The substance-exposed birthing person-infant/child dyad and health information exchange in the United States.

Objective: Timely access to data is needed to improve care for substance-exposed birthing persons and their infants, a significant public health problem in the United States. We examined the current state of birthing person and infant/child (dyad) data-sharing capabilities supported by health information exchange (HIE) standards and HIE network capabilities for data exchange to inform point-of-care needs assessment for the substance-exposed dyad.

Material And Methods: A cross-map analysis was performed using a set of dyadic data elements focused on pediatric development and longitudinal supportive care for substance-exposed dyads (70 birthing person and 110 infant/child elements).

Comparison of Alternative Approaches to Using Race-and-Ethnicity Data in Estimating Differences in Health Care and Social Determinants of Health.

Objective: The objective of this study was to compare 2 approaches for representing self-reported race-and-ethnicity, additive modeling (AM), in which every race or ethnicity a person endorses counts toward measurement of that category, and a commonly used mutually exclusive categorization (MEC) approach. The benchmark was a gold-standard, but often impractical approach that analyzes all combinations of race-and-ethnicity as distinct groups.

Methods: Data came from 313,739 respondents to the 2021 Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys who self-reported race-and-ethnicity.

National Health Expenditures In 2023: Faster Growth As Insurance Coverage And Utilization Increased.

Health care spending in the US reached $4.9 trillion and increased 7.5 percent in 2023, growing from a rate of 4.

Non-cost-related sources of medication nonadherence in the Medicare population.

Significant research and attention to date have focused on cost-related medication nonadherence as rising prescription drug prices worsen affordability and access for many Americans. This study investigated self-reported sources of medication nonadherence, measuring both cost- and non-cost-related medication nonadherence among community-dwelling Medicare Part D beneficiaries in 2022. A total of 13.

Use of proton pump inhibitors and risk of severe COVID-19: A case-control study in United States Medicare beneficiaries.

Background: Concerns have been raised regarding proton pump inhibitor (PPI) use and risk of severe coronavirus disease 2019 (COVID-19). Observational studies have yielded heterogeneous results and were subject to important methodological limitations.

Aims: To examine the association between the receipt of PPIs and risk of COVID-19 hospitalizations and severe in-hospital outcomes or death.

Health Care Use of ACA Marketplace Enrollees During the COVID-19 Pandemic.

The onset of the COVID-19 pandemic in March 2020 had a sudden and substantial impact on health care utilization for most, if not all, individuals. We study the impact the pandemic had on the population insured in the individual and small group markets under the Patient Protection and Affordable Care Act (ACA) of 2010, using administrative claims data from January 2019 through December 2021. Our results demonstrated how health care utilization differed between the acute phase (i.

Sharing Social Needs Data Across Sectors: Lessons From the Centers for Medicare and Medicaid Services Innovation Center's Accountable Health Communities Model.

Health-related social needs (HRSNs), like unstable housing, inability to afford utilities, food insecurity, unreliable transportation, and lack of personal safety, profoundly affect people's health and well-being. Between 2017 and 2022, awardees of the Accountable Health Communities Model (AHC) addressed the health-related social needs of Medicare and Medicaid beneficiaries through screening, referral, and community navigation services. Using and sharing HRSN data between clinical and community partners was a critical component of these efforts.

Trends of Pediatric Dental Rehabilitation Using General Anesthesia by Service Location During the COVID-19 Public Health Emergency, 2019 to 2021.

The purpose of this study was to investigate the trends of pediatric dental rehabilitation in hospital outpatient departments (HOPDs) and ambulatory surgery centers (ASCs) during the COVID-19 public health emergency (PHE) from 2019 to 2021 across states and demographic groups. This cross-sectional study utilized the 2019 to 2021 Transformed Medicaid Statistical Information System Analytical Files to examine trends in dental rehabilitation for children ages 12 years and younger enrolled in Medicaid or the Children's Health Insurance Program. The final analytic sample included 20,508,093 beneficiaries from 2019, 19,436,957 beneficiaries from 2020, and 20,416,440 beneficiaries from 2021.

The Effect Of Next Generation Accountable Care Organizations On Medicare Expenditures.

The Next Generation Accountable Care Organization (NGACO) model (active during 2016-21) tested the effects of high financial risk, payment mechanisms, and flexible care delivery on health care spending and value for fee-for-service Medicare beneficiaries. We used quasi-experimental methods to examine the model's effects on Medicare Parts A and B spending. Sixty-two ACOs with more than 4.

American Heart Association Cardiogenic Shock Registry: Design and Implementation.

Background: Cardiogenic shock is a morbid complication of heart disease that claims the lives of more than 1 in 3 patients presenting with this syndrome. Supporting a unique collaboration across clinical specialties, federal regulators, payors, and industry, the American Heart Association volunteers and staff have launched a quality improvement registry to better understand the clinical manifestations of shock phenotypes, and to benchmark the management patterns, and outcomes of patients presenting with cardiogenic shock to hospitals across the United States.

Methods: Participating hospitals will enroll consecutive hospitalized patients with cardiogenic shock, regardless of etiology or severity.

National Health Expenditure Projections, 2023-32: Payer Trends Diverge As Pandemic-Related Policies Fade.

