Cost of Health Care, Diabetes, Pharmacology / 21.10.2024

Access to affordable insulin remains a challenge for millions of people living with diabetes around the world, particularly in middle-income countries. To bridge this gap, platforms are emerging that connect patients with high-quality insulin at reduced prices. For individuals struggling to afford their life-saving medication, these services offer a convenient and affordable solution, making a significant impact on global health.

The Global Insulin Crisis

Diabetes affects millions worldwide, and the demand for insulin continues to rise. Major insulin manufacturers, including Novo Nordisk, Eli Lilly, and Sanofi, dominate the global market, producing essential medications for managing blood sugar levels. However, in many parts of the world, including countries like India, Mexico, and the Philippines, insulin prices remain prohibitively high. This leaves a substantial portion of the population without access to the medication they need to live healthy lives. Data shows that insulin prices are often out of reach for people in middle-income countries. The situation is particularly dire in regions like Kenya, Malaysia, and Vietnam, where the cost of insulin may equal a month's salary. With nearly three major companies controlling the insulin market, competition is limited, and prices remain high. As a result, many patients with type 1 and type 2 diabetes face inconsistent access to insulin, which can put their health at significant risk. (more…)
Alzheimer's - Dementia, Author Interviews, Cost of Health Care, Medicare, UCLA / 15.10.2024

MedicalResearch.com Interview with: Frank F. Zhou  |  he/him MD Candidate, Class of 2025 David Geffen School of Medicine at UCLA MedicalResearch.com: What is the background for this study? What is Lecanemab used for?  How is it given to patients? Response: Lecanemab is a new infusion therapy for Alzheimer's disease. Its dosing is based on each patient's body weight (10 mg/kg every two weeks), but the drug is only available in 500 mg and 200 mg single-use vials, meaning that any leftover drug in vials must be thrown away. Given that lecanemab is expected to cost Medicare billions of dollars each year, we hypothesized that discarded drug could result in significant wasteful spending. (more…)
Geriatrics, Medicare / 26.09.2024

senior-health-plan.jpg

Source

As healthcare continues to evolve, more attention is being given to senior health, and wellness programs are increasingly becoming a cornerstone of comprehensive senior care. Wellness programs focus on improving quality of life and managing chronic conditions through proactive measures such as exercise, nutrition, mental health support, and preventive care. For seniors, these programs are especially valuable because they address the unique challenges that come with aging. As part of senior health plans, wellness programs are not only a way to treat existing issues but also a way to prevent future problems by promoting healthy lifestyles. These programs offer a broad range of benefits, from improved physical health to enhanced mental well-being. Seniors enrolled in wellness initiatives often experience better control of conditions such as diabetes, heart disease, and arthritis. In addition, wellness programs can help reduce hospital visits, lower healthcare costs, and increase overall longevity by encouraging proactive health management. Seniors who engage in regular fitness activities, for instance, are less likely to experience falls, fractures, and other mobility-related issues, which are common concerns in older age. (more…)
Medicare / 20.09.2024

  Using Medicare can be quite challenging for those without experience dealing with this system and its numerous programs, plans, and services. Hiring a Medicare insurance agent is one of the best ways to guarantee that you get the right Medicare plan suitable for your needs. However, the problem of choosing the right agent might be even more daunting than the task of comprehending the insurance plans. This guide is designed to help you select the best Medicare insurance agent and make the right decision. (more…)
Cost of Health Care, Pharmacology / 12.09.2024

When you’re at the pharmacy, it’s normal to feel a bit of confusion about whether you would like to receive generic or brand-name medication when the pharmacy technician asks you the usual question. While health professionals, from pharmacists to doctors, nurses, and students of RN to MSN programs, will understand the differences between the two, it's important that you, as a patient, know them, too. In this article, we will break down the differences between generic and brand-name medications so that you will be more aware when you visit the pharmacy.

