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  1. AU="Oakes, Allison H"
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  1. Article ; Online: Reducing Low-Value Care and Improving Health Care Value.

    Oakes, Allison H / Radomski, Thomas R

    JAMA

    2021  Volume 325, Issue 17, Page(s) 1715–1716

    MeSH term(s) Delivery of Health Care/standards ; Fee-for-Service Plans ; Health Services/standards ; Humans ; Quality of Health Care ; United States
    Language English
    Publishing date 2021-04-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2021.3308
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Ua VI Zs.88: Show issues Location:
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  2. Article ; Online: National Trends in Billing Secure Messages as E-Visits.

    Holmgren, A Jay / Oakes, Allison H / Miller, Austin / Adler-Milstein, Julia / Mehrotra, Ateev

    JAMA

    2024  Volume 331, Issue 6, Page(s) 526–529

    Language English
    Publishing date 2024-01-10
    Publishing country United States
    Document type Letter
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2023.26584
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Time to address disparities in care by appointment time.

    Oakes, Allison H / Patel, Mitesh S

    Healthcare (Amsterdam, Netherlands)

    2020  Volume 9, Issue 1, Page(s) 100507

    Abstract: Quality of care systematically decreases over the course of the day. Ensuring that patients seen later in the day receive the same care as patients seen first thing in the morning has broad clinical and economic implications for our health care system. ... ...

    Abstract Quality of care systematically decreases over the course of the day. Ensuring that patients seen later in the day receive the same care as patients seen first thing in the morning has broad clinical and economic implications for our health care system. In this article, we outline feasible near-term solutions to direct clinicians and patients toward consistently better primary care decisions, throughout the day. These insights could be adapted to address similar challenges in other health care settings.
    MeSH term(s) Delivery of Health Care ; Humans ; Primary Health Care
    Language English
    Publishing date 2020-12-15
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2724773-9
    ISSN 2213-0772 ; 2213-0764 ; 2213-0772
    ISSN (online) 2213-0772 ; 2213-0764
    ISSN 2213-0772
    DOI 10.1016/j.hjdsi.2020.100507
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  4. Article ; Online: Rates of Routine Cancer Screening and Diagnosis Before vs After the COVID-19 Pandemic.

    Oakes, Allison H / Boyce, Kelly / Patton, Catherine / Jain, Sanjula

    JAMA oncology

    2022  Volume 9, Issue 1, Page(s) 145–146

    MeSH term(s) Humans ; Female ; COVID-19 ; Early Detection of Cancer ; Pandemics ; Colorectal Neoplasms/diagnosis ; Uterine Cervical Neoplasms/diagnosis ; COVID-19 Testing
    Language English
    Publishing date 2022-11-29
    Publishing country United States
    Document type Journal Article
    ISSN 2374-2445
    ISSN (online) 2374-2445
    DOI 10.1001/jamaoncol.2022.5481
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  5. Article ; Online: Observational Analysis of a Generalized, Health Plan-led Community Health Worker Intervention in Medicaid.

    Gordon, Aliza S / Oakes, Allison H / Allender, Rebeca / Vang, Lucida / Hennemann, Beau / Chi, Winnie C

    Journal of primary care & community health

    2023  Volume 14, Page(s) 21501319231153602

    Abstract: Introduction/objectives: In 2018, a Medicaid managed care plan launched a new community health worker (CHW) initiative in several counties within a state, designed to improve the health and quality of life of members who could benefit from additional ... ...

    Abstract Introduction/objectives: In 2018, a Medicaid managed care plan launched a new community health worker (CHW) initiative in several counties within a state, designed to improve the health and quality of life of members who could benefit from additional services. The CHW program involved telephonic and face-to-face visits from CHWs who provided support, empowerment, and education to members, while identifying and addressing health and social issues. The primary objective of this study was to evaluate the impact of a generalized (not disease-specific), health plan-led CHW program on overall healthcare use and spending.
    Methods: This retrospective cohort study used data from adult members who received the CHW intervention (N = 538 participants) compared to those who were identified for participation but were unable to be reached (N = 435 nonparticipants). Outcomes measures included healthcare utilization, including scheduled and emergency inpatient admissions, emergency department (ED) visits, and outpatient visits; and healthcare spending. The follow-up period for all outcome measures was 6 months. Using generalized linear models, 6-month change scores were regressed on baseline characteristics to adjust for between-group differences (eg, age, sex, comorbidities) and an indicator for group.
    Results: Program participants experienced a greater increase in outpatient evaluation and management visits (0.09 per member per month [PMPM]) than the comparison group during the first 6 months of the program. This greater increase was observed across in-person (0.07 PMPM), telehealth (0.03 PMPM), and primary care (0.06 PMPM) visits. There was no observed difference in inpatient admissions, ED utilization or allowed medical spending and pharmacy spending.
    Conclusions: A health plan-led CHW program successfully increased multiple forms of outpatient utilization in a historically disadvantaged population of patients. Health plans may be particularly well positioned to finance, sustain, and scale programs that address social drivers of health.
    MeSH term(s) Adult ; United States ; Humans ; Medicaid ; Retrospective Studies ; Community Health Workers ; Quality of Life ; Managed Care Programs
    Language English
    Publishing date 2023-02-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2550221-9
    ISSN 2150-1327 ; 2150-1319
    ISSN (online) 2150-1327
    ISSN 2150-1319
    DOI 10.1177/21501319231153602
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  6. Article ; Online: A nudge towards increased experimentation to more rapidly improve healthcare.

