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Medicaid Spending in Coordination-Only Dual-Eligible Special Needs Plans.
JAMA Netw Open
January 2025
Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina.
Importance: More than 4 million Medicare beneficiaries have enrolled in dual-eligible Special Needs Plans (D-SNPs), and coordination-only D-SNPs are common. Little is known about the impact of coordination-only D-SNPs on Medicaid-covered services and spending, including long-term services and supports, which are financed primarily by Medicaid.
Objective: To evaluate changes in Medicaid fee-for-service (FFS) spending before and after new enrollment in coordination-only D-SNPs vs new enrollment in non-D-SNP Medicare Advantage (MA) plans among community-living beneficiaries enrolled in both Medicare and North Carolina Medicaid.
From Policy to Practice: Challenges in Implementing PROMs Reporting Under the New CMS Mandate.
J Bone Joint Surg Am
January 2025
Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
The Centers for Medicare & Medicaid Services (CMS) recently introduced mandatory reporting of patient-reported outcomes (PROs) following primary, elective total joint arthroplasty (TJA) procedures. This article explores the implications and implementation challenges of this policy shift in the field of orthopaedic surgery. With a review of the existing literature, we analyze the potential benefits and limitations of PROs, discuss the role of CMS in health-care quality improvement initiatives, explain the predicted difficulties in the successful implementation of this new mandate, and provide recommendations for the successful integration of the reporting of PROs in clinical practice.
View Article and Find Full Text PDFNational Trends in Stroke Presentation, Treatments, and Outcomes During the First 2 Years of the COVID-19 Pandemic.
Neurol Clin Pract
April 2025
Department of Health Care Policy, Harvard Medical School, Boston, MA.
Background And Objectives: Early presentation and acute treatment for patients presenting with ischemic stroke are associated with improved outcomes. The onset of the COVID-19 pandemic was associated with a large decrease in patients presenting with ischemic stroke, but it is unknown whether these changes persisted.
Methods: This study analyzed emergency department (ED) stroke presentations (n = 158,060) to all nonfederal hospitals in the 50 states and Washington, D.
A time series analysis of Medicare-reimbursed telepsychiatry consultations across Australian states and territories before and after telehealth item expansion: Enabling policy can improve access to care.
J Telemed Telecare
January 2025
Academic Unit of Psychiatry & Addiction Medicine, School of Medicine and Psychology, The Australian National University, Canberra, Australia.
Objective: We aimed to examine the associations of telepsychiatry consultations with the Medicare Benefits Schedule (MBS) telehealth policy changes (pandemic-related expansion and subsequent consolidation).
Methods: We performed a time series analysis of MBS telepsychiatry usage (January 2016-December 2023) using state/territory-level Medicare panel data. Linear regression analyses with panel-corrected standard error and autocorrelation were performed for telepsychiatry consultations (overall and age and sex subgroups).
Economic impact and clinical benefits of clinical pharmacy interventions: A six-year multi-center study using an innovative medication management tool.
PLoS One
January 2025
Cleopatra Hospital, Cleopatra Hospitals Group-(CHG), Cairo, Egypt.
Background: Increasing healthcare costs, particularly in Low- and Middle-Income Countries (LMICs) like Egypt, highlight the need for rational economic strategies. Clinical pharmacy interventions offer potential benefits by reducing drug therapy problems and associated costs, thereby supporting healthcare system sustainability.
Objective: This study evaluates the economic impact and clinical benefits of clinical pharmacy interventions in four tertiary hospitals in Egypt by implementing an innovative tool for medication management, focusing on cost avoidance and return on investment (ROI), while accounting for case severity and drug therapy problem (DTP) resolution.
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