Reduced Cost Sharing and Medication Management Services for COPD: A Randomized Clinical Trial.

Importance: High out-of-pocket costs and improper use of maintenance inhalers contribute to poor outcomes among patients with chronic obstructive pulmonary disease (COPD). There is limited evidence for how addressing these barriers could improve adherence and affect COPD exacerbations, spending, or racial disparities in these outcomes.

Objective: To examine the effect of a national program to reduce beneficiary cost sharing for COPD maintenance inhalers and provide medication management services that included education on proper technique for inhaler use.

Effect of Cash Benefits on Health Care Utilization and Health: A Randomized Study.

Importance: Poverty is associated with greater barriers to health care and worse health outcomes, but it remains unclear whether income support can improve health.

Objective: To examine the effect of cash benefits on health care utilization and health.

Design, Setting, And Participants: The City of Chelsea, Massachusetts, a low-income community near Boston, randomly assigned individuals by lottery to receive cash benefits.

The Underuse of Medicare's Prevention and Coordination Codes in Primary Care : A Cross-Sectional and Modeling Study.

Background: Efforts to better support primary care include the addition of primary care-focused billing codes to the Medicare Physician Fee Schedule (MPFS).

Objective: To examine potential and actual use by primary care physicians (PCPs) of the prevention and coordination codes that have been added to the MPFS.

Design: Cross-sectional and modeling study.

Medicare's Care Management Codes Might Not Support Primary Care As Expected.

To enhance compensation for primary care activities that occur outside of face-to-face visits, the Centers for Medicare and Medicaid Services recently introduced new billing codes for transitional care management (TCM) and chronic care management (CCM) services. Overall, rates of adoption of these codes have been low. To understand the patterns of adoption, we compared characteristics of the practices that billed for these services to those of the practices that did not and determined the extent to which a practice other than the beneficiary's usual primary care practice billed for the services.

Professional Dissonance and Burnout in Primary Care: A Qualitative Study.

Importance: Burnout negatively affects physician health, productivity, and patient care. Its prevalence is high among physicians, especially those in primary care, yet few qualitative studies of burnout have been performed that engage frontline primary care practitioners (PCPs) for their perspectives.

Objective: To identify factors contributing to burnout and low professional fulfillment, as well as potential solutions, by eliciting the views of PCPs.

Blue-Collar Workers Had Greatest Insurance Gains After ACA Implementation.

Analyzing national survey data, we found that workers in traditionally blue-collar industries (service jobs, farming, construction, and transportation) experienced the largest gains in health insurance after implementation of the Affordable Care Act (ACA) in 2014. Compared to other occupations, these had lower employer-based coverage rates before the ACA. Most of the post-ACA coverage gains came from Medicaid and directly purchased nongroup insurance.

Patterns in Outpatient Benzodiazepine Prescribing in the United States.

Importance: Benzodiazepines are implicated in a growing number of overdose-related deaths.

Objectives: To quantify patterns in outpatient benzodiazepine prescribing and to compare them across specialties and indications.

Design, Setting, And Participants: This serial cross-sectional study (January 1, 2003, through December 31, 2015) used nationally representative National Ambulatory Medical Care Survey data.

A Novel Decision Aid to Encourage Smoking Cessation Among Patients at an Urban Safety Net Clinic.

Introduction: Decision aids are not readily available to individualize the benefits of smoking cessation but could help health care providers engage in meaningful conversations with their patients to explore and encourage an attempt to quit smoking. We conducted a pilot study of a novel decision aid among an underserved population to assess its effectiveness in increasing readiness to quit and quit attempts.

Methods: We designed a decision aid that used images of birthday cakes to highlight the number of years of life that could be gained from smoking cessation and tested it in an urban safety net clinic.