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Achieving Large-Scale Quality Improvement in Primary Care Annual Wellness Visits and Hierarchical Condition Coding
Abstract BackgroundCompletion of Medicare Annual Wellness Visits (AWV) and documentation of Hierarchical Condition Categories (HCC) are important...
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Comparison of diagnosis-based risk adjustment methods for episode-based costs to apply in efficiency measurement
BackgroundThe recent rising health spending intrigued efficiency and cost-based performance measures. However, mortality risk adjustment methods are...
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Risk stratification models for predicting preventable hospitalization in commercially insured late middle-aged adults with depression
BackgroundA significant number of late middle-aged adults with depression have a high illness burden resulting from chronic conditions which put them...
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The Impact of Biosimilar Use on Total Cost of Care and Provider Financial Performance in the Medicare Oncology Care Model: A Population-Based Simulation Study
IntroductionPayment for oncology care is increasingly moving from fee-for-service to value-based payment (VBP). VBPs are agreements in which...
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Improving risk adjustment with machine learning: accounting for service-level propensity scores to reduce service-level selection
The hierarchical condition category (HCC) risk adjustment model tends to produce over-predictions of health care expenditures for individuals who...
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Racial-Ethnic Composition of Primary Care Practices and Comprehensive Primary Care Plus Initiative Participation
BackgroundIt remains unclear whether the racial-ethnic composition or the socioeconomic profiles of eligible primary care practices better explain...
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Real-life assessment of standardized contrast-enhanced ultrasound (CEUS) and CEUS algorithms (CEUS LI-RADS®/ESCULAP) in hepatic nodules in cirrhotic patients—a prospective multicenter study
ObjectivesHepatocellular carcinoma (HCC) can be diagnosed non-invasively with contrast-enhanced ultrasound (CEUS) in cirrhosis if the characteristic...
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The Role of Nurse Practitioners in the Management of Heart Failure Patients and Programs
Purpose of ReviewThe goal of this paper is to highlight the multifaceted approach heart failure (HF) nurse practitioners (NPs) use to manage...
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Post-acute care use patterns among Hospital Service Areas by older adults in the United States: a cross-sectional study
BackgroundDespite the success of stroke rehabilitation services, differences in service utilization exist. Some patients with stroke may travel...
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Very high and low residual spenders in private health insurance markets: Germany, The Netherlands and the U.S. Marketplaces
We study the extremely high and low residual spenders in individual health insurance markets in three countries. A high (low) residual spender is...
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Dietary folate drives methionine metabolism to promote cancer development by stabilizing MAT IIA
Folic acid, served as dietary supplement, is closely linked to one-carbon metabolism and methionine metabolism. Previous clinical evidence indicated...
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Readmission Risk Assessment Technologies and the Anchoring and Adjustment Heuristic
Approximately 23% of patients discharged from primary healthcare facilities are readmitted within 30 days at an annual cost of roughly $42 billion....
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Segmentation of High-Cost Adults in an Integrated Healthcare System Based on Empirical Clustering of Acute and Chronic Conditions
BackgroundHigh-cost patients are a frequent focus of improvement projects based on primary care and other settings. Efforts to characterize...
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A Retrospective Study of Administrative Data to Identify High-Need Medicare Beneficiaries at Risk of Dying and Being Hospitalized
BackgroundDevelo** a definition of what constitutes high need among Medicare beneficiaries using administrative data is an important prerequisite...
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Association of Patient Social, Cognitive, and Functional Risk Factors with Preventable Hospitalizations: Implications for Physician Value-Based Payment
BackgroundAmbulatory care-sensitive condition (ACSC) hospitalizations are used to evaluate physicians’ performance in Medicare value-based payment...
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Family Caregiver Skills Training to Improve Experiences of Care: a Randomized Clinical Trial
ObjectiveTo evaluate the effectiveness of Hel** Invested Families Improve Veterans’ Experiences Study (HI-FIVES), a skills training program for...
