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J. Franklin Wharam

Professor of Medicine
Medicine, General Internal Medicine
710 West Main Street, Durham, NC 27710
Dept of Med, Durham, NC 27710

Selected Publications


Comparison of health care costs following sleeve gastrectomy versus Roux-en-Y gastric bypass among patients with type 2 diabetes.

Journal Article Obesity (Silver Spring) · April 2024 OBJECTIVE: The objective of this study was to compare the impact of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) on overall and diabetes-specific health care costs among patients with type 2 diabetes. METHODS: This retrospective cohort study ... Full text Link to item Cite

Out-of-Pocket Costs and Outpatient Visits Among Patients With Cancer in High-Deductible Health Plans.

Journal Article JAMA Oncol · March 1, 2024 IMPORTANCE: High-deductible health plans (HDHPs) have grown rapidly and may adversely affect access to comprehensive cancer care. OBJECTIVE: To evaluate the association of HDHPs with out-of-pocket medical costs and outpatient physician visits among patient ... Full text Link to item Cite

Acute Diabetes Complications After Transition to a Value-Based Medication Benefit.

Journal Article JAMA Health Forum · February 2, 2024 IMPORTANCE: The association of value-based medication benefits with diabetes health outcomes is uncertain. OBJECTIVE: To assess the association of a preventive drug list (PDL) value-based medication benefit with acute, preventable diabetes complications. D ... Full text Link to item Cite

Utilization and Spending With Preventive Drug Lists for Asthma Medications in High-Deductible Health Plans.

Journal Article JAMA Netw Open · August 1, 2023 IMPORTANCE: High-deductible health plans with health savings accounts (HDHP-HSAs) incentivize patients to use less health care, including necessary care. Preventive drug lists (PDLs) exempt high-value medications from the deductible, reducing out-of-pocket ... Full text Link to item Cite

Acute Care Utilization and Costs Up to 4 Years After Index Sleeve Gastrectomy or Roux-en-Y Gastric Bypass: A National Claims-based Study.

Journal Article Ann Surg · January 1, 2023 OBJECTIVE: To compare acute care utilization and costs following sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). SUMMARY BACKGROUND DATA: Comparing postbariatric emergency department (ED) and inpatient care use patterns could assist with proce ... Full text Link to item Cite

Health Care Utilization Trends Across the Transition Period in a National Cohort of Adolescents and Young Adults With Type 1 Diabetes.

Journal Article Diabetes Care · November 1, 2022 OBJECTIVE: Lack of effective transition from pediatric to adult care may contribute to adverse outcomes in young adults with type 1 diabetes. The understanding of outpatient and acute care utilization patterns across the adolescent to young adult transitio ... Full text Link to item Cite

Association of Interprofessional Discharge Planning Using an Electronic Health Record Tool With Hospital Length of Stay Among Patients with Multimorbidity: A Nonrandomized Controlled Trial.

Journal Article JAMA Netw Open · September 1, 2022 IMPORTANCE: Whether interprofessional collaboration is effective and safe in decreasing hospital length of stay remains controversial. OBJECTIVE: To evaluate the outcomes and safety associated with an electronic interprofessional-led discharge planning too ... Full text Link to item Cite

Diabetes Microvascular Disease Diagnosis and Treatment After High-Deductible Health Plan Enrollment.

Journal Article Diabetes Care · August 1, 2022 OBJECTIVE: The Affordable Care Act mandates that primary preventive services have no out-of-pocket costs but does not exempt secondary prevention from out-of-pocket costs. Most commercially insured patients with diabetes have high-deductible health plans ( ... Full text Link to item Cite

Evaluating Natural Experiments that Impact the Diabetes Epidemic: an Introduction to the NEXT-D3 Network.

Journal Article Curr Diab Rep · August 2022 PURPOSE OF REVIEW: Diabetes is an ongoing public health issue in the USA, and, despite progress, recent reports suggest acute and chronic diabetes complications are increasing. RECENT FINDINGS: The Natural Experiments for Translation in Diabetes 3.0 (NEXT- ... Full text Link to item Cite

State Mandatory Paid Sick Leave Associated With A Decline In Emergency Department Use In The US, 2011-19.

