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Member Adherence to a Health Insurer-Sponsored Gap Closure Program Using Multi-Target Stool DNA Test for Colorectal Cancer Screening.
J Prim Care Community Health
December 2024
Exact Sciences Corporation, Madison, WI, USA.
Objectives: To describe member adherence to a mail-based, health insurer-sponsored gap closure program for colorectal cancer (CRC) screening using multi-target stool DNA (mt-sDNA; Cologuard) tests.
Methods: Combined patient data from Exact Sciences Laboratories LLC and data from mass-mailed mt-sDNA orders placed by a large Medicare Advantage Insurance Plan were analyzed (03/01/2023-06/30/2023). Adherence and time to test return were the primary and secondary outcomes, respectively.
Testing the Feasibility of a Cross-Setting Measure to Address the Rising Trend in Hospital Outpatient TJA Procedures.
J Bone Joint Surg Am
December 2024
Center for Outcomes Research and Evaluation, Yale New Haven Health Services Corporation, New Haven, Connecticut.
Background: Elective primary total hip and total knee arthroplasty (collectively, total joint arthroplasties [TJAs]) are commonly performed procedures that can reduce pain and improve function. TJAs are generally safe, but complications can occur. Although historically performed as inpatient procedures, TJAs are increasingly being performed in the outpatient setting.
View Article and Find Full Text PDFThe physician payments Sunshine Act and medical oncology: a seven-year financial analysis.
Med Oncol
November 2024
Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.
The integration of pharmaceutical and medical device companies with clinical practice is under scrutiny due to financial incentives that may influence oncology care. The Physician Payments Sunshine Act mandates transparency in these financial relationships. This study examines the trends in non-research payments to oncology specialists between 2017 and 2023, analyzing amounts, reasons, and variations by subspecialty and region.
View Article and Find Full Text PDFStrength of evidence underlying the CMS-FDA parallel review of comprehensive genomic profiling tests in the cancer setting.
J Natl Cancer Inst
January 2025
Cancer Outcomes Public Policy and Effectiveness Research Center, Yale School of Medicine, New Haven, CT, USA.
Article Synopsis
- The study evaluated the evidence supporting the use of comprehensive genomic profiling (CGP) for cancer patients through an analysis of literature cited in a key coverage memorandum for the FoundationOne CDx test.
- Researchers reviewed 113 studies, finding that most were not conducted within a clinical setting and showed a wide variety of cancer types without consistency in the depth of sequencing.
- The review highlighted significant gaps in evidence, especially lacking rigorous studies that assess how CGP affects clinical outcomes, suggesting a need for better research to guide the approval of such diagnostic tests.
Market Factors, Not Quality, Influence Reimbursement for Pancreaticoduodenectomy in an Era of Price Transparency.
Ann Surg Oncol
November 2024
Department of Surgery, Duke University Medical Center, Durham, NC, USA.
Background: The Centers for Medicare and Medicaid Services (CMS) price transparency rule tries to facilitate cost-conscious decision-making. For surgical services, such as pancreaticoduodenectomy (PD), factors mediating transparency and real-world reimbursement are not well described.
Methods: The Leapfrog Survey was used to identify United States hospitals performing PD.
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