The American journal of managed care
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The authors disagree with previous research concluding that the Home Health Care Consumer Assessment of Healthcare Providers and Services (CAHPS) publicly reported data are insufficiently adjusted for patient comorbidities.
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Migraine is a debilitating condition that affects approximately 16% of adults and is the fifth leading cause of emergency department visits in the United States. There are several treatment options for migraines; opioids are frequently prescribed. Results from a recent study showed that more than half of the patients with chronic migraine and a third of the patients with episodic migraine received an opioid prescription in the past year. ⋯ Patients with migraine have more than twice the healthcare costs as patients without migraines. The additional increase in healthcare costs in patients with migraine who use opioids for treatment and/or have 2 or more comorbidities is significant. Control of the pain associated with migraine, specifically among those with multiple comorbid conditions, may contribute to substantial reductions in healthcare costs.
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This study evaluates the impact of concomitant medical conditions on patients with and without migraine, assessing healthcare utilization, and total cost of care. Medical and pharmacy claims from multiple health plans, both nationally and internationally, were examined to evaluate overall real-world trends in commercially insured patients diagnosed with migraine. A total of 53,608 patients with diagnosis codes for migraine met the study criteria and were matched 1:1 with controls (81.8% female; mean age, 42 years; mean Charlson Comorbidity Index score, 0.34). ⋯ These patients also utilize healthcare resources at a significantly higher rate compared with similar patients without a migraine diagnosis. An unmet need exists for new treatment modalities in this patient population. More effective interventions and proper management may lead to improved patient outcomes and healthcare costs for patients with migraine.
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Pragmatic Clinical Trial
Impact of complex care management on spending and utilization for high-need, high-cost Medicaid patients.
Complex care management programs have emerged as a promising model to better care for high-need, high-cost patients. Despite their widespread use, relatively little is known about the impact of these programs in Medicaid populations. This study evaluated the impact of a complex care management program on spending and utilization for high-need, high-cost Medicaid patients. ⋯ Carefully designed and targeted complex care management programs may be an effective approach to caring for high-need, high-cost Medicaid patients.
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To mark the 25th anniversary of the journal, each issue in 2020 will include an interview with a healthcare thought leader. For the February issue, we turned to Gail Wilensky, PhD, an economist and senior fellow at Project HOPE.