The Prevalence of Incontinence and Its Association With Urinary Tract Infections, Dermatitis, Slips and Falls, and Behavioral Disturbances Among Older Adults in Medicare Fee-for-Service.

Purpose: The purpose of this study was to examine the prevalence of urinary (UI), fecal (FI), and dual incontinence (DI) in older adults and their association with urinary tract infections, dermatitis, slips and falls, and behavioral disturbances based on Medicare fee-for-service (FFS) claims data.

Design: Retrospective analysis.

Subjects And Settings: Data from administrative claims from the CMS Medicare Limited Data Set (5% sample) for all months in 2018 were reviewed.

Automated Movement Assessment in Stroke Rehabilitation.

We are developing a system for long term Semi-Automated Rehabilitation At the Home (SARAH) that relies on low-cost and unobtrusive video-based sensing. We present a cyber-human methodology used by the SARAH system for automated assessment of upper extremity stroke rehabilitation at the home. We propose a hierarchical model for automatically segmenting stroke survivor's movements and generating training task performance assessment scores during rehabilitation.

Understanding the impact of five major determinants of health (genetics, biology, behavior, psychology, society/environment) on type 2 diabetes in U.S. Hispanic/Latino families: Mil Familias - a cohort study.

Background: In the United States (U.S.), the prevalence of both diagnosed and undiagnosed type 2 diabetes (T2D) is nearly twice as high among Mexican-origin Hispanic/Latino adults compared to non-Hispanic Whites.

Left-handed metamaterial bandpass filter for GPS, Earth Exploration-Satellite and WiMAX frequency sensing applications.

Interferences and accuracy problem are one of the most talked issues in today's world for sensor technology. To deal with this contention, a microstrip framework consisting of a dual mode double negative (DNG) metamaterial based bandpass filter is presented in this article. To obtain the ultimate noise reduction bandpass filter, the proposed structure has to go through a series of development process, where the characteristics of the structure are tested to the limit.

Racial and Ethnic Disparities in the Burden and Cost of Diabetes for US Medicare Beneficiaries.

To examine the burden and cost of diabetes among fee-for-service Medicare beneficiaries. Medicare 5% File data for type 1 diabetes (T1D) and type 2 diabetes (T2D) consisting of 1,397,933 enrollees in fee-for-service without Medicare Advantage during the period 2012-2013 were analyzed by race and ethnicity. Although non-Hispanic whites (nHWs) comprised most of this population (86%), prevalence of T1D and T2D was higher for Hispanics than nHWs (3.

Effects of a Population Health Community-Based Palliative Care Program on Cost and Utilization.

New population health community-based models of palliative care can result in more compassionate, affordable, and sustainable high-quality care. We evaluated utilization and cost outcomes of a standardized, population health community-based palliative care program provided by nurses and social workers. We conducted a retrospective propensity-adjusted study to quantify cost savings and resource utilization associated with a community-based palliative care program.

Medicare Cost at End of Life.

As the Medicare program struggles to control expenditures, there is increased focus on opportunities to manage patient populations more efficiently and at a lower cost. A major source of expense for the Medicare program is beneficiaries at end of life. Estimates of the percentage of Medicare costs that arise from patients in the last year of life differ, ranging from 13% to 25%, depending on methods and assumptions.

Reduced Cost Of Specialty Care Using Electronic Consultations For Medicaid Patients.

Specialty care accounts for a significant and growing portion of year-over-year Medicaid cost increases. Some referrals to specialists may be avoided and managed more efficiently by using electronic consultations (eConsults). In this study a large, multisite safety-net health center linked its primary care providers with specialists in dermatology, endocrinology, gastroenterology, and orthopedics via an eConsult platform.

Achieving Health Equity by Normalizing Cardiac Care.

It is well known that minority patients, and particularly African Americans undergo lower rates of cardiac procedures than the white population, even when covered by equivalent insurance. We analyzed the rates of percutaneous transluminal coronary angioplasty (PTCA) for acute myocardial infarction (AMI) and for intermediate coronary syndrome (ICS), and rates of transcatheter aortic valve replacement for aortic stenosis in the 2012-2013 Medicare Limited Data Set (5% sample) file. Although blacks have similar prevalence rates for AMI and ICS, they experience lower PTCA rates when compared with that of white patients (10.

Oral chemotherapy program improves adherence and reduces medication wastage and hospital admissions.

