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Public Awareness and Use of Price Transparency: Report From a National Survey

Public Awareness and Use of Price Transparency: Report From a National Survey

HPT requires hospitals to post prices or negotiated rates of common, “shoppable,” services, as defined by the Centers for Medicare and Medicaid (CMS), in a machine-readable format. Examples of these shoppable services include common blood tests and radiology services such as X-rays and mammograms. In July 2022, the CMS also mandated that payers post the prices for a more expansive set of services, under the Transparency in Coverage (TIC) regulation [6].

Yuvraj Pathak, David Muhlestein

Interact J Med Res 2024;13:e64439

Unintended Consequences of Data Sharing Under the Meaningful Use Program

Unintended Consequences of Data Sharing Under the Meaningful Use Program

The Meaningful Use program requires providers to share data with the Centers for Medicare and Medicaid Services (CMS) to ensure satisfactory health care quality. Using the Quality Reporting Document Architecture [4], providers are required to submit data in support of the quality measures applicable to their practice. If covered providers do not submit data, their rate of reimbursement is reduced.

Irmgard Ursula Willcockson, Ignacio Herman Valdes

JMIR Med Inform 2024;12:e52675

Transitional Care Support for Medicaid-Insured Patients With Serious Mental Illness: Protocol for a Type I Hybrid Effectiveness-Implementation Stepped-Wedge Cluster Randomized Controlled Trial

Transitional Care Support for Medicaid-Insured Patients With Serious Mental Illness: Protocol for a Type I Hybrid Effectiveness-Implementation Stepped-Wedge Cluster Randomized Controlled Trial

Medicaid, as the largest payer of mental health services, covers 26% of nonelderly adults with SMI [2]. However, up to half of Medicaid-insured individuals with comorbid SMI experience unmet treatment needs [3]. Our population of interest is Medicaid-insured individuals who are hospitalized for a medical condition but live with comorbid SMI.

J Margo Brooks Carthon, Heather Brom, Kelvin Eyram Amenyedor, Michael O Harhay, Marsha Grantham-Murillo, Jacqueline Nikpour, Karen B Lasater, Daniela Golinelli, Pamela Z Cacchione, Amanda P Bettencourt

JMIR Res Protoc 2024;13:e64575

Prevalence, Mortality, and Access to Care for Chronic Kidney Disease in Medicaid-Enrolled Adults With Sickle Cell Disease in California: Retrospective Cohort Study

Prevalence, Mortality, and Access to Care for Chronic Kidney Disease in Medicaid-Enrolled Adults With Sickle Cell Disease in California: Retrospective Cohort Study

This is a retrospective cohort study of Medicaid-enrolled people with SCD in California. All study data were obtained from the California SCDC program. The SCDC program leverages a variety of data sources to identify and longitudinally monitor individuals with SCD within the state.

Jhaqueline Valle, Jeffrey D Lebensburger, Pranav S Garimella, Srila Gopal

JMIR Public Health Surveill 2024;10:e57290

Insider Threats to the Military Health System: A Systematic Background Check of TRICARE West Providers

Insider Threats to the Military Health System: A Systematic Background Check of TRICARE West Providers

The Centers for Medicare and Medicaid (CMS) require federally funded health care organizations to screen out providers against two sources at regular intervals: the Office of Inspector General’s (OIG) List of Excluded Individuals and Entities (LEIE) and the General Services Administration’s (GSA) SAM.gov exclusion list [6].

David Bychkov

JMIRx Med 2024;5:e52198

Evaluation of Telehealth Services that are Clinically Appropriate for Reimbursement in the US Medicaid Population: Mixed Methods Study

Evaluation of Telehealth Services that are Clinically Appropriate for Reimbursement in the US Medicaid Population: Mixed Methods Study

The US Medicaid program was a major beneficiary of the surge in telehealth popularity, being one of the largest insurers with over 85 million people covered in the United States. Medicaid beneficiaries primarily include people whose income is below the federal poverty level, children, pregnant women, older individuals, and individuals with disabilities [3].

Sanjeev Saravanakumar, Andrey Ostrovsky

J Med Internet Res 2024;26:e46412

Equity-Centered Postdischarge Support for Medicaid-Insured People: Protocol for a Type 1 Hybrid Effectiveness-Implementation Stepped Wedge Cluster Randomized Controlled Trial

Equity-Centered Postdischarge Support for Medicaid-Insured People: Protocol for a Type 1 Hybrid Effectiveness-Implementation Stepped Wedge Cluster Randomized Controlled Trial

This postdischarge support can be especially beneficial for nearly 80 million individuals in the United States who are insured by Medicaid [1] and experience higher rates of chronic illness [2], more frequent hospitalizations, and worse clinical outcomes following discharge [3-5]. Readmissions among adults insured by Medicaid ages 45-64 years stand at 24% compared to 20% for older adults insured by Medicare [6].

J Margo Brooks Carthon, Heather Brom, Marsha Grantham-Murrillo, Kathy Sliwinski, Aleigha Mason, Mindi Roeser, Donna Miles, Dianne Garcia, Jovan Bennett, Michael O Harhay, Emilia Flores, Kelvin Amenyedor, Rebecca Clark

JMIR Res Protoc 2024;13:e54211