    Oakes, Allison H / Patel, Mitesh S

    BMJ quality & safety

    2019  Volume 29, Issue 3, Page(s) 179–181

    MeSH term(s) Delivery of Health Care/standards ; Humans ; Quality Improvement ; Randomized Controlled Trials as Topic ; Research Design
    Language English
    Publishing date 2019-11-19
    Publishing country England
    Document type Editorial
    ZDB-ID 2592909-4
    ISSN 2044-5423 ; 2044-5415
    ISSN (online) 2044-5423
    ISSN 2044-5415
    DOI 10.1136/bmjqs-2019-009948
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3754: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  7. Article ; Online: Understanding Geographic Variation in Systemic Overuse Among the Privately Insured.

    Oakes, Allison H / Sen, Aditi P / Segal, Jodi B

    Medical care

    2020  Volume 58, Issue 3, Page(s) 257–264

    Abstract: Background: Medical care overuse is a significant source of patient harm and wasteful spending. Understanding the drivers of overuse is essential to the design of effective interventions.: Objective: We tested the association between structural ... ...

    Abstract Background: Medical care overuse is a significant source of patient harm and wasteful spending. Understanding the drivers of overuse is essential to the design of effective interventions.
    Objective: We tested the association between structural factors of the health care delivery system and regional differences systemic overuse.
    Research design: We conducted a retrospective analysis of deidentified claims for 18- to 64-year-old adults from the IBM MarketScan Commercial Claims and Encounters Database. We calculated a semiannual Johns Hopkins Overuse Index for each of the 375 Metropolitan Statistical Areas in the United States, from January 2011 to June 2015. We fit an ordinary least squares regression to model the Johns Hopkins Overuse Index as a function of regional characteristics of the health care system, adjusted for confounders and time.
    Results: The supply of regional health care resources was associated with systemic overuse in commercially insured beneficiaries. Regional characteristics associated with systemic overuse included number of physicians per 1000 residents (P=0.001) and higher Medicare malpractice geographic price cost index (P<0.001). Regions with a higher density of primary care physicians (P=0.008) and a higher proportion of hospital-based providers (P=0.016) had less systemic overuse. Differences in hospital and insurer market power were inversely associated with systemic overuse.
    Conclusions: Systemic overuse is associated with observable, structural characteristics of the regional health care system. These findings suggest that interventions that aim to improve care efficiency via reductions in overuse should focus on the structural drivers of this phenomenon, rather than on the eradication of individual overused procedures.
    MeSH term(s) Adult ; Delivery of Health Care/economics ; Delivery of Health Care/trends ; Female ; Geography ; Health Services Misuse/economics ; Health Services Misuse/trends ; Humans ; Insurance Benefits/economics ; Insurance Benefits/trends ; Male ; Medicare/economics ; Middle Aged ; Private Sector ; Retrospective Studies ; United States ; Young Adult
    Language English
    Publishing date 2020-02-26
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 411646-x
    ISSN 1537-1948 ; 0025-7079
    ISSN (online) 1537-1948
    ISSN 0025-7079
    DOI 10.1097/MLR.0000000000001271
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.B 518: Show issues Location:
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    Zs.MO 63: Show issues

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  8. Article ; Online: The impact of global budget payment reform on systemic overuse in Maryland.

    Oakes, Allison H / Sen, Aditi P / Segal, Jodi B

    Healthcare (Amsterdam, Netherlands)

    2020  Volume 8, Issue 4, Page(s) 100475

    Abstract: Background: Medical overuse is a leading contributor to the high cost of the US health care system and is a definitive misuse of resources. Elimination of overuse could improve health care efficiency. In 2014, the State of Maryland placed the majority ... ...

