Author Interviews, Cost of Health Care, Genetic Research, Hematology, JAMA / 22.03.2021

MedicalResearch.com Interview with: [caption id="attachment_57001" align="alignleft" width="150"]Patrick DeMartino MD Pediatric Hematology and Oncology Fellow Doernbecher Children's Hospital Oregon Health & Science University Dr. DeMartino[/caption] Patrick DeMartino MD Pediatric Hematology and Oncology Fellow Doernbecher Children's Hospital Oregon Health & Science University MedicalResearch.com: What is the background for this study? Response: Dozens of gene therapies are expected to be on the market within a decade or so. Much has been written about the high prices of the therapies currently on the market (exceeding $1 million). However, only a small number of patients are eligible for these existing therapies each year. Gene therapy for sickle cell disease (SCD) appears promising and would potentially apply to a relatively large number of individuals in the U.S. We sought to explore potential affordability challenges associated with a gene therapy for SCD.
Author Interviews, Cost of Health Care, JAMA / 19.03.2021

MedicalResearch.com Interview with: Sungchul Park, MPH PhD Assistant Professor, Health Management and Policy Dornsife School of Public Health Drexel University Philadelphia, PA 19104Sungchul Park, MPH PhD Assistant Professor, Health Management and Policy Dornsife School of Public Health Drexel University Philadelphia, PA 19104   MedicalResearch.com: What is the background for this study? Response: Evidence suggests that a significant share of health care costs in the US is of low value. In some cases, low-value care can be associated with harmful patient outcomes. Thus, decreasing use of low-value care is a major goal for Medicare given the potential to decrease costs and harms. Compared with traditional fee-for-service Medicare (TM), Medicare Advantage (MA) is more strongly financially incentivized to decrease use of low-value care.
Author Interviews, Cost of Health Care, Dermatology, Gender Differences, JAMA, Medicare, Race/Ethnic Diversity / 18.02.2021

MedicalResearch.com Interview with: [caption id="attachment_56715" align="alignleft" width="107"]Lauren A. V. Orenstein, MD | She/her/hers  Assistant Professor of Dermatology Dr. Orenstein[/caption] Lauren A. V. Orenstein, MD | She/her/hers Assistant Professor of Dermatology [caption id="attachment_56716" align="alignleft" width="100"]Robert A. Swerlick, MD Professor and Alicia Leizman Stonecipher Chair of Dermatology Emory University School of Medicine Dr. Swerlick[/caption] Robert A. Swerlick, MD Professor and Alicia Leizman Stonecipher Chair of Dermatology Emory University School of Medicine Atlanta, GA 30322 MedicalResearch.com: What is the background for this study? Response: Financial incentives have the potential to drive provider behavior, even unintentionally. The aim of this study was to evaluate differences in clinic “productivity” measures that occur in outpatient dermatology encounters. Specifically, we used data from 2016-2020 at one academic dermatology practice to evaluate differences in work relative value units (wRVUs, a measure of clinical productivity) and financial reimbursement by patient race, sex, and age. 66,463 encounters were included in this study, among which 70.1% of encounters were for white patients, 59.6% were for females, and the mean age was 55.9 years old.
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Heart Disease, JAMA / 28.07.2020

MedicalResearch.com Interview with: [caption id="attachment_54971" align="alignleft" width="160"]Frank Wharam, MD, MPH Department of Population Medicine Harvard Medical School and Harvard Pilgrim Healthcare Institute Boston, MA 02215 Dr. Wharam[/caption] Frank Wharam, MD, MPH Department of Population Medicine Harvard Medical School and Harvard Pilgrim Healthcare Institute Boston, MA 02215 MedicalResearch.com: What is the background for this study? Response:  There is substantial concern that high-deductible health plans increase people’s risk of major adverse health events such as heart attack and stroke. No studies have examined this question. This study examines the effects of a transition to a high-deductible health plan on the risk of major adverse cardiovascular outcomes (myocardial infarction and stroke). The study group included individuals with risk factors for cardiovascular disease who were continuously enrolled in low-deductible (<$500) health plans during a baseline year followed by up to 4 years in high-deductible (≥$1000) plans after an employer-mandated switch. The matched control group included individuals with the same risk factors who were contemporaneously enrolled in low-deductible plans.  We examined time to first major adverse cardiovascular event, defined as myocardial infarction or stroke. 
Author Interviews, Cost of Health Care, Diabetes, JAMA, Pediatrics / 01.06.2020