Journal Article Health Aff (Millwood) · August 2022 Paid sick leave provides workers with job-protected paid time off to address short-term illnesses or seek preventive care for themselves and their family members. We studied the impact of mandatory paid sick leave at the state level on emergency department ... Full text Link to item Cite

Reply to "When too much is too much".

Journal Article J Allergy Clin Immunol Pract · June 2022 Full text Link to item Cite

Comparison of Ambulatory Health Care Costs and Use Associated With Roux-en-Y Gastric Bypass vs Sleeve Gastrectomy.

Journal Article JAMA Netw Open · May 2, 2022 IMPORTANCE: Studies comparing contemporary bariatric surgical types could facilitate procedure selection for patients interested in reducing their frequency of health care visits and reliance on prescription drugs. OBJECTIVE: To compare the association of ... Full text Link to item Cite

Use of Palliative Care Among Commercially Insured Patients With Metastatic Cancer Between 2001 and 2016.

Journal Article JCO Oncol Pract · May 2022 PURPOSE: Early palliative care, concomitant with disease-directed treatments, is recommended for all patients with advanced cancer. This study assesses population-level trends in palliative care use among a large cohort of commercially insured patients wit ... Full text Link to item Cite

Trends in Annual Surveillance Mammography Participation Among Breast Cancer Survivors From 2004 to 2016.

Journal Article J Natl Compr Canc Netw · April 2022 BACKGROUND: Annual mammography is recommended for breast cancer survivors; however, population-level temporal trends in surveillance mammography participation have not been described. Our objective was to characterize trends in annual surveillance mammogra ... Full text Link to item Cite

High-Deductible Health Plans Paired With Health Savings Accounts Increased Medication Cost Burden Among Individuals With Bipolar Disorder.

Journal Article J Clin Psychiatry · March 9, 2022 Objective: High-deductible health plans paired with health savings accounts (HSA-HDHPs) require substantial out-of-pocket spending for most services, including medications. We examined effects of HSA-HDHPs on medication out-of-pocket spending and use among ... Full text Link to item Cite

Comparison of health care costs following sleeve gastrectomy versus Roux-en-Y gastric bypass among patients with type 2 diabetes.

Journal Article Obesity (Silver Spring) · April 2024 OBJECTIVE: The objective of this study was to compare the impact of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) on overall and diabetes-specific health care costs among patients with type 2 diabetes. METHODS: This retrospective cohort study ... Full text Link to item Cite

Out-of-Pocket Costs and Outpatient Visits Among Patients With Cancer in High-Deductible Health Plans.

Journal Article JAMA Oncol · March 1, 2024 IMPORTANCE: High-deductible health plans (HDHPs) have grown rapidly and may adversely affect access to comprehensive cancer care. OBJECTIVE: To evaluate the association of HDHPs with out-of-pocket medical costs and outpatient physician visits among patient ... Full text Link to item Cite

Acute Diabetes Complications After Transition to a Value-Based Medication Benefit.

Journal Article JAMA Health Forum · February 2, 2024 IMPORTANCE: The association of value-based medication benefits with diabetes health outcomes is uncertain. OBJECTIVE: To assess the association of a preventive drug list (PDL) value-based medication benefit with acute, preventable diabetes complications. D ... Full text Link to item Cite

Utilization and Spending With Preventive Drug Lists for Asthma Medications in High-Deductible Health Plans.

Journal Article JAMA Netw Open · August 1, 2023 IMPORTANCE: High-deductible health plans with health savings accounts (HDHP-HSAs) incentivize patients to use less health care, including necessary care. Preventive drug lists (PDLs) exempt high-value medications from the deductible, reducing out-of-pocket ... Full text Link to item Cite

Acute Care Utilization and Costs Up to 4 Years After Index Sleeve Gastrectomy or Roux-en-Y Gastric Bypass: A National Claims-based Study.

Journal Article Ann Surg · January 1, 2023 OBJECTIVE: To compare acute care utilization and costs following sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). SUMMARY BACKGROUND DATA: Comparing postbariatric emergency department (ED) and inpatient care use patterns could assist with proce ... Full text Link to item Cite

Health Care Utilization Trends Across the Transition Period in a National Cohort of Adolescents and Young Adults With Type 1 Diabetes.

