Medicaid Experiment in Oregon Leads to Decreased Use of Imaging Services

AHRQ Stats: Highest Rates of Opioid-Related Inpatient Stays

Hospitals in the New England Census division had the nation’s highest rates of opioid-related stays in 2016. This includes hospitalization rates for metropolitan hospitals (41 per 1,000 stays), adjacent rural areas (33 per 1,000) or more remote rural areas (35 per 1,000). (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #258, Hospital Burden of Opioid-Related Inpatient Stays: Metropolitan and Rural Hospitals, 2016.)

Today's Headlines:

• Medicaid Experiment in Oregon Leads to Decreased Use of Imaging Services.
• AHRQ-Funded Guide Helps Hospitals Redesign Systems To Improve Patient Care.
• Highlights From AHRQ’s Patient Safety Network.
• Apply by Oct. 5 for Funding To Improve Quality of Care and Patient Outcomes During Care Transitions.
• AHRQ in the Professional Literature.

Medicaid Experiment in Oregon Leads to Decreased Use of Imaging Services

The switch to a patient-centered medical home (PCMH) model of care combined with a new per-member per-month payment structure in Oregon’s Medicaid program decreased use of imaging services by more than 42 percent, but other outcomes were unaffected, a new AHRQ-funded study has found. Researchers said that the study, published in Health Affairs, offers lessons to other states that are interested in using payment reform to advance the PCMH model for the Medicaid population. Oregon adopted elements of the PCMH model for its Medicaid program in 2013 by changing the reimbursement structure for traditional primary care services for some community health centers. Access the abstract.

AHRQ-Funded Guide Helps Hospitals Redesign Systems To Improve Patient Care

An AHRQ-funded implementation guide is now available to help hospitals make changes to establish the structure and shared accountability needed to coordinate high-quality care and improve performance over time. The guide was developed by the RESET project, an initiative led by researchers at Northwestern University Feinberg School of Medicine. It is designed to address challenges such as managing large teams with evolving membership and ensuring collaboration between clinicians in distant hospital locations. Strategies also are aimed at ensuring patients and family members receive the information needed to engage in decision-making and care planning. Access the toolkit’s implementation guide.

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:

• Effect on patient safety of a resident physician schedule without 24-hour shifts.
• Contributing factors for pediatric ambulatory diagnostic process errors: Project RedDE.
• Failure to rescue deteriorating patients: a systematic review of root causes and improvement strategies.

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).

Apply by Oct. 5 for Funding To Improve Quality of Care and Patient Outcomes During Care Transitions

Funding from AHRQ is available to test promising health information technology solutions to improve communication and care coordination during care transitions. Poorly managed transitions can lead to costly, unsafe and low-quality care. AHRQ’s funding opportunity announcement focuses on improving care transitions between multiple providers and different institutional care settings with a focus on patients and their families and communities. Applications will be accepted on a rolling basis. The deadline for new applications is Oct. 5. Learn more.

AHRQ in the Professional Literature

Discussing out-of-pocket costs with patients: shared decision making for sacubitril-valsartan in heart failure. Smith GH, Shore S, Allen LA, et al. J Am Heart Assoc 2019 Jan 8;8(1):e010635. Access the abstract on PubMed®.

Effect of the patient-centered medical home on racial disparities in quality of care. Swietek KE, Gaynes BN, Jackson GL, et al. J Gen Intern Med 2020 Feb 24. [Epub ahead of print.] Access the abstract on PubMed®.

Trends in regionalization of emergency care for common pediatric conditions. Cushing AM, Bucholz E, Michelson KA. Pediatrics 2020 Apr;145(4): e20192989. Epub 2020 Mar 13. Access the abstract on PubMed®.

Causes and consequences of chemotherapy delays in ambulatory oncology practices: a multisite qualitative study. Lafferty M, Fauer A, Wright N, et al. Oncol Nurs Forum 2020 Jul 1;47(4):417-27. Access the abstract on PubMed®.

Improving care pathways for acute coronary syndrome: patients undergoing percutaneous coronary intervention. Amin AP, Spertus JA, Kulkarni H, et al. Am J Cardiol 2020 Feb;125(3):354-61. Epub 2019 Oct 26. Access the abstract on PubMed®.

Comparative effectiveness of high-dose versus standard-dose influenza vaccine among patients receiving maintenance hemodialysis. Butler AM, Layton JB, Dharnidharka VR, et al. Am J Kidney Dis 2020 Jan;75(1):72-83. Epub 2019 Aug 1. Access the abstract on PubMed®.

Suitability of elderly adult hospital readmission rates for profiling readmissions in younger adult and pediatric populations. Bucholz EM, Toomey SL, Butala NM, et al. Health Serv Res 2020 Apr;55(2):277-87. Epub 2020 Feb 9. Access the abstract on PubMed®.

Sharing information electronically with other hospitals is associated with increased sharing of patients. Everson J, Adler-Milstein J. Health Serv Res 2020 Feb;55(1):128-35. Epub 2019 Nov 12. Access the abstract on PubMed®.