Health care spending growth is expected to outpace that of the gross domestic product (GDP) during the coming decade, resulting in a health share of GDP that reaches 19.7 percent by 2032 (up from 17.3 percent in 2022).

Evaluating data quality for blended data using a data quality framework.

In 2020 the U.S. Federal Committee on Statistical Methodology (FCSM) released "A Framework for Data Quality", organized by 11 dimensions of data quality grouped among three domains of quality (utility, objectivity, integrity).

Comparing HEDIS performance of Dual Eligible Special Needs Plans with other coverage types for dually eligible people.

People eligible for both Medicare and Medicaid coverage ("dually eligible individuals") have lower levels of income and assets and often higher health care needs and costs than those eligible for Medicare but not Medicaid coverage. Their 3 most common Medicare coverage options are Medicare Advantage (MA) Dual Eligible Special Needs Plans (D-SNPs), non-D-SNP MA plans, and fee-for-service (FFS) Medicare with a stand-alone prescription drug plan. No prior study has examined clinical quality of care for dually eligible individuals across these 3 coverage types.

Remote Physiologic Monitoring Use Among Medicaid Population Increased, 2019-21.

Remote physiologic monitoring use increased more than 1,300 percent from 2019 to 2021, and use varied by state. This increase was driven by a small number of (predominantly internal medicine) providers. Female beneficiaries, residents of metropolitan areas, and people diagnosed with diabetes or hypertension had the highest rates of use.

An explainable machine learning model for prediction of high-risk nonalcoholic steatohepatitis.

Early identification of high-risk metabolic dysfunction-associated steatohepatitis (MASH) can offer patients access to novel therapeutic options and potentially decrease the risk of progression to cirrhosis. This study aimed to develop an explainable machine learning model for high-risk MASH prediction and compare its performance with well-established biomarkers. Data were derived from the National Health and Nutrition Examination Surveys (NHANES) 2017-March 2020, which included a total of 5281 adults with valid elastography measurements.

Socioeconomic factors associated with uptake and satisfaction with a post-hospitalization meals benefit in Medicare Advantage.

Background: Kaiser Permanente Southern California began offering a 4-week supplemental benefit of home-delivered meals to Medicare Advantage members after discharge from a hospitalization for heart failure and other medical conditions in 2021. The purpose of this study is to explore the associations between socioeconomic disadvantage and food insecurity with patient uptake of and satisfaction with the meals.

Methods: Data for this cross-sectional study were drawn from survey and electronic medical record data for members referred for the meals benefit (n = 6169) and linked to a hospitalization encounter (n = 2254) between January and December 2021.

Real-world Effectiveness of mRNA COVID-19 Vaccines Among US Nursing Home Residents Aged ≥65 Years in the Pre-Delta and High Delta Periods.

Background: Long-term care residents were among the most vulnerable during the COVID-19 pandemic. We estimated vaccine effectiveness of mRNA COVID-19 vaccines in Medicare nursing home residents aged ≥65 years during pre-Delta and high Delta periods.

Methods: We conducted a retrospective cohort study from 13 December 2020 to 20 November 2021 using Medicare claims data.

Comparing the Centers for Medicare and Medicaid Services (CMS) enrollment data death dates to the National Death Index (NDI).

Purpose: In the United States, the National Death Index (NDI) is the most complete source of death information, while epidemiologic studies with mortality outcomes often rely on U.S. Medicare data for outcome ascertainment.

Antipsychotics in Perspective: Past, Present, and Future.

For more than half a century, there has been controversy and conflict over using psychotropic medications ("psychotropics") as strategies to modulate behavior, enhance mood, and address cognitive issues for nursing home residents. The current situation reflects a long history of investigation, reports, discussions, government and professional activity, and other attempted improvement. Although attention has focused primarily on the use of antipsychotics, particularly to manage symptoms associated with dementia, there are much broader issues.

National Health Care Spending In 2022: Growth Similar To Prepandemic Rates.

Health care spending in the US grew 4.1 percent to reach $4.5 trillion in 2022, which was still a faster rate of growth than the increase of 3.

The role of payment and financing in achieving health equity.

Objective: The aim was to identify healthcare payment and financing reforms to promote health equity and ways that the Agency for Healthcare Research and Quality (AHRQ) may promote those reforms.

Data Sources And Study Setting: AHRQ convened a payment and financing workgroup-the authors of this paper-as part of its Health Equity Summit held in July 2022. This workgroup drew from its collective experience with healthcare payment and financing reform, as well as feedback from participants in a session at the Health Equity Summit, to identify the evidence base and promising paths for reforms to promote health equity.

Supportive Services at End of Life can Help Reduce Acute Care Services: Observations From the Medicare Care Choices Model.

Objectives: This study identifies the mechanisms through which supportive and palliative care services at the end-of-life helped prevent unnecessary use of acute care services.

Background: From 2016 to 2021, the Medicare Care Choices Model (MCCM) tested whether offering Medicare beneficiaries the option to receive supportive and palliative care services through hospice providers, concurrently with treatments for their terminal conditions, improved patients' quality of life and care and reduced Medicare expenditures. Previous MCCM evaluation results showed that the model achieved its goals, but did not examine in depth the causal mechanisms leading to these results.