Journal Article Diabetes Care · November 1, 2022 OBJECTIVE: Lack of effective transition from pediatric to adult care may contribute to adverse outcomes in young adults with type 1 diabetes. The understanding of outpatient and acute care utilization patterns across the adolescent to young adult transitio ... Full text Link to item Cite

Association of Interprofessional Discharge Planning Using an Electronic Health Record Tool With Hospital Length of Stay Among Patients with Multimorbidity: A Nonrandomized Controlled Trial.

Journal Article JAMA Netw Open · September 1, 2022 IMPORTANCE: Whether interprofessional collaboration is effective and safe in decreasing hospital length of stay remains controversial. OBJECTIVE: To evaluate the outcomes and safety associated with an electronic interprofessional-led discharge planning too ... Full text Link to item Cite

Diabetes Microvascular Disease Diagnosis and Treatment After High-Deductible Health Plan Enrollment.

Journal Article Diabetes Care · August 1, 2022 OBJECTIVE: The Affordable Care Act mandates that primary preventive services have no out-of-pocket costs but does not exempt secondary prevention from out-of-pocket costs. Most commercially insured patients with diabetes have high-deductible health plans ( ... Full text Link to item Cite

Evaluating Natural Experiments that Impact the Diabetes Epidemic: an Introduction to the NEXT-D3 Network.

Journal Article Curr Diab Rep · August 2022 PURPOSE OF REVIEW: Diabetes is an ongoing public health issue in the USA, and, despite progress, recent reports suggest acute and chronic diabetes complications are increasing. RECENT FINDINGS: The Natural Experiments for Translation in Diabetes 3.0 (NEXT- ... Full text Link to item Cite

State Mandatory Paid Sick Leave Associated With A Decline In Emergency Department Use In The US, 2011-19.

Journal Article Health Aff (Millwood) · August 2022 Paid sick leave provides workers with job-protected paid time off to address short-term illnesses or seek preventive care for themselves and their family members. We studied the impact of mandatory paid sick leave at the state level on emergency department ... Full text Link to item Cite

Reply to "When too much is too much".

Journal Article J Allergy Clin Immunol Pract · June 2022 Full text Link to item Cite

Comparison of Ambulatory Health Care Costs and Use Associated With Roux-en-Y Gastric Bypass vs Sleeve Gastrectomy.

Journal Article JAMA Netw Open · May 2, 2022 IMPORTANCE: Studies comparing contemporary bariatric surgical types could facilitate procedure selection for patients interested in reducing their frequency of health care visits and reliance on prescription drugs. OBJECTIVE: To compare the association of ... Full text Link to item Cite

Use of Palliative Care Among Commercially Insured Patients With Metastatic Cancer Between 2001 and 2016.

Journal Article JCO Oncol Pract · May 2022 PURPOSE: Early palliative care, concomitant with disease-directed treatments, is recommended for all patients with advanced cancer. This study assesses population-level trends in palliative care use among a large cohort of commercially insured patients wit ... Full text Link to item Cite

Trends in Annual Surveillance Mammography Participation Among Breast Cancer Survivors From 2004 to 2016.

Journal Article J Natl Compr Canc Netw · April 2022 BACKGROUND: Annual mammography is recommended for breast cancer survivors; however, population-level temporal trends in surveillance mammography participation have not been described. Our objective was to characterize trends in annual surveillance mammogra ... Full text Link to item Cite

High-Deductible Health Plans Paired With Health Savings Accounts Increased Medication Cost Burden Among Individuals With Bipolar Disorder.

Journal Article J Clin Psychiatry · March 9, 2022 Objective: High-deductible health plans paired with health savings accounts (HSA-HDHPs) require substantial out-of-pocket spending for most services, including medications. We examined effects of HSA-HDHPs on medication out-of-pocket spending and use among ... Full text Link to item Cite

“Choose the Plan That’s Right for You”: Choice Devolution as Class-Biased Institutional Change in U.S. Employer-Sponsored Health Insurance

Journal Article Sociological Science · January 1, 2022 This study examines the distributional consequences of U.S. employers’ efforts to devolve responsibility for managing their employees’ medical insurance risk. The logic of consumer choice has increasingly come to dominate insurance benefit design, requirin ... Full text Cite

Out-of-Pocket Spending for Asthma-Related Care Among Commercially Insured Patients, 2004-2016.