(more…)

Medicare / 20.08.2024

Medicare can often seem like a maze of deadlines and enrollments, especially for retirees. Missing critical Medicare enrollment periods can lead to fines and gaps in coverage. Understanding why these specific time frames exist can save a lot of hassle and ensure continuous healthcare access. The Initial Enrollment Period (IEP) is a seven-month window that allows retirees to enroll in Medicare. Specifically, it starts three months before the month you turn 65, includes your birth month, and ends three months after. Missing this period usually results in penalties that could affect your healthcare costs for the rest of your life. Understanding this window is crucial because it shapes the foundation of your healthcare plan. To make the most of your IEP, it's advisable to start planning as soon as you approach 65. Setting reminders and being proactive can help you take full advantage of this period, avoid future complications, and ensure you receive medical coverage without interruptions or financial strains.  (more…)
Medical Billing / 15.08.2024

Once upon a time, outsourcing physician medical billing services was seen as a novel concept. Many physicians initially viewed it as an unnecessary expense, believing it only benefited larger institutions like hospitals, clinics, and group practices. However, in recent years, it has increasingly become a standard practice. Even independent solo practitioners are now considering outsourcing for their medical billing and coding needs. If you are a solo practitioner finding healthcare billing and coding challenging, you are not alone. Many in the field struggle to deal with the complexities of coding and billing, often failing to maximize revenue. It's important to recognize that the healthcare market is changing, with regulations and rules for medical billing and coding constantly developing. Implementing an effective medical billing and coding system is therefore crucial for physicians seeking a strategic advantage. Outsourcing medical billing services is no longer just about cutting costs; it has become a vital tool that provides numerous benefits to practicing physicians. Moreover, these advancements can be incorporated into oncology medical billing systems to ensure precise and efficient billing for cancer treatments and diagnostics. (more…)
Abuse and Neglect, Cost of Health Care, Race/Ethnic Diversity / 06.08.2024

MedicalResearch.com Interview with: Benjamin Ukert PhD Assistant Professor Department of Health Policy and Management Texas A&M University, School of Public Health Texas 77843-1266 MedicalResearch.com: What is the background for this study? Response: The Affordable Care Act (ACA) was enacted in March 2010 with one major goal to increase access to insurance coverage. This was done through the expansion of the Medicaid program for low income individuals and the establishment of formal health insurance marketplaces for individuals without access to employer sponsored insurance. Texas did not expand Medicaid for low income individuals, but the health insurance marketplace should have led to increases in insurance coverage, due to generous federal subsidies that cover a large share of the health insurance premium. Gaining insurance coverage can affect providers, such as hospitals, who treat a large share of uninsured individuals. We focused on the inpatient setting and evaluated whether the ACA led to changes in demand for hospital care, and whether the ACA led to reduction in the share of uninsured individuals treated by hospitals. (more…)
Medicare, Primary Care / 23.07.2024

Navigating the complexities of Medicare can be challenging, especially when it comes to finding and choosing the right primary care doctor. This guide will help you understand the different parts of Medicare, how it covers primary care services, and provide actionable steps to find and evaluate primary care doctors that accept Medicare.

Understanding Medicare and Its Different Parts

Medicare is a federal health insurance program primarily for individuals aged 65 and older, though it also covers certain younger people with disabilities. Medicare consists of four parts:
  1. Medicare Part A: Covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
  2. Medicare Part B: Covers certain doctors' services, outpatient care, medical supplies, and preventive services.
  3. Medicare Part C (Medicare Advantage): An alternative to Original Medicare that offers all Part A and Part B services through private insurance companies. These plans often include additional benefits like vision, dental, and prescription drug coverage.
  4. Medicare Part D: Covers prescription drugs.
(more…)
Author Interviews, Cost of Health Care, Telemedicine / 09.07.2024

The United States currently has a doctor-patient ratio of 2.6 in 1000, and although it is above the recommended 1:1000, medical practitioners are still having a hard time finding the right system to balance administrative tasks and patient care. Healthcare providers are struggling to keep up with the ever-increasing demands of their patients. That is why there is now a fast-growing demand for Virtual Patient Coordinators. Virtual Patient Coordinators are skilled individuals who work remotely to assist medical practices in managing their patients' needs. They are responsible for a wide range of tasks, including scheduling appointments, coordinating referrals, and organizing medical records. By utilizing advanced technology and secure communication platforms, virtual patient coordinators are able to efficiently handle these tasks from anywhere in the world, ensuring that patients receive the care they need in a timely manner. Let’s find out the ways they are changing the game for busy medical practices. (more…)
Cost of Health Care, Medical Billing / 04.07.2024

Patient insurance coverage frequently changes, which can lead to missed details when tracked manually. This often results in claim denials and subsequent reimbursement issues. This article explores the benefits and effectiveness of automated eligibility coverage tracking platforms designed to address these challenges effectively.

