorder, and differences by for-profit vs nonprofit center status.

Access to Office-Based Buprenorphine Treatment in Areas With High Rates of Opioid-Related Mortality: An Audit Study.

Background: Improving access to treatment for opioid use disorder is a national priority, but little is known about the barriers encountered by patients seeking buprenorphine-naloxone ("buprenorphine") treatment.

Objective: To assess real-world access to buprenorphine treatment for uninsured or Medicaid-covered patients reporting current heroin use.

Design: Audit survey ("secret shopper" study).