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  • The Importance of Relative Prices in Health Care Spending

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    JAMA. 2018; doi: 10.1001/jama.2017.20047

    This Viewpoint discusses how distortions of prices in health care services influence policies and payments that encourage use of lower value services, and it proposes policies that target price distortions as a means to address rising health care expenditures.

  • Transforming the Military Health System

    Abstract Full Text
    JAMA. 2017; 318(24):2427-2428. doi: 10.1001/jama.2017.16718

    This Viewpoint describes the five lines of reform the US Department of Defense is implementing for its TRICARE health plan, the main provider of health care services to enlisted service members in all military branches, their families, and retirees.

  • Global Budgets for Safety-Net Hospitals

    Abstract Full Text
    JAMA. 2017; 318(18):1759-1760. doi: 10.1001/jama.2017.14957

    This Viewpoint discusses steps necessary to develop an all-payer hospital global budgeting system as one means to incentivize health systems to emphasize preventive care that reduces health service utilization and costs.

  • JAMA April 11, 2017

    Figure 4: Health Care and Social Service Spending Across Countries in the Organisation for Economic Co-operation and Development (OECD)

    Compared with other high-income countries, the United States spends a greater proportion of health care and social service expenditures on health care services. For every $1 spent on health care, about $2 is spent on social services by countries in the OECD overall but only about $0.50 is spent on social services by the United States. GDP indicates gross domestic product. Data are from OECD countries (n = 30) from 1995 to 2005 according to the 2009 release of the OECD Health Data 2009 Statistics and Indicators and OECD Social Expenditure Database. Adapted from Bradley and Taylor.
  • JAMA February 14, 2017

    Figure: The One With Friends : A TV Show Within a Play

    The One With Friends starring Nick McLoughlin and Miranda Wynne.
  • JAMA September 13, 2016

    Figure: Perfect Care Indexes During a 3-Year Interval for the Total Joint Replacement Initiative

    Monthly results from quality improvement, using 2 different but overlapping definitions of perfect care, are highlighted. Thick line segments indicate the 4-month baseline and measurement periods used to assess statistical significance of the process redesign. Perfect care index is reported as the percentage of perfect care encounters per period of measurement. For perfect care definition 1, the perfect care index comprised 6 nationally and locally defined quality indicators: (1) 30-day readmission; (2) Surgical Care Improvement Project composite; (3) 35 Hospital Acquired Condition/Patient Safety Indicator measures; (4) admission to the orthopedic acute care unit during hospitalization; (5) early mobility (out of bed on day of surgery); and (6) emergency department visit within 90 days of discharge. Early mobility was identified as a key exposure for improving outcomes and decreasing length of stay and facility costs. For perfect care definition 2, the perfect care index was defined as the following: (1) 35 Hospital Acquired Condition/Patient Safety Indicator measures; (2) admission to the orthopedic acute care unit during hospitalization; (3) emergency department visit within 90 days of discharge; and (4) discharge to home with home health services. First evaluation year corresponds to the implementation year, while second evaluation year was the postimplementation year.
  • JAMA August 16, 2016

    Figure 1: Probabilistic Sensitivity Analyses Showing the Proportion of Optimal Simulations as a Function of Drug Price

    At 2015 US prices and a threshold of $100 000 per quality-adjusted life-year (QALY), proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors were not cost-effective among patients with heterozygous familial hypercholesterolemia or atherosclerotic cardiovascular disease. Lowering the drug price or increasing the cost-effectiveness threshold would increase the proportion of simulations that are cost-effective. Vertical dotted lines show the list price of a 1-year supply of evolocumab in the United States ($14 100), the United Kingdom ($6427; the National Health Service receives an additional discount), Austria ($8110), and Finland ($8700).
  • Toward an Integrated Federal Health System

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    JAMA. 2016; 315(23):2521-2522. doi: 10.1001/jama.2016.4641

    This Viewpoint discusses the fragmented nature of the current US federal health system and proposes approaches for achieving a more integrated and efficient system.