The Problem: Manual Tracking Just Doesn't Cut It Anymore

Determining a patient’s status as well as his or her insurance is a crucial but time-consuming process in the billing department. Previously, it included calling insurance companies, verifying the data in different systems, and entering the information into spreadsheets. Since patient details are dynamic and various claims need to be addressed every week, it becomes impossible to manage information updates through traditional methods. Some of the problems include:
  • Time-Consuming Process - Verifying coverage manually can take up to 30 minutes per patient. For large billing companies, this may translate into big time losses.
  • Human Error - Manually compiling and updating records inevitably leads to inaccurate or outdated information falling through the cracks.
  • Claim Denials - Incorrect policy details lead to higher denial rates, payment delays and lost revenue.
  • Lack of Visibility - With records scattered across systems and spreadsheets, billing teams lack clear visibility into coverage changes.
Traditional ways of checking eligibility can't keep up with increasing patient numbers and complexity. Billing teams handling medical billing denials and solutions urgently require automation support to manage this crucial data. (more…)
Author Interviews, Cost of Health Care, JAMA, Kidney Disease, Transplantation / 01.07.2024

MedicalResearch.com Interview with: Amal Trivedi, MD, MPH Professor of Health Services, Policy & Practice Brown University School of Public Health MedicalResearch.com: What is the background for this study? Response: On January 1st, 2021, the Centers for Medicare & Medicaid Services (CMS) launched the mandatory End-Stage Renal Disease Treatment Choices (ETC) Model, which randomly assigned approximately 30% of U.S. dialysis facilities and managing clinicians to financial incentives to increase the use of home dialysis and kidney transplantation. The program is set to run through 2027, with financial incentives and penalties increasing as the model progresses. Our study sought to assess the ETC’s effect on these outcomes of interest in the first two years, as well as to examine outcome changes by race, ethnicity and socioeconomic status. (more…)
Author Interviews, Cost of Health Care, Gastrointestinal Disease, Health Care Systems / 20.05.2024

MedicalResearch.com Interview with: Laura Targownik, MD Lead author and Clinician-Investigator Mount Sinai Hospital in Toronto Departmental Division Director, Gastroenterology and Hepatology University of Toronto MedicalResearch.com: What is the background for this study? Was there a difference in the types of patients or need for surgery seen by the female/male physicians? Response: The background for this study is that there is an emerging body of literature that having a female physician leads to better patient outcomes in many health care settings, especially amongst patients undergoing surgery or being admitted to hospital.  However, this has not previously been evaluated in gastroenterology.  Female and male gastroenterologists may have different styles of practice on average, and this potentially could lead to differences in how patients engage with the health care system following an initial assessment. (more…)
Author Interviews, Cost of Health Care, JAMA, Kidney Disease, Medicare / 11.01.2024

MedicalResearch.com Interview with: Kalli Koukounas, MPH Ph.D. Student, Health Services Research Brown University School of Public Health Providence, RI MedicalResearch.com: What is the background for this study? Response:  On Jan. 1st, 2021, the Centers for Medicare and Medicaid Services (CMS) implemented the End-Stage Renal Disease Treatment Choices (ETC) Model, one of the largest randomized tests of pay-for-performance incentives ever conducted in the US. The goal of the model was to enhance the use of home dialysis and kidney transplant or waitlisting among kidney failure patients in traditional Medicare. The model randomly assigned approximately 30% of US dialysis facilities and nephrologists to receive financial incentives, ranging from bonuses of 4% to penalties of 5%, based on their patients’ use of home dialysis and kidney transplant/waitlisiting. The payment adjustments apply to all Medicare-based reimbursement for dialysis services. Prior research has demonstrated that dialysis facilities that disproportionately serve populations with high social risk have lower use of home dialysis and kidney transplant, raising concerns that these sites may fare poorly in the payment model. Using data released by CMS, we examined the first year of ETC model performance and financial penalties across dialysis facilities, stratified by the measured social risk of the facilities’ incident patients. (more…)
Author Interviews, Cost of Health Care, Pharmacology / 09.12.2023

MedicalResearch.com Interview with: Joseph T. DiPiro, Pharm.D Associate Vice President, Faculty Affairs Virginia Commonwealth University Dr. DiPiro is an editor for Pharmacotherapy: A Pathophysiologic Approach MedicalResearch.com: What is the background for this study? Response: The ASHP/ASHP Foundation Pharmacy Forecast Report is constructed from a survey of health-system pharmacy leaders who were asked to rate the likelihood of events, scenarios, and trends occurring in the next five years. The purpose is for health-system pharmacists and pharmacy leaders to inform their strategic planning efforts. The Pharmacy Forecast is not intended to predict future events. Rather, the report is intended to be a provocative stimulant for the thinking, discussion, and planning that must take place in every health system. Leaders must be informed of potential developments to help position their organizations to care for patients, enhance population health, and improve medication outcomes. (more…)
Author Interviews, Cancer Research, Cost of Health Care, JAMA, Pharmacology / 17.11.2023