MedicalResearch.com Interview with: [caption id="attachment_54411" align="alignleft" width="148"]Kao-Ping Chua, M.D., Ph.D. Assistant Professor, Pediatrics, Medical School Susan B. Meister Child Health Evaluation and Research Center University of Michigan Dr. Kao-Ping Chua[/caption] Kao-Ping Chua, M.D., Ph.D. Assistant Professor, Pediatrics, Medical School Susan B. Meister Child Health Evaluation and Research Center University of Michigan MedicalResearch.com: What is the background for this study? Response: Due to high and rising prices, insulin has become increasingly unaffordable for patients with type 1 diabetes who must pay out-of-pocket for this life-saving medication. Over the past 5 months, many states and insurers have taken steps to cap insulin out-of-pocket spending. For example, Cigna imposed a $25 monthly cap earlier this year. This week, the Centers for Medicare and Medicare Services announced a $35 monthly cap for many Medicare Part D beneficiaries.
Author Interviews, Cost of Health Care, JAMA / 19.05.2020

MedicalResearch.com Interview with: [caption id="attachment_54268" align="alignleft" width="142"]James D. Chambers, PhD, MPharm, MSc Associate Professor of Medicine Tufts Medical Center Institute for Clinical Research and Health Policy Studies Dr. Chambers[/caption] James D. Chambers, PhD, MPharm, MSc Associate Professor of Medicine Tufts Medical Center Institute for Clinical Research and Health Policy Studies MedicalResearch.com: What is the background for this study? Response: We know that biosimilars have not had the same uptake in the US as they have had elsewhere. We know that this is in part due to reference product manufacturer tactics to delay biosimilar market entry and patent disputes. In this study we examined whether lack of preferred coverage by commercial health insurers may also play a role.
Author Interviews, Cost of Health Care, JAMA, Primary Care / 19.05.2020

MedicalResearch.com Interview with: [caption id="attachment_54263" align="alignleft" width="168"]Sara Martin, MD, MSc Santa Rosa Family Medicine Residency Program Santa Rosa, California Dr. Martin[/caption] Sara Martin, MD, MSc Santa Rosa Family Medicine Residency Program Santa Rosa, California MedicalResearch.com: What is the background for this study? Response: To improve access to comprehensive primary care, we need to understand how much is being spent on primary care. Until recently, the United States lacked any data-based estimate of primary care expenditure.  This study utilizes Medical Expenditure Panel Survey (MEPS)data from 2002 – 2016 to estimate the percentage of healthcare expenditures that was spent on primary care. Most discussions around health care expenditure in the U.S. focus on the fact that we spend more than any other country and do not have the corresponding outcomes to match that investment.  This paper focuses the conversation around the distribution of the expenditure.
Asthma, AstraZeneca, Author Interviews, Cost of Health Care / 01.05.2020

MedicalResearch.com Interview with: Yen Chung, PharmD Payer Evidence Director US Medical Affairs, AstraZeneca MedicalResearch.com: What is the background for this study? Response: Among patients with persistent asthma, use of systemic corticosteroids (SCS) is typically reserved for treatment of asthma exacerbations and as a supplemental maintenance therapy for patients whose disease remains uncontrolled with maximum maintenance controller therapies. However, SCS therapy comes with known risks for acute and chronic complications. It is well established that patients with severe asthma are responsible for a disproportionate amount of the economic burden of asthma;  however, less clear is the extent to which systemic corticosteroids use and its consequences specifically contributes to the cost burden of asthma. The purpose of this study was to use administrative claims to follow asthma patients with and without SCS treatment for up to 3 years and compare their complication rates, health care resource utilization, and costs. 
Author Interviews, Cost of Health Care, Electronic Records / 20.03.2020