  • Development and Implementation of Expected Practices to Reduce Inappropriate Variations in Clinical Practice

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    JAMA. 2016; 315(20):2163-2164. doi: 10.1001/jama.2016.4255

    This Viewpoint describes approaches taken by the Los Angeles Department of Health Services to reduce clinical practice variaton across the system.

  • Training Physicians to Provide High-Value, Cost-Conscious Care: A Systematic Review

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    JAMA. 2015; 314(22):2384-2400. doi: 10.1001/jama.2015.16353

    This systematic review analyzes how physicians are educated to deliver high-value, cost-conscious care and the circumstances that influence this learning.

  • Bill Would Allow Moral and Religious Objections to Health Care Services

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    JAMA. 2015; 314(14):1439-1439. doi: 10.1001/jama.2015.12649
  • Learning About Competition From the UK’s National Health Service

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    JAMA. 2015; 314(6):547-548. doi: 10.1001/jama.2015.9195
  • The Role of University Health Centers in Intervention and Prevention of Campus Sexual Assault

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    JAMA. 2015; 314(5):438-440. doi: 10.1001/jama.2015.8213

    This Medical News and Perspectives piece discusses the role of campus health services in sexual assault prevention and intervention initiatives, highlighting the challenges college communities face in mitigating assault.

  • JAMA January 13, 2015

    Figure 6: US Funding for Health Services Research by Source, 2004-2011

    AHRQ indicates Agency for Healthcare Research and Quality; NIH, National Institutes of Health. Data were calculated according to methods outlined in eTable 5 in the Supplement.aAdjusted to 2012 dollars using the Biomedical Research and Development Price Index.bCompound annual growth rate (CAGR) supposing that year A is x and year B is y, CAGR = (y/x){1/(B−A)}−1.cHealth services industry includes funding from hospitals, ambulatory health care services, nursing and residential facilities. Health insurance companies were not included. Data may not fully capture the entirety of funding for health services research and quality improvement initiatives for the US health care services industry.dOther federal funding includes the Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services, Veterans Health Administration, Health Resources and Services Administration, and Patient Centered Outcomes Research Institute (in 2011 only).eFoundation funding includes total giving from the Robert Wood Johnson Foundation, California Endowment, Pew Charitable Trusts, W. K. Kellogg Foundation, and Commonwealth Fund.
  • JAMA January 13, 2015

    Figure 7: Research and Development Investment Ranking of Industrial Sectors Among US-Based Companies, 2011

    Research and development expenditures for US-based companies performing research by the industrial sector were obtained from the National Science Foundation. Data include research funds spent both domestically and abroad. Industry revenues were obtained from the National Science Foundation or US Census Bureau based on the availability of data. Revenues and research and development expenditures were matched by industry using North American Industry Classification System codes.aThe pharmaceuticals and biotechnology, medical devices, and health care services industries are highlighted in red.bAdjusted to 2012 dollars using the Biomedical Research and Development Price Index.cHealth care services industry includes US-based hospitals, ambulatory health care services, and nursing and residential facilities.
  • Association Between Availability of Health Service Prices and Payments for These Services

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    JAMA. 2014; 312(16):1670-1676. doi: 10.1001/jama.2014.13373

    This analysis of claims data from employer-insured patients found that those who accessed a pricing platform to check the cost of clinician visits, laboratory testing services, or imaging studies had lower total claims payments than those who did not check prices.

  • Older Individuals Living With HIV/AIDS to Shift Health Care Service Needs

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    JAMA. 2013; 310(18):1912-1912. doi: 10.1001/jama.2013.281877
  • State Repayment Programs for Health Care Education Loans

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    JAMA. 2013; 310(18):1982-1984. doi: 10.1001/jama.2013.281644
  • JAMA July 10, 2013

    Figure: Release of Data on What Hospitals Charge Appears More Likely to Confuse Rather Than Enlighten Consumers

    Citing the need for transparency, the federal government suggests that the release of hospital prices and charges for frequently billed Medicare discharges will help patients make economically informed choices when they seek health care services.
  • Health Services Innovation: The Time Is Now

    Abstract Full Text
    JAMA. 2013; 309(11):1113-1114. doi: 10.1001/jama.2013.2007