MedicalResearch.com Interview with: Lisa-Marie Smale, PharmD PhD Candidate Clinical Pharmacy Radboud University Medical Center Department of Pharmacy Nijmegen, the Netherlands Lisa-Marie Smale, PharmDPhD Candidate Clinical PharmacyRadboud University Medical CenterDepartment of PharmacyNijmegen, the Netherlands   MedicalResearch.com: What is the background for this study? Response: Cancer drugs are not always fully used by patients, while these drugs are mostly expensive and environmentally damaging, both in production and (waste) disposal. Therefore we investigated whether unused drugs of patients can be collected, verified of quality by a pharmacy, to be redispensed to other patients instead of being disposed of. We were interested whether such an approach ultimately leads to lower environmental impacts and costs. (more…)
Alzheimer's - Dementia, Author Interviews, Cost of Health Care, JAMA, UCLA / 20.05.2023

MedicalResearch.com Interview with: Julia Cave Arbanas Project Manager and     John N. Mafi, MD, MPH Associate Professor of Medicine General Internal Medicine & Health Services Research David Geffen School of Medicine at UCLAJohn N. Mafi, MD, MPH Associate Professor of Medicine General Internal Medicine & Health Services Research David Geffen School of Medicine at UCLA   MedicalResearch.com: What is the background for this study? What is lecanemab used for and how well does it work? Response: Lecanemab is a treatment for mild cognitive impairment and mild dementia that was approved in January 2023 as part of the Food and Drug Administration’s (FDA) accelerated approval program. The results from a recent phase 3 clinical trial show a modest clinical benefit: the rate of cognitive decline by 27% in an 18-month study involving participants experiencing the early stage of Alzheimer’s, with an 0.45-point absolute difference in cognitive testing scores. However, due to the risk of brain swelling and bleeding (also known as amyloid-related imaging abnormalities), treatment with lecanemab involves frequent MRIs and neurology or geriatrics appointments to monitor for these abnormalities, which can be life threatening. So far, three patient deaths have potentially been tied to lecanemab. It is likely that the FDA will grant is lecanemab traditional approval later this year, prompting Medicare to reconsider its current coverage restrictions and potentially enabling widespread use. (more…)
Author Interviews, Cost of Health Care, Heart Disease, JACC / 26.02.2023

MedicalResearch.com Interview with: Rishi K. Wadhera, MD, MPP, MPhil Section Head, Health Policy and Equity, Richard A. and Susan F. Smith Center for Outcomes Research Associate Program Director Cardiovascular Medicine Fellowship at Beth Israel Deaconess Medical Center Assistant Professor of Medicine, Harvard Medical School @rkwadhera MedicalResearch.com: What is the background for this study? Response: High and rising prescription drug costs in the United States contribute to medication non-adherence and financial strain among adults with cardiovascular risk factors or disease. As a result, addressing prescription drug costs in patients with chronic conditions has become a national priority. In response to these growing concerns, federal policymakers passed the Inflation Reduction Act on August 16, 2022, which aims to address high out-of-pocket drug costs for adults enrolled in Medicare Part D, by placing a $2000 annual cap on out-of-pocket prescription drug costs and expanding eligibility for full low-income subsidies to individuals that reduce deductible costs and prescription copayments (among several other provisions). It is unclear how these provisions will affect Medicare beneficiaries with cardiovascular risk factors and/or conditions. (more…)
Author Interviews, Cost of Health Care, JAMA, Pharmaceutical Companies, Yale / 22.01.2023

MedicalResearch.com Interview with: Neeraj Patel Medical Student (MS-2), Yale School of Medicine New Haven, CT MedicalResearch.com: What is the background for this study? Response: Direct-to-consumer pharmaceutical advertising has been increasing in popularity for the past two decades or so, particularly via television. But it’s highly controversial. Only two high-income countries (the U.S. and New Zealand) widely permit this type of advertising for prescription drugs. Critics have pointed to a growing body of literature that suggests that direct-to-consumer advertising for prescription drugs can be misleading, lead to inappropriate prescribing, and inflate healthcare costs. Proponents have argued that it improves public health by promoting clinically beneficial prescribing. (more…)
Author Interviews, Cost of Health Care, JAMA / 19.12.2022