MedicalResearch.com Interview with: [caption id="attachment_53592" align="alignleft" width="200"]Rohit Bishnoi, M.D. Division of Hematology and Oncology Department of Medicine University of Florida Gainesville, FL Dr. Bishnoi[/caption] Rohit Bishnoi, M.D. Division of Hematology and Oncology Department of Medicine University of Florida Gainesville, FL MedicalResearch.com: What is the background for this study? Response: National Healthcare expenditure was $3.6 trillion in 2018 and 17.7% of Gross Domestic Product. Redundant laboratory testing is one part of this problem that is more pronounced in hospitalized patients as they are often seen by multiple physicians from the time of admission till discharge. This added burden on the US health care system leads to increased costs, decreased patient satisfaction, and unnecessary phlebotomy. It also leads to iatrogenic anemia over time and unnecessary transfusions. The Choosing Wisely initiative recommendation from the Society of Hospital Medicine, Society for the Advancement of Blood Management, and the Critical Care Societies Collaborative have recommended avoiding repetitive labs. As one of the physicians in the division of hospital medicine at the University of Florida (UF) Health Shands hospital, we encountered this problem frequently where a patient will get multiple HbA1c or lipid profiles or iron studies during the same hospital stay without any clear clinical indication. Most often these tests were ordered by different physicians seeing the same patient and not realizing that either the test has already been ordered or sometimes it is related to practice pattern of physicians. We often heard complaints about this from our nursing and laboratory staff and, most importantly by patients themselves.
Author Interviews, Cost of Health Care / 10.03.2020

MedicalResearch.com Interview with: [caption id="attachment_53363" align="alignleft" width="200"]Olivier Wouters, Ph.D. Assistant Professor of Health Policy Department of Health Policy (COW 2.06) London School of Economics and Political Science Dr. Wouters[/caption] Olivier Wouters, Ph.D. Assistant Professor of Health Policy Department of Health Policy London School of Economics and Political Science London MedicalResearch.com: What is the background for this study? Response: Although both Democrats and Republicans consider lowering prescription drug prices a priority, lobbyists and campaign donors in the pharmaceutical industry may counteract efforts by federal and state governments to decrease these costs. In this study, I tracked every dollar spent by the pharmaceutical and health product industry on lobbying and campaign contributions in the US from 1999 to 2018. These data were obtained from the Center for Responsive Politics and the National Institute on Money in Politics—two non-profit, non-partisan US organizations. 
Author Interviews, Cost of Health Care, Emergency Care, Neurology / 10.01.2020

MedicalResearch.com Interview with: [caption id="attachment_52759" align="alignleft" width="200"]Simon Borghs Simon Borghs[/caption] Simon Borghs MSc RWE Strategy Lead of Neurology UCB:  Union Chimique Belge MedicalResearch.com: What is the background for this study? Response: Epilepsy is an episodic disease and so is associated with a more or less unpredictable occurrence of health care encounters. These encounters are costly and so reducing them, or their unpredictability, could be cost saving. The objective was to assess one half of this equation, that is the actual cost of those encounters to insurers. This could prompt insurers to consider addressing possible interventions in epilepsy to reduce the number of encounters
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Rheumatology / 13.11.2019

MedicalResearch.com Interview with: [caption id="attachment_52139" align="alignleft" width="200"]Natalie McCormick, Ph.D. Post-Doctoral Research Fellow Clinical Epidemiology Program Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital Department of Medicine, Harvard Medical School Arthritis Research Canada Dr. McCormick[/caption] Natalie McCormick, Ph.D. Post-Doctoral Research Fellow Clinical Epidemiology Program Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital Department of Medicine, Harvard Medical School Arthritis Research Canada  MedicalResearch.com: What is the background for this study? Response: Biologic disease-modifying anti-rheumatic drugs (bDMARDs) have improved the health and productivity of many people living with moderate-to-severe inflammatory rheumatic diseases. They are also among the highest-spend drugs in the USA, with substantial out-of-pocket costs that pose barriers to treatment initiation and adherence. To understand the drivers of ongoing bDMARD spending growth, and effective ways of containing costs, we analysed drug spending data for all bDMARD claims in Medicare Part D, Part B fee-for-service, and Medicaid over 2012 to 2016, isolating the impact of changes in drug prices from changes in utilisation. 
Author Interviews, Cost of Health Care, JAMA / 01.11.2019

MedicalResearch.com Interview with: [caption id="attachment_51983" align="alignleft" width="133"]Rena M. Conti, PhD, Associate Professor Department of Markets, Public Policy and Law Questrom School of Business Boston University Boston, MA 02215 Dr. Conti[/caption] Rena M. Conti, PhD, Associate Professor Department of Markets, Public Policy and Law Questrom School of Business Boston University Boston, MA 02215 Co-Authors: Sayeh S. Nikpay, PhD Melinda B. Buntin, PhD Vanderbilt University School of Medicine MedicalResearch.com: What is the background for this study? Response: The federal 340B program provides deep discounts on the acquisition cost of prescription drugs for participating hospitals and places no limits on what hospitals charge patients and insurers.  Congress intended 340B profits generated from hospital participation to subsidize the provision of safety net care for patients residing in the community. This study is the first to estimate the size of profits hospitals participating in the 340B drug discount program collect from Medicare patients for the outpatient clinic administration of prescription drugs.
Author Interviews, Cost of Health Care, Health Care Systems / 22.10.2019

