Informal Physician Interaction Could Result in Lower Payments for Surgery, AHRQ Study Finds

AHRQ Stats: Private Insurance vs. Medicaid for Hospital Payments

Medicaid was the primary payer for 54 percent of hospitalizations for patients younger than 18 (excluding hospitalizations for pregnancies and newborns) in 2015. That represented a sizeable increase from 2000, when Medicaid paid for 39 percent of hospitalizations in that category. (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #235: Trends in Hospital Inpatient Stays by Age and Payer, 2000-2015.)

Today's Headlines:

• Informal Physician Interaction Could Result in Lower Payments for Surgery, AHRQ Study Finds.
• Highlights From AHRQ's Patient Safety Network.
• New AHRQ Views Blog Posts: AHRQ Stands Ready To Assist Secretary Azar in the Fight Against Opioid Epidemic.
• Studies Featured on the Nation's Health Systems.
• March 7 Webcast To Explore Women's Mental Health Across Lifespans.
• New Research and Evidence From AHRQ.
• AHRQ in the Professional Literature. 

Informal Physician Interaction Could Result in Lower Payments for Surgery, AHRQ Study Finds

Increased informal interaction among primary- and specialty-care physicians within health systems was associated with lower Medicare payments for surgery, according to AHRQ-funded research in JAMA Surgery. Researchers analyzed the records of about 253,000 Medicare beneficiaries who underwent coronary artery bypass graft surgeries. They concluded that increased interactions among physicians—defined as "informal integration"—were associated with lower payments due to fewer duplicate tests, treatments or other services. Such informal integration could provide a model to reduce surgery costs nationally, researchers said. Savings were greatest for reduced hospital readmissions (13 percent) and post-acute care (5.8 percent). The authors concluded that increasing informal interactions may be a promising method to lower surgery payments, in addition to formal integration,such as that from accountable care organizations. Access the abstract.

Highlights From AHRQ's Patient Safety Network

AHRQ's Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

• Tracking progress in improving diagnosis: a framework for defining undesirable diagnostic events.
• Implementation of diagnostic pauses in the ambulatory setting.
• Systems thinking and incivility in nursing practice: an integrative review.

Review additional new publications in PSNet's current issue or access recent cases and commentaries in AHRQ's WebM&M (Morbidity and Mortality Rounds on the Web).

New AHRQ Views Blog Posts: AHRQ Stands Ready To Assist Secretary Azar in the Fight Against Opioid Epidemic

Director Gopal Khanna, M.B.A., welcomes new HHS Secretary Alex Azar, and details how AHRQ is uniquely positioned to support the Secretary and HHS' five-point strategy to combat the opioid crisis. AHRQ plans several notable initiatives in 2018, including the release of county-level data on hospital stays related to substance abuse disorder; a research report on the effectiveness of noninvasive, nonpharmacologic treatments of chronic pain; and a new AHRQ-funded website to assist opioid users, their families and public health officials gain access to naloxone, a potentially life-saving drug that reverses overdoses. Access the blog post.

Studies Featured on the Nation's Health Systems

AHRQ's Comparative Health System Performance Initiative funds studies about how health care delivery systems promote evidence-based practices and patient-centered outcomes research in delivering care. Publications include:

• Random or predictable? Adoption patterns of chronic care management practices in physician organizations.
• Explaining sluggish savings under accountable care.
• ACOs serving high proportions of racial and ethnic minorities lag in quality performance.

Access the initiative's Compendium of U.S. Health Systems, 2016, the first publicly available database that provides researchers, policymakers and health care administrators with a snapshot of the nation's health systems.

March 7 Webcast To Explore Women's Mental Health Across Lifespans

Register now to observe a webcast workshop on March 7, from 8:30 a.m. to 5 p.m. ET, on women's mental health. Hosted by the National Academies of Sciences, Engineering, and Medicine, the event will explore how environmental, sociocultural, behavioral and biological factors affect women's mental health across the course of life and among different racial and ethnic goups. Access more information.

New Research and Evidence From AHRQ

• Effectiveness of Indoor Allergen Reduction in Management of Asthma.

AHRQ in the Professional Literature

Cost effectiveness and cost containment in the era of interferon-free therapies to treat hepatitis C virus genotype 1. Linas BP, Morgan JR, Pho MT, et al. Open Forum Infect Dis 2016 Dec 27;4(1):ofw266. Access the abstract on PubMed®.

Hospital days attributable to immune reconstitution inflammatory syndrome in persons living with HIV before and after the 2012 DHHS HIV guidelines. Liu P, Dillingham R, McManus K. AIDS Res Ther 2017 May 2;14:25. Access the abstract on PubMed®.

Sex differences in lipid profiles and treatment utilization among young adults with acute myocardial infarction: results from the VIRGO study. Lu Y, Zhou S, Dreyer RP, et al. Am Heart J 2017 Jan;183:74-84. Epub 2016 Oct 3. Access the abstract on PubMed®.

Use of daily interruption of sedation and early mobility in US hospitals. Manojlovich M, Ratz D, Miller MA, et al. J Nurs Care Qual 2017 Jan/Mar;32(1):71-6. Access the abstract on PubMed®.

Reasons for lack of diagnostic colonoscopy after positive result on fecal immunochemical test in a safety-net health system. Martin J, Halm EA, Tiro JA, et al. Am J Med 2017 Jan;130(1):93.e1-93.e7. Epub 2016 Aug 31. Access the abstract on PubMed®.

The effects of pay-for-performance programs on health, health care use, and processes of care: a systematic review. Mendelson A, Kondo K, Damberg C, et al. Ann Intern Med 2017 Mar 7;166(5):341-53. Epub 2017 Jan 10. Access the abstract on PubMed®.

Critical access hospital use of TeamSTEPPS to implement shift-change handoff communication. Natafgi N, Zhu X, Baloh J, et al. J Nurs Care Qual 2017 Jan/Mar;32(1):77-86. Access the abstract on PubMed®.

Commentary on EPC methods: an exploration of the use of text-mining software in systematic reviews. Paynter R, Bañez LL, Erinoff E, et al. J Clin Epidemiol 2017 Apr;84:33-6. Epub 2017 Jan 18. Access the abstract on PubMed®.