MedicalResearch.com Interview with: Anna L. Goldman, M.D., M.P.A., M.P.H Assistant Professor of Medicine General Internal Medicine Boston University Chobanian & Avedisian School of Medicine   MedicalResearch.com: What is the background for this study? Response: Experts on the healthcare labor market have long debated the existence and magnitude of a physician shortage. Physician work hours are a major contributor to physician supply issues, but little research is available on recent trends in work hours by physicians.  In addition, no available studies have rigorously estimated changes in the physician workforce size during the pandemic. (more…)
Author Interviews, Cost of Health Care, Rheumatology, University of Pittsburgh / 01.12.2022

MedicalResearch.com Interview with: Raisa Silva, M.D. Resident physician in Internal medicine University of Pittsburgh Medical Center MedicalResearch.com: What is the background for this study? Response: Systemic lupus erythematosus (lupus for short) is a complex disease that significantly affects patients’ lives. Adherence to medications for lupus is known to be suboptimal (it can be as low as 15% in some studies). Multiple social factors may affect treatment adherence. For example, costs of medications (including copayments, deductibles, co-sharing), polypharmacy (patients with lupus often have comorbid diseases that also need medications), and potential side effects are some of the reasons why patients may have difficulty in taking medications for lupus every day. The costs of insurance copayment may represent a major obstacle to adherence. The lack of adherence to lupus medications is associated with poor control of disease, more symptoms, and worse disease outcomes, such as more hospitalizations and more severe disease. In our study, we examined the association between lupus medications copayment and adherence to these medications (some of the most commonly used medications for lupus). (more…)
Author Interviews, CDC, Cost of Health Care, Hepatitis - Liver Disease / 05.10.2022

MedicalResearch.com Interview with: William W. Thompson, Ph.D. Epidemiologist Division of Viral Hepatitis CDC MedicalResearch.com: What is the background for this study? Response: Prior to this analysis, we knew only an estimated 1.2 million persons initiated hepatitis C treatment with DAA agents in the United States during 2014–2020, far below the number needed to achieve national hepatitis C elimination goals. Further, the number of persons treated was highest in 2015 and declined to its lowest level in 2020. This analysis used a large national health care claims database to assess the level and timing of hepatitis C treatment among persons with diagnosed HCV infection with breakdowns by sex, age, race, insurance type (i.e., private, Medicaid, and Medicare), and by state. (more…)
Author Interviews, Cost of Health Care, COVID -19 Coronavirus, JAMA / 26.09.2022

MedicalResearch.com Interview with:

Allison Witman PhD Assistant Professor of Economics Economics & Finance Cameron School of Business University of North Carolina, Wilmington

Yu Wang PhD Assistant Professor Congdon School of Supply Chain, Business Analytics, & Information Systems Cameron School of Business University of North Carolina Wilmington David Cho PhD Assistant Professor of Management California State University, Fullerton

MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic placed tremendous financial pressure on hospitals. Beginning in March of 2020, hospitals cancelled outpatient and elective procedures to accommodate surges in demand from COVID-19 patients. As these procedures account for more than 60% of an average hospital’s revenue, cancellation posed serious challenges to the financial health of hospitals. Revenue from COVID-19 patients may have partially offset these effects, but the American Hospital Association estimated a total loss of $202.6 billion by American hospitals between March and June 2020. In response, the U.S. government created large federal assistance programs aimed to stabilize hospitals’ financial situation as their ability to maintain operations was critical to the health of the nation. Due to differences in hospital characteristics, certain hospitals such as rural hospitals and those serving a higher share of Medicaid and uninsured patients (e.g., safety net hospitals) may have been more financially susceptible to the effects of the pandemic. These hospitals that serve vulnerable patient populations historically have had lower profit margins and were candidates for targeted COVID relief funding (e.g., Safety Net Hospitals Payments, a $10 billion component of the Provider Relief Fund). (more…)
Author Interviews, Cost of Health Care, Dermatology, JAMA / 08.09.2022