MedicalResearch.com Interview with: [caption id="attachment_51910" align="alignleft" width="200"]David S Buck, MD, MPH Associate Dean of Community Health Professor, Clinical Sciences University of Houston - College of Medicine Houston, TX 77204 Dr. Buck[/caption] David S Buck, MD, MPH Associate Dean of Community Health Professor, Clinical Sciences University of Houston - College of Medicine Houston, TX 77204  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: High-Needs, High-Cost (HNHC) patients account for 5% of the general population and cost 50% of the healthcare spending. In Harris County, one patient alone costed $439,600 in a year when he visited multiple medical, social and behavioral agencies for care. This was a result of siloed systems working independently of each other leading to inefficient care for the patient. By providing coordinated care, using patient-centered goals and values, we are able to better engage and provide a holistic approach to patient care.  This paper introduces a novel ‘values-based’ intervention mechanism for the HNHC patients, in addition to a coordinated care management approach, through a single record system. The findings indicate an improved daily functioning of the HNHC patients over 4 months, improved relationship between the providers and the patients and moderate well-being scores.
Author Interviews, Cost of Health Care, Health Care Systems, JAMA / 08.10.2019

MedicalResearch.com Interview with: [caption id="attachment_51752" align="alignleft" width="150"]William Shrank, MD, MSHS Chief Medical Officer Humana Dr. Shrank[/caption] William Shrank, MD, MSHS Chief Medical Officer Humana  MedicalResearch.com: What is the background for this study? Response: Health care waste is a serious problem in the system and the rising and uncontrolled costs of healthcare remain one of the top political and social issues in the U.S. We thought that sufficient time had passed since the 2012 groundbreaking analysis that was developed by Donald M. Berwick, MD, MPP and Andrew D. Hackbarth, MPhil, that first characterized waste in the US health system. 
Author Interviews, Critical Care - Intensive Care - ICUs, End of Life Care, Primary Care, Pulmonary Disease, University of Pennsylvania / 07.10.2019

MedicalResearch.com Interview with: [caption id="attachment_51756" align="alignleft" width="180"]Gary Weissman, MD, MSHP Assistant Professor of Medicine Pulmonary, Allergy, and Critical Care Division Palliative and Advanced Illness Research (PAIR) Center University of Pennsylvania Perelman School of Medicine  Dr. Weissman[/caption] Gary Weissman, MD, MSHP Assistant Professor of Medicine Pulmonary, Allergy, and Critical Care Division Palliative and Advanced Illness Research (PAIR) Center University of Pennsylvania Perelman School of Medicine  MedicalResearch.com: What is the background for this study? Response: There are millions of hospitalizations every year in the United States (US) that include a stay in an intensive care unit (ICU). Such ICU stays put strain on health system resources, may be unwanted by patients, and are costly to society. As the population of the US gets older and more medically complex, some have argued that we need more ICU beds and a larger ICU workforce to keep pace. We hypothesized that some proportion of these ICU admissions could be prevented with early and appropriate outpatient care. Such a strategy would alleviate some of the strains and costs associated with ICU stays. If an appreciable proportion of ICU stays were preventable in this way, it would strengthen support for an alternative population-health based framework instead of further investments in the ICU delivery infrastructure. 
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Diabetes, JAMA / 02.10.2019

MedicalResearch.com Interview with: [caption id="attachment_51730" align="alignleft" width="200"]Andrew Sumarsono, MD UT Southwestern Medical Center Dr. Sumarsono[/caption] Andrew Sumarsono, MD UT Southwestern Medical Center MedicalResearch.com: What is the background for this study?   Response: There are currently 12 types of medications used to treat type 2 diabetes. With approximately 30 million adults living with diabetes in the United States, the rising cost of insulin has raised concerns about the affordability of diabetes care. We evaluated trends in total spending and number of prescriptions of all diabetes therapies among Medicare Part D beneficiaries between 2012 and 2017.
ASCO, Author Interviews, Cancer Research, Cost of Health Care, End of Life Care / 17.09.2019

