To help patients with cancer everywhere track their signs and symptoms at home, Alishahi Tabriz and his team are piloting a HIPAA-compliant remote symptom management app they hope to make commercially available. It’s the health system’s responsibility to differentiate your symptoms.” If you feel something isn’t right, seek care. “You shouldn’t be the judge of your signs and symptoms. “There shouldn’t be any burden on the patient’s shoulders to reduce potentially preventable ED visits,” says Amir Alishahi Tabriz, the study’s lead researcher and a physician and health services researcher at Moffitt Cancer Center in Tampa, Florida. It does not question patient decisions about getting care. The study highlights the need for cancer care programs to devise ways to better manage cancer treatment complications, such as pain, in outpatient settings. The definition doesn’t account for patients’ access to other care, such as urgent care or primary care. The researchers used the Centers for Medicare & Medicaid Services’ definition of potentially preventable ED visits, which is based on billing code data for conditions, such as anemia, fever and dehydration. The study evaluated national ED admission billing code data from the annual Centers for Disease Control and Prevention National Hospital Ambulatory Medical Care Survey. Of those visits, 51.6% were for reasons such as anemia, nausea, fever, dehydration, neutropenia, diarrhea, pain, pneumonia, sepsis and emesis, which are considered potentially preventable through regular care. The study, which evaluated 35.5 million ED visits among patients with cancer, found that the number of visits per year rose from 1.8 million in 2012 to 3.2 million in 2019. 1,2 Plans can ensure that members receive appropriate, coordinated primary care to address preventable ED visits.EMERGENCY DEPARTMENT (ED) visits for cancer patients are on the rise, and more than half of those visits are potentially avoidable, according to a study published in the January 2023 issue of JAMA Network Open. A high rate of ED utilization may indicate poor care management, inadequate access to care or poor patient choices, resulting in ED visits that could be prevented. Some ED events may be attributed to preventable or treatable conditions. Why It MattersĮD visits are a high-intensity service and a cost burden on the health care system, as well as on patients. The observed-to-expected ratio is multiplied by the emergency department visit rate across all health plans to produce a risk-standardized rate which allows for national comparison. The observed and expected rates are used to calculate a calibrated observed-to-expected ratio that assesses whether plans had more, the same or less emergency department visits than expected, while accounting for incremental improvements across all plans over time. Plans report observed rates of ED use and a predicted rate of ED use based on the health of the member population. Advertising and Marketing Your NCQA StatusĪssesses emergency department (ED) utilization among commercial (18 and older) and Medicare (18 and older) health plan members. ![]()
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