Journal Article J Allergy Clin Immunol Pract · December 2021 BACKGROUND: Out-of-pocket (OOP) health care costs can cause financial burden and deferred care for many Americans. Little is known about OOP spending for asthma-related care among the commercially insured. OBJECTIVES: To analyze OOP spending for asthma-rel ... Full text Link to item Cite

Trends in high deductible health plan enrolment and spending among commercially insured members with and without chronic conditions: a Natural Experiment for Translation in Diabetes (NEXT-D2) Study.

Journal Article BMJ Open · September 13, 2021 OBJECTIVES: To examine trends in high deductible health plan (HDHP) enrolment among members with diabetes and cardiovascular disease (CVD) compared with healthy members and compare out-of-pocket (OOP) and total spending for members with chronic conditions ... Full text Link to item Cite

Impact of High-Deductible Health Plans on Emergency Department Patients With Nonspecific Chest Pain and Their Subsequent Care.

Journal Article Circulation · August 3, 2021 BACKGROUND: Timely evaluation of acute chest pain is necessary, although most evaluations will not find significant coronary disease. With employers increasingly adopting high-deductible health plans (HDHP), how HDHPs impact subsequent care after an emerge ... Full text Link to item Cite

Impact of High-Deductible Health Plans on Medication Use Among Individuals With Bipolar Disorder.

Journal Article Psychiatr Serv · August 1, 2021 OBJECTIVE: High-deductible health plans (HDHPs) require substantial out-of-pocket spending for most services, although medications may be subject to traditional copayment arrangements. This study examined effects of HDHPs on medication out-of-pocket spendi ... Full text Link to item Cite

Controller Medication Use and Exacerbations for Children and Adults With Asthma in High-Deductible Health Plans.

Journal Article JAMA Pediatr · August 1, 2021 IMPORTANCE: High-deductible health plans (HDHPs) are increasingly common and associated with decreased medication use in some adult populations. How children are affected is less certain. OBJECTIVE: To examine the association between HDHP enrollment and as ... Full text Link to item Cite

High-deductible health plans and low-value imaging in the emergency department.

Journal Article Health Serv Res · August 2021 OBJECTIVE: To examine the effect of an employer-mandated switch to high-deductible health plans (HDHP) on emergency department (ED) low-value imaging. DATA SOURCES: Claims data of a large national insurer between 2003 and 2014. STUDY DESIGN: Difference-in- ... Full text Link to item Cite

Comparative Effectiveness of Vertical Sleeve Gastrectomy Versus Roux-en-Y Gastric Bypass for Diabetes Treatment: A Claims-based Cohort Study.

Journal Article Ann Surg · May 1, 2021 OBJECTIVE: The aim of the study was to compare diabetes outcomes following vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB). BACKGROUND: There are few comparative studies on diabetes outcomes after VSG and RYGB. METHODS: We used a US-w ... Full text Link to item Cite

Financial Pollution in the US Health Care System.

Journal Article JAMA Health Forum · March 1, 2021 Full text Link to item Cite

Experiences of health care costs among people with employer-sponsored insurance and bipolar disorder.

Journal Article J Affect Disord · February 15, 2021 BACKGROUND: Cost-sharing disproportionately affects people with chronic illnesses needing more care. Our qualitative study examined lived experiences navigating insurance benefits and treatment for bipolar disorder, which requires ongoing access to behavio ... Full text Link to item Cite

Intensity of End-of-Life Care in a Cohort of Commercially Insured Women With Metastatic Breast Cancer in the United States.

Journal Article JCO Oncol Pract · February 2021 PURPOSE: There is limited evidence on the intensity of end-of-life (EOL) care for women < 65 years old, who account for about 40% of breast cancer deaths in the United States. Using established indicators, we estimated the intensity of EOL care among these ... Full text Link to item Cite

Integrating Stakeholder Engagement With Claims-Based Research on Health Insurance Design and Bipolar Disorder.