MedicalResearch.com Interview with: Richy Agajanian, M.D. Chief Medical Officer and Senior Regional Director The Oncology Institute of HopeRichy Agajanian, M.D. Chief Medical Officer and Senior Regional Director The Oncology Institute of Hope and Innovation MedicalResearch.com: What is the background for this study? Response: Cancer patients and their families face status-quo treatment protocols and reimbursement models which often result in confusion and unnecessary pain and suffering in the final weeks or months of life while also causing enormous financial burden. To help combat these issues, The Oncology Institute, in collaboration with the Stanford University School of Medicine and CareMore Health, released the study, Enhancing community capacity to deliver value-based cancer care at the end-of-life. This study evaluated the effect of using lay health workers (LHWs), who are non-physician members of the community who have received specialized training to support patient care and navigation, on end-of-life cancer care outcomes, quality and cost. 
Author Interviews, Cost of Health Care, Health Care Systems / 06.09.2019

MedicalResearch.com Interview with: [caption id="attachment_51181" align="alignleft" width="200"]Vivian Ho, PhD The James A. Baker III Institute Chair in Health Economics Director of the Center for Health and Biosciences Rice's Baker Institute for Public Policy Dr. Vivian Ho[/caption] Vivian Ho, PhD The James A. Baker III Institute Chair in Health Economics Director of the Center for Health and Biosciences Rice's Baker Institute for Public Policy MedicalResearch.com: What is the background for this study? Response: In 2003, approximately 29% of U.S. hospitals employed physicians, a number that rose to 42% by 2012. The share of physician practices owned by hospitals rose from 14% in 2012 to 29% in 2016. Economists refer to these relationships between hospitals and physicians as vertical integration, because they represent hospitals exerting more control over physicians as an essential part of inpatient care. As hospitals gain more control over physicians, they may incentivize delivery of more services but not necessarily higher quality care. When we launched this study, we hypothesized that tighter integration of physicians with hospitals would improve care coordination.
Author Interviews, Cost of Health Care, JAMA, Medical Imaging, UCSF / 05.09.2019