    Abstract Background: Medical overuse is a leading contributor to the high cost of the US health care system and is a definitive misuse of resources. Elimination of overuse could improve health care efficiency. In 2014, the State of Maryland placed the majority of its hospitals under an all-payer, annual, global budget for inpatient and outpatient hospital services. This program aims to control hospital use and spending.
    Objective: To assess whether the Maryland global budget program was associated with a reduction in the broad overuse of health care services.
    Methods: We conducted a retrospective analysis of deidentified claims for 18-64 year old adults from the IBM MarketScan® Commercial Claims and Encounters Database. We matched 2 Maryland Metropolitan Statistical Areas (MSAs) to 6 out-of-state comparison MSAs. In a difference-in-differences analysis, we compared changes in systemic overuse in Maryland vs the comparison MSAs before (2011-2013) and after implementation (2014-2015) of the global budget program. Systemic overuse was measured using a semiannual Johns Hopkins Overuse Index.
    Results: Global budgets were not associated with a reduction in systemic overuse. Over the first 1.5 years of the program, we estimated a nonsignificant differential change of -0.002 points (95%CI, -0.372 to 0.369; p = 0.993) relative to the comparison group. This result was robust to multiple model assumptions and sensitivity analyses.
    Conclusions: We did not find evidence that Maryland hospitals met their revenue targets by reducing systemic overuse. Global budgets alone may be too blunt of an instrument to selectively reduce low-value care.
    MeSH term(s) Adolescent ; Adult ; Budgets/methods ; Budgets/standards ; Budgets/statistics & numerical data ; Delivery of Health Care/trends ; Female ; Health Care Reform/methods ; Health Care Reform/standards ; Health Care Reform/statistics & numerical data ; Humans ; Male ; Maryland ; Medical Overuse/statistics & numerical data ; Medical Overuse/trends ; Middle Aged ; Reimbursement Mechanisms/standards ; Reimbursement Mechanisms/trends ; Retrospective Studies
    Language English
    Publishing date 2020-10-04
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2724773-9
    ISSN 2213-0772 ; 2213-0764 ; 2213-0772
    ISSN (online) 2213-0772 ; 2213-0764
    ISSN 2213-0772
    DOI 10.1016/j.hjdsi.2020.100475
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  9. Article ; Online: Systemic overuse of health care in a commercially insured US population, 2010-2015.

    Oakes, Allison H / Chang, Hsien-Yen / Segal, Jodi B

    BMC health services research

    2019  Volume 19, Issue 1, Page(s) 280

    Abstract: Background: Overuse is a leading contributor to the high cost of health care in the United States. Overuse harms patients and is a definitive waste of resources. The Johns Hopkins Overuse Index (JHOI) is a normalized measure of systemic health care ... ...

    Abstract Background: Overuse is a leading contributor to the high cost of health care in the United States. Overuse harms patients and is a definitive waste of resources. The Johns Hopkins Overuse Index (JHOI) is a normalized measure of systemic health care services overuse, generated from claims data, that has been used to describe overuse in Medicare beneficiaries and to understand drivers of overuse. We aimed to adapt the JHOI for application to a commercially insured US population, to examine geographic variation in systemic overuse in this population, and to analyze trends over time to inform whether systemic overuse is an enduring problem.
    Methods: We analyzed commercial insurance claims from 18 to 64 year old beneficiaries. We calculated a semiannual JHOI for each of the 375 Metropolitan Statistical Areas and 47 rural regions of the US. We generated maps to examine geographic variation and then analyzed each region's change in their JHOI quintile from January 2011 to June 2015.
    Results: The JHOI varied markedly across the US. Across the country, rural regions tended to have less systemic overuse than their MSA counterparts (p < 0.01). Regional systemic overuse is positively correlated from one time period to the next (p < 0.001). Between 2011 and 2015, 53.7% (N = 226) of regions remained in the same quintile of the JHOI. Eighty of these regions had a persistently high or persistently low JHOI throughout study duration.
    Conclusions: The systemic overuse of health care resources is an enduring, regional problem. Areas identified as having a persistently high rate of systemic overuse merit further investigation to understand drivers and potential points of intervention.
    MeSH term(s) Adolescent ; Adult ; Female ; Humans ; Insurance Claim Reporting/statistics & numerical data ; Insurance, Health ; Male ; Medical Overuse/statistics & numerical data ; Middle Aged ; United States ; Young Adult
    Language English
    Publishing date 2019-05-02
    Publishing country England
    Document type Journal Article
    ZDB-ID 2050434-2
    ISSN 1472-6963 ; 1472-6963
    ISSN (online) 1472-6963
    ISSN 1472-6963
    DOI 10.1186/s12913-019-4079-0
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  10. Article ; Online: Variation in Cardiologist Statin Prescribing by Clinic Appointment Time.

    Oakes, Allison H / Adusumalli, Srinath / Snider, Christopher K / Rareshide, Charles A L / Patel, Mitesh S

    Journal of the American College of Cardiology

    2021  Volume 77, Issue 5, Page(s) 661–662

    MeSH term(s) Cardiologists/standards ; Drug Prescriptions/statistics & numerical data ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Practice Patterns, Physicians'
    Chemical Substances Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Language English
    Publishing date 2021-02-03
    Publishing country United States
    Document type Letter ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 605507-2
    ISSN 1558-3597 ; 0735-1097
    ISSN (online) 1558-3597
    ISSN 0735-1097
    DOI 10.1016/j.jacc.2020.11.057
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