Health related social needs and whole person health: Relationship between unmet social needs, health outcomes, and healthcare spending among commercially insured adults.

Commercially-insured adults comprise a majority of health plan members but are least likely to be surveyed about their social needs. Little is known, consequently, about health-related social needs (HRSNs) in this population. The primary aim of this study was to assess the prevalence of HRSNs and health among commercially-insured adults and estimate their relationship with health outcomes and spending.

Impact of COVID-19 on Behavioral Health Services Use Among Medicaid Enrollees with Chronic Behavioral Needs by Race and Ethnicity.

The COVID-19 pandemic may widen the disparities in access to behavioral health (BH) services among groups that have been historically marginalized. However, the rapid expansion of telehealth presents an opportunity to reduce these disparities. The objective was to assess the impact of COVID-19 on BH visits, including in-person and telehealth, and BH treatments by different race and ethnicity groups.

Association of a Risk Evaluation and Mitigation Strategy Program With Transmucosal Fentanyl Prescribing.

Importance: Transmucosal immediate-release fentanyl (TIRF) drugs are potent, rapid-acting opioids approved to treat breakthrough pain in patients with cancer who are tolerant to other around-the-clock opioid analgesics. In March 2012, a US Food and Drug Administration-approved Risk Evaluation and Mitigation Strategy (REMS) was implemented, mandating prescribers, distributors, pharmacies, and patients to enroll in the REMS to prescribe, dispense, or receive TIRF drugs.

Objective: To evaluate the association of the TIRF-REMS Access Program with TIRF prescribing.

Effect of Peer Comparison Letters for High-Volume Primary Care Prescribers of Quetiapine in Older and Disabled Adults: A Randomized Clinical Trial.

Importance: Antipsychotic agents, such as quetiapine fumarate, are frequently overprescribed for indications not supported by clinical evidence, potentially causing harm.

Objective: To investigate if peer comparison letters targeting high-volume primary care prescribers of quetiapine meaningfully reduce their prescribing.

Design, Setting, And Participants: Randomized clinical trial (intent to treat) conducted from 2015 to 2017 of prescribers and their patients nationwide in the Medicare program.

Financial Relationships between Urologists and Industry: An Analysis of Open Payments Data.

Introduction: The Open Payments Program was enacted to increase transparency of financial relationships between physicians and the medical device and pharmaceutical industry. We examined nonresearch related financial relationships between urologists and industry in the United States using the latest Open Payments data.

Methods: We performed a descriptive analysis of Open Payments data released by the Centers for Medicare and Medicaid Services for 2014.

Elucidating the impacts of initial supersaturation and seed crystal loading on struvite precipitation kinetics, fines production, and crystal growth.

To reduce intra-plant nutrient cycling, and recover phosphorus (P) fertilizers from nutrient-rich sidestreams, wastewater utilities increasingly elect to employ struvite precipitation processes without a clear understanding of the inherent tradeoffs associated with specific design and operating decisions. Specifically, the impact of reactor conditions on struvite crystallization rate, and distribution between formation of fines particles and secondary growth onto large diameter seed crystals represent critical knowledge gaps limiting the predictive capabilities of existing process models. In this work, the relative impacts of initial supersaturation (S), and seed loading, on P removal kinetics, and struvite solids distribution were investigated.

Value-Based Approaches for Emergency Care in a New Era.

Although emergency departments (EDs) play an integral role in the delivery of acute unscheduled care, they have not been fully integrated into broader health care reform efforts. Communication and coordination with the ambulatory environment remain limited, leaving ED care disconnected from patients' longitudinal care. In a value-based environment focused on improving quality, decreasing costs, enhancing population health, and improving the patient experience, this oversight represents a missed opportunity for emergency care.

Association between payments from manufacturers of pharmaceuticals to physicians and regional prescribing: cross sectional ecological study.

Objective:  To examine the association between payments made by the manufacturers of pharmaceuticals to physicians and prescribing by physicians within hospital referral regions.

Design:  Cross sectional analysis of 2013 and 2014 Open Payments and Medicare Part D prescribing data for two classes of commonly prescribed, commonly marketed drugs: oral anticoagulants and non-insulin diabetes drugs, overall and stratified by physician and payment type.

Setting:  306 hospital referral regions, United States.

Industry Relationships With Pediatricians: Findings From the Open Payments Sunshine Act.

Background And Objectives: Ties between physicians and pharmaceutical/medical device manufactures have received considerable attention. The Open Payments program, part of the Affordable Care Act, requires public reporting of payments to physicians from industry. We sought to describe payments from industry to physicians caring for children by (1) comparing payments to pediatricians to other medical specialties, (2) determining variation in payments among pediatric subspecialties, and (3) identifying the types of payment and the products associated with payments to pediatricians.

Medicare Letters To Curb Overprescribing Of Controlled Substances Had No Detectable Effect On Providers.

Inappropriate prescribing is a rising threat to the health of Medicare beneficiaries and a drain on Medicare's finances. In this study we used a randomized controlled trial approach to evaluate a low-cost, light-touch intervention aimed at reducing the inappropriate provision of Schedule II controlled substances in the Medicare Part D program. Potential overprescribers were sent a letter explaining that their practice patterns were highly unlike those of their peers.

Aligning emergency care with the triple aim: Opportunities and future directions after healthcare reform.

The Triple Aim of better health, better care, and lower costs has become a fundamental framework for understanding the need for broad health care reform and describing health care value. While the framework is not specific to any clinical setting, this article focuses on the alignment between the framework and Emergency Department (ED) care. The paper explores where emergency care is naturally aligned with each Aim, as well as current barriers which must be addressed to meet the full vision of the Triple Aim.

Crowd-sourcing delivery system innovation: A public-private solution.

We propose the establishment of a public-private approach which creates and maintains a "delivery systems innovations knowledge management system" to define, describe, and assess novel delivery approaches. The public sector could provide the foundational technology, resources and convening power for this innovations database. The private sector would contribute practical innovations that could guide annual strategic planning and implementation.