MedicalResearch.com Interview with: [caption id="attachment_51136" align="alignleft" width="150"]Rebecca Smith-Bindman, MD Professor, Department of Radiology and Biomedical Imaging, Epidemiology and Biostatistics Philip R. Lee Institute for Health Policy Studies University of California, San Francisco Dr. Smith-Bindman[/caption] Rebecca Smith-Bindman, MD Professor, Department of Radiology and Biomedical Imaging, Epidemiology and Biostatistics Philip R. Lee Institute for Health Policy Studies University of California, San Francisco MedicalResearch.com: What is the background for this study? Response: Medical imaging increased rapidly from 2000 to 2006. The rise in imaging can be attributed to improvements in technical aspects of imaging, strong physician and patient demand, and strong financial incentives. While imaging contributes to accurate disease diagnosis and improved treatment, imaging can also increase costs and patient harms, such as incidental findings, overdiagnosis, anxiety, and radiation exposure associated with increased risk of cancer. Potential overuse of diagnostic testing has been addressed by the American Board of Internal Medicine Foundation’s Choosing Wisely Campaign and initiatives by payers to reduce imaging through payment reductions, but there remains uncertainty in the impact of these initiatives on imaging rates.The objective of our study was to evaluate recent trends in medical imaging. Our study assessed imaging from 2000 through 2016 among individuals enrolled in diverse U.S. integrated healthcare systems and among individuals residing in Ontario, Canada and assessed changes in medical imaging utilization over time by country, health system, and patient demographic factors.
Author Interviews, Cost of Health Care / 12.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50702" align="alignleft" width="173"]Erin L. Duffy, PhD, MPH Adjunct Policy Researcher RAND  Dr. Duffy[/caption] Erin L. Duffy, PhD, MPH Adjunct Policy Researcher RAND  MedicalResearch.com: What is the background for this study?   Response: A patient treated at a hospital in his or her insurer’s network may be involuntarily treated by out-of-network (OON) physicians. In these cases, the OON physician can seek to collect full billed charges from the patient’s insurer and, if the insurer does not pay the full amount, the physician can bill the patient for the remaining balance. These unexpected bills from out-of-network physicians are known as “surprise medical bills” and most result from anesthesiology, radiology, and pathology services. California implemented a comprehensive policy (AB-72) addressing surprise medical billing for out-of-network nonemergency physician services at in-network hospitals in 2017 for patients in fully-insured health plans. AB-72 limits patients’ cost sharing to in-network levels, unless patients provide written consent to billing 24 hours in advance of services. Insurers and health plans pay out-of-network physicians at in-network hospitals the greater of the payer’s local average contracted rate or 125% of Medicare’s fee-for-service reimbursement rate. 
Author Interviews, Cost of Health Care, Medicare, UCLA / 08.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50628" align="alignleft" width="154"]Auyon Siddiq PhD Assistant Professor/INFORMS Member Decisions, Operations & Technology Management  UCLA Anderson School of Management Dr. Siddiq[/caption] Auyon Siddiq PhD Assistant Professor/INFORMS Member Decisions, Operations & Technology Management UCLA Anderson School of Management MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Medicare Shared Savings Program (MSSP) was created under the Patient Protection and Affordable Care Act to control escalating Medicare spending by incentivizing providers to deliver healthcare more efficiently. Medicare providers that enroll in the MSSP earn bonus payments for reducing spending to below a risk-adjusted financial benchmark that depends on the provider's historical spending. To generate savings, a provider must invest to improve efficiency, which is a cost that is absorbed entirely by the provider under the current contract. This has proven to be challenging for the MSSP, with a majority of participating providers unable to generate savings due to the associated costs. This study presents a predictive analytics approach to redesigning the MSSP contract, with the goal of better aligning incentives and improving financial outcomes from the MSSP. We build our model from data containing the financial performance of providers enrolled in the MSSP, which together accounted for 7 million beneficiaries and over $70 billion in Medicare spending.
Author Interviews, Cost of Health Care, JAMA, NYU, Ophthalmology, Pharmaceutical Companies / 02.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50532" align="alignleft" width="150"] Dr. Thiel[/caption] Cassandra L. Thiel, PhD Assistant Professor NYU Langone School of Medicine Department of Population Health NYU Wagner Graduate School of Public Service NYU Tandon School of Engineering MedicalResearch.com: What is the background for this study? Response: Most healthcare professionals and researchers are aware that the healthcare sector makes up about 18% of the US Gross Domestic Product. What many do not realize is that all of that economic activity results in sizable resource consumption and environmental emissions. The healthcare industry is responsible for 10% of the US’s greenhouse gas (GHG) emissions and 9% of air pollutants.1 Sustainability in healthcare is a developing field of research and practice, and my lab offers data and information by quantifying resource use and emissions of healthcare delivery. We started looking at cataract surgery a few years ago, in part because operating rooms (ORs) typically represent the largest portion of spending and garbage generation in a hospital.2,3 Cataract surgeries are interesting because they are one of the most common surgeries performed in the world. In the US, we spend $6.8 billion on them each year. Any changes we can make to individual cases would have much larger, global impacts. I studied cataract surgeries at a world-renowned, high-volume eye surgery center in India and helped validate that clinical care could be designed in a way that was effective, cost-efficient, and resource efficient. Compared to the same procedure in the UK, this surgery center generates only 5% of the carbon emissions (with the same outcomes).2 This site’s standard policy is to multi-dose their eye drops, or use them on multiple patients until the bottle was empty. As such, the site generated very little waste. Returning to the US, I observed cataract cases and heard the complaints of OR staff that they had to throw out many partially used or unused pharmaceuticals. In reviewing the literature, we could not find a study that quantified how much we were throwing away and what it cost us to do so. We, therefore, set up a study to look at this particular issue.
Author Interviews, Cost of Health Care, JAMA / 28.07.2019

