The American journal of managed care
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Patient and Caregiver Support for Serious Illness (PACSSI), a per-member per-month (PMPM) alternative reimbursement structure for palliative care (PC) services, has been described as overly generous by HHS. We developed a modified version, PACSSI-Flexible (PACSSI-F), by modeling reimbursement for PC based on the changes in patient functional status. We estimated reimbursement for the first year that an organization might implement the PACSSI-F for PC services. ⋯ Modeling of the PACSSI-F using secondary data provides a novel example of economic forecasting for alternative reimbursement structures in PC. Alternative reimbursement payment policies are necessary to expand PC for the seriously ill population.
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Identification of patients with asthma at increased risk for hospitalization and emergency department (ED) visits presents opportunity for intervention. ⋯ Texas Children's Health Plan asthma risk score stratifies risk of asthma hospitalization and ED visits for Medicaid-insured children. The risk score performs better for children aged 3 to less than 18 years than for those aged 1 to less than 3 years.
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To complete a scoping review of US health insurers' use of health-related quality of life (HRQOL) patient-reported outcome measures (PROMs). ⋯ This review found a wide variety of articles across insurance providers, health conditions, and uses of PROMs. There is a noted paucity of data in pediatric populations and little information about the use of data collected within health care settings that is transmitted to health insurers.
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Strategies to maintain hospital capacity during the COVID-19 pandemic included reducing hospital length of stay (LOS) for infected patients. We sought to evaluate the association between LOS and enrollment in the COVID Accelerated Care Pathway, which consisted of a hospital observation protocol and postdischarge automated text message-based monitoring. ⋯ Patients with COVID-19 who were managed through an accelerated hospital observation protocol and postdischarge monitoring service had reduced hospital LOS compared with patients receiving standard care. Hospital preparedness for future public health emergencies may involve the design of pathways that reduce the time that patients spend in the hospital, lower cost, and ensure continued recovery upon discharge.
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Optimizing patient outcomes is a goal for medication therapy management (MTM) programs, with patient satisfaction representing a valuable measure to provide information about pharmacist-delivered services and the overall effectiveness of the program. The objective of this study was to assess patient satisfaction after engaging in a telephonic comprehensive medication review (CMR) with a pharmacist in a Medicaid population. ⋯ Overall, Medicaid patients in this study were very satisfied with the telephonic MTM services provided and found the information relayed during the conversation with the pharmacist to be helpful. Further studies are recommended to confirm these findings.