MedicalResearch.com Interview with: Jane M. Zhu, M.D., M.P.P., M.S.H.P. Assistant Professor of Medicine Division of General Internal Medicine and Geriatrics School of Medicine Oregon Health & Science University Portland, Oregon MedicalResearch.com: What is the background for this study? Response: Private equity (PE) acquisitions of physician practices are accelerating across many specialties, but there is still little robust evidence on the effects of these acquisitions. Concerns about PE involvement is predicated on the fact that these firms expect high annual returns, which require either reducing costs or increasing revenue, or both. Using PE acquisition data from 2016-2020, linked to commercial claims data, we sought to understand what common mechanisms of revenue generation were being adopted after private equity acquisition of physician practices. (more…)
Author Interviews, Cost of Health Care, JAMA, Pharmaceutical Companies / 31.08.2022

MedicalResearch.com Interview with: Prof. Katharina Blankart, PhD Faculty of Economics and Business Administration University of Duisburg-Essen Essen, Germany MedicalResearch.com: What is the background for this study? Response: Given the high drug prices and policy discussions, we were interested whether the US may miss opportunities from medical innovation in availability of medicines compared to Germany. Since 2011, Germany has a unique way to determine value of new medicines after regulatory approval and to negotiate prices. We aimed to find out differences in availability of medicines in these two countries and timing of availability. We evaluated the differences in timing of availability and to characterize medicines not available to one of the two countries. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA / 09.06.2022

MedicalResearch.com Interview with: Benjamin N. Rome MD Instructor, Harvard Medical School Internal Medicine Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital MedicalResearch.com:  What is the background for this study? What are the main findings?  Response: Manufacturers of brand-name drugs are granted periods, free from direct competition, during which they can set and raise prices as they choose. We found that the prices for newly marketed brand-name drugs increased by 20% per year from 2008 to 2021. In 2020 and 2021, nearly half of new drugs were launched at a price greater than $150,000 per year, compared with 9% of drugs in 2008-2013. These dramatic trends are only partly explained by changes in the types of drugs coming to market. (more…)
Author Interviews, Cost of Health Care, COVID -19 Coronavirus, JAMA / 15.02.2022

MedicalResearch.com Interview with: Kao-Ping Chua, MD, PhD Assistant Professor, Department of Pediatrics Assistant Professor, Health Management and Policy School of Public Health University of Michigan MedicalResearch.com:  What is the background for this study? Response: In 2020, most insurers waived the cost of COVID-19 hospitalization for patients. In early 2021, many major insurers started to abandon those waivers. By August 2021, the vast majority of insurers had started billing patients for COVID-19 hospitalizations again. (more…)
ADHD, Author Interviews, Cost of Health Care, Eating Disorders, Pharmacology / 09.01.2022

MedicalResearch.com Interview with: Sneha Vaddadi, BS Department of Medical Education Geisinger Commonwealth School of Medicine Scranton, Pennsylvania MedicalResearch.com: What is the background for this study? Response: The prescription stimulants methylphenidate, amphetamine, and lisdexamfetamine, classified as Schedule II substances, are sympathomimetic drugs with therapeutic use widely used in the US for Attention Deficit Hyperactivity Disorder. Changes in criteria for diagnosis of Attention Deficit Hyperactivity Disorder in 2013 and approval of lisdexamfetamine for binge eating disorder in 2015 may have impacted usage patterns. The goal of this study1 was to extend upon past research2 to compare the pharmacoepidemiology of these stimulants in the United States from 2010–2017, including consideration to variation within geographic regions, the Hispanic population, and the Medicaid population. (more…)
Author Interviews, Cost of Health Care, JAMA, Kidney Disease, Social Issues, Transplantation / 14.12.2021

MedicalResearch.com Interview with: Rebecca Thorsness, PhD Research Associate Department of Health Services, Policy, and Practice Brown University School of Public Health  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2019, the President signed the Advancing American Kidney Health executive order, which included provisions to increase the use of home dialysis and kidney transplant for Americans living with kidney failure. To carry out this vision, the Centers for Medicare & Medicaid Services (CMS) developed the ESRD Treatment Choices (ETC) payment model, which uses financial incentives and penalties to incentivize dialysis facilities to pursue home dialysis or kidney transplant for their patients. Transplant and home dialysis are optimal care for people with kidney failure, but there are social and clinical reasons that patients with high social risk (such as those exposed to racism, poverty, or housing instability) may not be candidates for these treatments. This means that facilities which serve a large number of patients with high social risk might be disproportionately penalized by this new payment model. Using data immediately prior to the implementation of the ETC model, we found that dialysis facilities that serve high proportions of patients with high social risk have lower rates of home dialysis and kidney transplantation than facilities that care for lower proportions of such patients. (more…)