MedicalResearch.com Interview with: blood-tests-lab-testsRenuka S Bindraban, MD and Prabath W. B. Nanayakkara, MD, PhD Section of Acute Medicine Department of Internal Medicine Amsterdam Public Health Research Institute Amsterdam UMC Vrije Universiteit Amsterdam, Amsterdam, the Netherland  MedicalResearch.com: What is the background for this study? Response: It is well known that a significant portion of healthcare activities is considered of low-value. Eliminating such low-value care is often targeted in efforts to both contain rapidly increasing healthcare costs as well as maintain high-quality care. In this context, our study focused on reducing unnecessary laboratory testing. In 2008, our study group performed a multifaceted intervention aimed at reducing unnecessary diagnostic testing at the Internal Medicine department of the Amsterdam University Medical Center, location Vrije Universiteit (VU). In the ‘Reduction of Unnecessary Diagnostics Through Attitude Change of the Caregivers’, we implemented this successful intervention in the Internal Medicine departments of four large teaching hospitals in the Netherlands. The intervention included creating awareness through education and feedback, intensified supervision of residents, and changes in order entry systems.
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, ENT, Surgical Research / 25.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50402" align="alignleft" width="133"]Vinay K. Rathi, MD Otolaryngology Resident | Massachusetts Eye and Ear Project Manager | Partners Ambulatory Care MBA Candidate | Harvard Business School Dr. Rathi[/caption] Vinay K. Rathi, MD Otolaryngology Resident | Massachusetts Eye and Ear Project Manager | Partners Ambulatory Care MBA Candidate | Harvard Business School  MedicalResearch.com: What is the background for this study?  Response: This study is a secondary subgroup analysis that follows on the heels of a recently published study in The New England Journal of Medicine (NEJM) examining physician reimbursement for surgical procedures in the Medicare Physician Fee Schedule (PFS), which both public and private insurers use to determine payment rates for clinician services. Although it is widely understood that physician time (i.e., the amount of physician time required to perform a procedure) is perhaps the most important factor used to determine payment rates, the Centers for Medicare and Medicaid Services (CMS) has historically relied upon limited and potentially biased survey data to estimate physician time. Leveraging time data from American College of Surgeons National Quality Improvement Program, the authors of the recent NEJM study demonstrated that CMS does not appear to systematically misestimate intraoperative times, but there are substantial discrepancies that may result in over- or undercompensation for certain procedures and specialties.
Author Interviews, CDC, Cost of Health Care, Diabetes / 09.07.2019

MedicalResearch.com Interview with: Xiaohui Zhuo, PhD Division of Diabetes Translation National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention, Atlanta, GA  MedicalResearch.com: What is the background for this study? Response: Prescription drug spending (spending from families and individuals, their medical providers (doctors, hospitals, pharmacies, etc.) and employees across the United States) has increased at a much higher rater than other components of the total medical expenditure associated with diabetes.  The share of spending on prescription drugs in per capita annual excess expenditure due to diabetes increased from 27% to 41% between 1987 and 2011, according to a previous study using national data from the Agency for Healthcare Research and Quality Medical Expenditures Panel Surveys. In this most recent study, CDC researchers estimated the increase in the national spending on antidiabetic drugs from 2005 to 2016 in total and by drug class and broke down the increase in total national spending by examining what factors have contributed to the increase estimating the magnitude of each factor’s contribution.
Author Interviews, Cost of Health Care, Kidney Disease / 03.07.2019

MedicalResearch.com Interview with: "Plugged into dialysis" by Dan is licensed under CC BY 2.0Andrew C. Qi,  Medical student Karen E. Joynt Maddox MD MPH Assistant professor of medicine Washington University School of Medicine Saint Louis, Missouri.  MedicalResearch.com: What is the background for this study?   Response: The End-Stage Renal Disease Quality Incentive Program (ESRD QIP) is a Medicare program that evaluates dialysis facilities in the U.S. based on a set of quality measures, and penalizes low-performing facilities. We’ve seen a growing understanding of how social risk factors like poverty and race/ethnicity impact patient outcomes in other settings, making it difficult for providers caring for disadvantaged populations to perform as well in these kinds of pay-for-performance programs. We were interested in seeing if this was the case for dialysis facilities as well, especially since patients receiving dialysis are already a vulnerable population.
Author Interviews, Cancer Research, JAMA / 03.07.2019

MedicalResearch.com Interview with: [caption id="attachment_46733" align="alignleft" width="120"]Farhad Islami, MD PhD Scientific Director, Surveillance Research American Cancer Society, Inc. Atlanta, GA 30303 Dr. Islami[/caption] Farhad Islami, MD PhD Scientific Director, Surveillance Research American Cancer Society, Inc MedicalResearch.com: What is the background for this study?   Response: In the United States, cancer is the second leading cause of death, and premature cancer deaths impose significant economic burden. Contemporary information on the economic burden of cancer mortality can inform policies and help prioritize resources for cancer prevention and control, but this information is lacking. In our study, we provide contemporary estimates for the loss of future earnings (lost earnings) due to cancer death at national and state levels for all cancers combined and for major cancers.