Results 51 to 60 of about 8,117 (202)

Inappropriate Appeal Denials for Head and Neck Cancer Surgery in Medicare Advantage Plans

OTO Open, Volume 10, Issue 2, April-June 2026.
Abstract Medicare Advantage (MA) plans use prior authorization to manage utilization, with denied services appealable through a five‐level process. Independent review entities (IREs) adjudicate second‐level appeals, determining whether initial plan denials were appropriate.
Jeffrey R. Bellinger, Cameron B. Fattahi, Ericka L. Erickson, Nolan B. Seim, Vinay K. Rathi, Lauren E. Miller   +5 more
wiley   +1 more source

The Resurgence of Home-Based Primary Care Models in the United States

Geriatrics, 2018
This article describes the forces behind the resurgence of home-based primary care (HBPC) in the United States and then details different HBPC models. Factors leading to the resurgence include an aging society, improved technology, an increased emphasis ...
Mattan Schuchman, Mindy Fain, Thomas Cornwell   +2 more
doaj   +1 more source

Supporting General Practitioners to Deprescribe Benzodiazepines and Z‐Drugs in Primary Care: Findings From a Modified Delphi Study

Basic &Clinical Pharmacology &Toxicology, Volume 138, Issue 4, April 2026.
ABSTRACT Long‐term use of benzodiazepines and Z‐drugs (collectively known as benzodiazepine receptor agonists; BZRAs) is associated with a range of adverse effects including dependence and withdrawal on stopping or reducing the dose. Deprescribing is recommended to improve patient outcomes and reduce medication‐related harm, but its implementation in ...
Erin Oldenhof, Megan Pisegna, Mark Horowitz, Hester Wilson, Karen Gelb, Stephen Trumble, Catherine Andronis, Marguerite Tracy, Nicholas A. Zwar, Andrew Mau, Anna Chapman, Petra K. Staiger   +11 more
wiley   +1 more source

Duration of virtual maternity program engagement and neonatal outcomes: A multistate retrospective cohort study

Pregnancy, Volume 2, Issue 2, March 2026.
Abstract Introduction Virtual maternity solutions vary widely in clinical depth, and their association with physiological outcomes in high‐risk populations remains understudied. We evaluated the association between the duration of engagement in a multispecialty virtual maternity program and neonatal outcomes among a medically complex population ...
Lena Bertozzi, Madeline F. Perry, Thomas Galeon, Adam Kubsh, Isabelle Von Kohorn, Ian J. Hooley   +5 more
wiley   +1 more source

Serving Rural Communities, Coping with Medicaid Cuts, and Having a Successful Practice: Case Studies from Oregon and Northern New England

Journal of the California Dental Association
Background Medicaid dental programs face potential challenges with anticipated federal funding cuts. Traditional fee-for-service models have struggled to serve all Medicaid populations effectively.Case Description This case study examines two successful ...
Jonny Norris, Mike Shirtcliff, Peter Milgrom   +2 more
doaj   +1 more source

Medicaid Work Requirements: Engaging Clinics and Pharmacies to Prevent Disenrollment

The Milbank Quarterly, Volume 104, Issue 1, Page 48-57, March 2026.
Policy Points The One Big Beautiful Bill Act introduces the first nationwide Medicaid work requirement, replacing state‐level variation with a uniform federal standard. Past state experiences show that poor reporting design drives most procedural disenrollments—highlighting the need for accessible, integrated verification systems.
T. JOSEPH MATTINGLY II, MADELINE O'NEAL
wiley   +1 more source

General practitioner remuneration : overview of selected countries with a mixed system of fee-for-service and lump-sum payments

, 2023
56 p.Ill.,LIST OF FIGURES 4 -- LIST OF TABLES 4 -- LIST OF ABBREVIATIONS 5 -- SCIENTIFIC REPORT 7 -- 1 BACKGROUND 7 -- 2 METHOD 8 -- 2.1 SELECTION OF COUNTRIES 8 -- 2.2 INFORMATION COLLECTION PROCESS 8 -- 2.3 STRUCTURE OF THE COUNTRY DESCRIPTION 8 -- 3 ...
Lefevre, Mélanie
core   +1 more source

Ongoing Challenges to Integrating Care in Settings That Serve Patients With Serious Mental Illness and Substance Use Disorder

Psychiatric Research and Clinical Practice, Volume 8, Issue 1, Page 30-37, Spring 2026.
Background People with serious mental illness (SMI) and substance use disorders (SUD) experience difficulties accessing high‐quality medical care, despite their elevated risk for chronic health conditions. One proposed solution is the integration of medical and behavioral health services.
Jennifer D. Hall, Maria N. Danna, Deborah J. Cohen, K. John McConnell   +3 more
wiley   +1 more source

A Comparison of capitation and fee for service provider payment mechanisms and their effects on cost of healthcare: a case study of the Avenue Hospital, Nairobi [PDF]

, 2019
A thesis submitted in partial fulfillment of the requirements for the Degree of Master of Business Administration in Healthcare Management at Strathmore Business SchoolIncreasing health costs globally have resulted in more patients seeking pre-payment ...
Ochieng, Teddy Brian
core  

Social Capital and Audit Fees

بررسی‌های حسابداری و حسابرسی, 2018
Objective: The purpose of this research is to identify the effect of social capital on audit fees. As an emerging form of economic capital, social capital leads to mutual trust and beneficial partnerships in business environment and thereby driving economic behaviors toward collective well-being. In a capital market, audit fees are affected by client's
Mehrabanpour, Mohammadreza, Jandaghi Ghomi, Mohammad, Rajabbeyki, Mohammad Ali   +2 more
openaire   +2 more sources