In 2014, Maryland initiated the global budget revenue (GBR) model, placing caps on total hospital expenditures across all care sites. The GBR program aims to reduce unnecessary utilization while maint...
To compare changes in spending, clinical outcomes, and acute care utilization through 4 years of the GBR program among Medicare beneficiaries who undergo cancer-directed surgery in Maryland vs matched...
Drawing from a matched pool of hospitals in Maryland (n = 35) and 24 control states with a similar timing of Medicaid expansion (n = 101), we identified Medicare beneficiaries from Maryland and contro...
Thirty-day episode spending, mortality, readmissions, and emergency department (ED) visits....
Relative to Medicare beneficiaries undergoing cancer surgery in control states (n = 4737; 3323 [70.1%] female; 571 [12.1%] dual-eligible; mean [SD] age 74.9 [6.5] years), patients in Maryland (n = 20 ...
Global budget revenue was not associated with changes in expenditures, ED utilization, or clinical outcomes after cancer-directed surgery through 4 years. There was a modest decline in 30-day readmiss...
U.S. hospitals provide large amounts of low-value care and devote inordinate resources to administration, while some hospitals leverage market power to realize large profits. Meanwhile, many rural and...
As a result of the success of Maryland's full risk capitated payment model experiment (Global Budget Revenue) in constraining healthcare costs, there is momentum for expanding the reach of such models...
Cross-sectional study using a difference-in-difference analysis to examine changes in patient experiences according to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) dom...
A total of 844 hospitals were included. Compared to hospitals in non-GBR states, hospitals in GBR states experienced significant declines in the following HCAHPS domains: "would definitely recommend t...
These findings suggest there should be efforts made to ascertain and mitigate potential adverse effects of care transformation initiatives on patient experience. Patients are stakeholders and their in...
This study aimed to study the influence of the interactive budget on enterprise innovation performance from the perspective of managerial psychology, and to examine the mediating effect of managers' s...
There is a severe shortage of donor organs globally. There is growing interest in understanding how a 'soft opt-out' organ donation system could help bridge the supply and demand gap for donor organs....
A decision-analytic model was developed to estimate the incremental costs from a health system's perspective, quality-adjusted life-years (QALYs), and death averted of people who have kidney failure, ...
A 20% increase in organ donation rates could have a cost saving of 650 million Australian dollars (A$) and a 10,400-QALY gain. A 20% increase would avert more than 1500 deaths, while a 40% increase wo...
A 'soft opt-out' organ donation system would return a cost saving for the healthcare system, a net gain in QALYs, and prevention of a significant number of deaths. Advantageous budgetary impact is imp...
Gene therapy is known to be unaffordable to those who need it the most; however, evidence on the financial impact is limited....
This study aimed to estimate the budget impact and affordability of the gene therapy idecabtagene vicleucel for the treatment of adult patients with relapsed or refractory multiple myeloma (rrMM) in t...
A budget impact model was developed to estimate the budget impact to the US healthcare plan compared with bortezomib-based maintenance therapy. The target population size was based on a hypothetical 1...
An estimated 22 patients with rrMM each year would be eligible for idecabtagene vicleucel. The model projected the annual cost per patient in the first year as $19,449 and $517,528.13 for bortezomib a...
This study suggests that the high cost of the gene therapy idecabtagene vicleucel is justifiable due to the low number of rrMM patients....
The twin deficit hypothesis suggests that budget deficits are crucial factors leading to current account deficits, and substantial empirical evidence documents a significant positive statistical corre...
Priority setting in health directly impacts the general public as payers and final consumers, so the public preferences must be considered. The present study aimed to provide public preferences about ...
A choice-based survey method was used to assess the general public's preferences regarding 8 critical criteria with a societal aspect. One thousand sixty-four adult citizens of Tehran, Iran, participa...
Based on expressed participants' preferences, criteria of disease severity, age, daily care needs, Number of alternative interventions, individual's economic status, and diseases with absence from wor...
Iranian general public pays special attention to the criteria of equitable allocation, including patients' economic status, criteria with societal aspects such as absenteeism from work and the need fo...
To determine the budget impact of virtual care....
We conducted a budget impact analysis of virtual care from the perspective of a large teaching hospital in the Netherlands. Virtual care included remote monitoring of vital signs and three daily remot...
Net budget impact over 5 years was €2 090 000 for implementation in one ward, €410 000 for two wards and €-6 206 000 for the entire hospital. Costs/patient/day in the first year were €303 for implemen...
With present cost levels, virtual care only saves money if it is deployed at sufficient scale or if it can be designed such that the active involvement of health professionals is minimised. Taking a g...
Non-pharmacological interventions (NPIs) could be considered in the early management of prehypertensive population. This study aimed to evaluate the potential cost-effectiveness of NPIs and the budget...
Five NPIs including usual care, lifestyle, strengthen exercise, relaxation, and diet therapy were selected based on the practice of hypertension management in China. A nine-state Markov model was cons...
Strengthen exercise was the most cost-effective intervention with a probability of 78.1% under the given WTP threshold. Our results were sensitive to the cost of interventions, and the utility of preh...
Strengthen exercise was a potential NPI that can be considered in priority for early management in prehypertensive population. Although early management can acquire medical cost saving, the related pr...
