The American journal of managed care
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This study was designed to assess physician experiences with utilization management and burnout and investigate whether they are linked. ⋯ These findings indicate that utilization management has a detrimental impact on physicians and patient care and contributes to physician burnout.
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Provider directory inaccuracies have important implications for care navigation and access as well as ongoing regulatory efforts. We assessed the extent to which identified provider directory inaccuracies persisted across 7 specialties (cardiology, dermatology, endocrinology, gastroenterology, neurology, obstetrics-gynecology, primary care) and 5 carriers in the Pennsylvania Affordable Care Act insurance marketplace. ⋯ A large number of provider directory inaccuracies persist well beyond the 90-day expectation mandated by federal regulations, raising substantial concerns about compliance. These inaccuracies may impose substantial barriers to patient access and may render existing assessments of network adequacy ineffective.
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Despite recent policy interest in improving access to mental health care in Medicare, little is known about how demand for care will change among the Medicare population as newer cohorts age into the program. We documented the growing rate of counseling and psychotherapy use in the decade prior to turning age 65 years among subsequent cohorts aging into Medicare. We characterized how this growth varied across demographic groups, income levels, and mental and physical health status. ⋯ Our findings suggest that more recent cohorts aging into Medicare seek significantly more counseling and psychotherapy than prior cohorts. This increased utilization is pervasive across subpopulations, suggesting that plans must prepare to accommodate the needs of new Medicare entrants.
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Idiopathic pulmonary fibrosis (IPF) is characterized by a progressive decline in lung function, worsening quality of life, and high mortality. However, the rate and pattern of progression of IPF are variable. Real-world studies, which include a broader population of patients than clinical trials and collect data over longer periods, have provided important information on the clinical course of IPF and further insights into the efficacy and safety of antifibrotic therapies. ⋯ Data from patient registries and analyses of claims data suggest that antifibrotic therapy is more likely to be used in patients who have worse lung function and that its use is associated with an improvement in life expectancy. The safety profile of antifibrotic therapies in real-world populations is consistent with that observed in clinical trials. Further real-world studies are needed to improve understanding of the course and impact of IPF in specific groups of patients and how the care provided to these patients might be improved.
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We previously described a 6-item teamwork index (TEAM) with a strong relationship to provider experience, lower burnout, and intent to stay. We now sought to determine whether (1) TEAM relates to higher patient Net Promoter Score (NPS, or likelihood of patient referring to the organization) and (2) teamwork mediates a provider experience-NPS relationship. ⋯ Teamwork and provider experience relate to patient NPS, and the provider experience-NPS relationship appears to be mediated by teamwork.