Adherence, medication wastage, and reduction in hospital admissions were investigated in a retrospective test-control study design for patients enrolled in the oral chemotherapy cycle management program (CMP), a program that offers clinical support, dose monitoring, and early identification of side effects for patients on select oral chemotherapy. Patients who initiated oral chemotherapy with sorafenib, sunitinib, or erlotinib during June 2008 through December 2009 and who were enrolled in the CMP were included as a test group. Patients who initiated oral chemotherapy with these drugs using Walgreens Specialty Pharmacy during January 2007 through May 2008 and were not part of the CMP were included as control group 1, and patients from a national payor database who initiated therapy with sorafenib, sunitinib, or erlotinib during June 2008 through August 2010 were included as control group 2.

Community pharmacy and mail order cost and utilization for 90-day maintenance medication prescriptions.

Background: Pharmacy benefit management (PBM) companies promote mail order programs that typically dispense 90-day quantities of maintenance medications, marketing this feature as a key cost containment strategy to address plan sponsors' rising prescription drug expenditures. In recent years, community pharmacies have introduced 90-day programs that provide similar cost advantages, while allowing these prescriptions to be dispensed at the same pharmacies that patients frequent for 30-day quantities.

Objective: To compare utilization rates and corresponding costs associated with obtaining 90-day prescriptions at community and mail order pharmacies for payers that offer equivalent benefits in different 90-day dispensing channels.

Medication adherence for 90-day quantities of medication dispensed through retail and mail order pharmacies.

Objectives: To examine relative medication adherence of patients filling 90-day supplies of maintenance medications using retail and mail order channels. It was hypothesized that adherence rates would not differ across the 2 channels.

Study Design: A cross-sectional retrospective analysis was conducted using de-identified pharmacy claims data from a large pharmacy benefit manager (PBM) database over a 2-year period (January 2008 to August 2010).

Impact of clinical oral chemotherapy program on wastage and hospitalizations.

Purpose: The oral chemotherapy cycle management program (CMP) provides clinical management support to patients receiving certain oral chemotherapies. The CMP includes a dose-monitoring (ie, split-fill) plan for early identification and management of adverse effects. If serious adverse effects are identified mid cycle, the remainder of the monthly supply is withheld, thus avoiding potential waste associated with early therapy discontinuation.

Assessing the value of the diabetes educator.

Purpose: The purpose of this study was to evaluate the effectiveness of diabetes self-management education or training provided by diabetes educators in reducing complications and improving quality of life.

Methods: Commercial and Medicare payer-derived claims data were used to assess the relationship between DSME/T and cost. Unlike the prior study that examined diabetes education provided by all professionals, the current study focused on the value of interventions performed as part of formal accredited/recognized diabetes education programs provided by diabetes educators only.

Impact of clinical oral chemotherapy program on wastage and hospitalizations.

Objective: The oral chemotherapy cycle management program (CMP) provides clinical management support to patients receiving certain oral chemotherapies. The CMP includes a dose-monitoring (ie, split-fill) plan for early identification and management of adverse effects. If serious adverse effects are identified mid cycle, the remainder of the monthly supply is withheld, thus avoiding potential waste associated with early therapy discontinuation.

Effects of a pregnancy management program on birth outcomes in managed Medicaid.

Objective: Examine the effect of a prenatal program on birth outcomes, specifically birth weight, in a managed Medicaid pregnant population, and identify the potential barriers to obtaining the risk screening information required for successful interventions.

Design: Retrospective propensity-adjusted cohort comparison.

Methods: Retrospective propensity-adjusted comparison of pregnant women in a managed Medicaid plan enrolled in a prenatal program and pregnant women who were not enrolled.

A cohort study of the impact of a national disease management program on HEDIS diabetes outcomes.

Diabetes disease management programs (DDMP) are proliferating, but their overall impact in improving quality of care using Health Employer Data and Information Set (HEDIS) quality metrics has not been well studied. Furthermore, DDMPs are usually ongoing, but the incremental benefits of continuing the program beyond the initial patient educational intervention have not been rigorously tested. This study evaluates the impact of length of DDMP participation on diabetes-related HEDIS 2002 quality indicators across 20 health plans.

Effectiveness of a disease management program for patients with diabetes.

Diabetes disease management programs (DDMPs) are proliferating, but their effectiveness in improving quality and mitigating health care spending has been difficult to measure. Using two quasi-experimental methods, this study analyzed the first-year results of a multistate DDMP for people with diabetes sponsored by a national managed care organization. In both analyses, overall cost of care were significantly lower in DDMP sites, and the payer saved more than it spent.