Journal Article Psychiatr Serv · February 1, 2021 Researchers increasingly recognize that stakeholder involvement enhances research relevance and validity. However, reports of patient engagement in research that relies on administrative records data are rare. The authors' collaborative project combined qu ... Full text Link to item Cite

Concurrent hiatal hernia repair and bariatric surgery: outcomes after sleeve gastrectomy and Roux-en-Y gastric bypass.

Journal Article Surg Obes Relat Dis · January 2021 BACKGROUND: Hiatal hernias are often repaired concurrently with bariatric surgery to reduce risk of gastroesophageal reflux disease-related complications. OBJECTIVES: To examine the association between concurrent hiatal hernia repair (HHR) and bariatric ou ... Full text Link to item Cite

A Randomized Encouragement Trial to Increase Mail Order Pharmacy Use and Medication Adherence in Patients with Diabetes.

Journal Article J Gen Intern Med · January 2021 BACKGROUND: Mail order pharmacy (MOP) use has been linked to improved medication adherence and health outcomes among patients with diabetes. However, no large-scale intervention studies have assessed the effect of encouraging MOP use on medication adherenc ... Full text Link to item Cite

Trends in screening breast magnetic resonance imaging use among US women, 2006 to 2016.

Journal Article Cancer · December 15, 2020 BACKGROUND: Supplemental breast cancer screening with breast magnetic resonance imaging (MRI) is recommended for women at high risk of breast cancer. To the authors' knowledge, recent national trends in breast MRI use are unknown. METHODS: The authors used ... Full text Link to item Cite

Suitability of administrative claims databases for bariatric surgery research - is the glass half-full or half-empty?

Journal Article BMC Med Res Methodol · September 7, 2020 BACKGROUND: Claims databases are generally considered inadequate for obesity research due to suboptimal capture of body mass index (BMI) measurements. This might not be true for bariatric surgery because of reimbursement requirements and changes in coding ... Full text Link to item Cite

Perioperative Serum 25-Hydroxyvitamin D Levels as a Predictor of Postoperative Opioid Use and Opioid Use Disorder: a Cohort Study.

Journal Article J Gen Intern Med · September 2020 IMPORTANCE: Vitamin D deficiency is associated with chronic pain syndromes and higher opioid use among cancer patients, but its association with opioid use among opioid-naïve subjects following a major surgical procedure with acute pain has not been explor ... Full text Link to item Cite

Costs Are Higher For Marketplace Members Who Enroll During Special Enrollment Periods Compared With Open Enrollment.

Journal Article Health Aff (Millwood) · August 2020 More than 20 percent of Affordable Care Act (ACA) exchange market (Marketplace) members insured by a large national insurer in 2015 and 2016 enrolled during a special enrollment period (SEP), defined as any enrollment outside the annual open enrollment per ... Full text Link to item Cite

Association Between Switching to a High-Deductible Health Plan and Major Cardiovascular Outcomes.

Journal Article JAMA Netw Open · July 1, 2020 IMPORTANCE: Most people with commercial health insurance in the US have high-deductible plans, but the association of such plans with major health outcomes is unknown. OBJECTIVE: To describe the association between enrollment in high-deductible health plan ... Full text Link to item Cite

Trends in Insulin Out-of-Pocket Costs and Reimbursement Price Among US Patients With Private Health Insurance, 2006-2017.

Journal Article JAMA Intern Med · July 1, 2020 This cohort study reports a decade of increases and decreases in insulin prices and cost burden for insured patients with diabetes. ... Full text Link to item Cite

Effect of high-deductible insurance on health care use in bipolar disorder.

Journal Article Am J Manag Care · June 2020 OBJECTIVES: To determine the impact of high-deductible health plans (HDHPs) on health care use among individuals with bipolar disorder. STUDY DESIGN: Interrupted time series with propensity score-matched control group design, using a national health insure ... Full text Link to item Cite

Reduced Cost-sharing for Preventive Drugs Preferentially Benefits Low-income Patients With Diabetes in High Deductible Health Plans With Health Savings Accounts.

Journal Article Med Care · June 2020 BACKGROUND: High deductible health plans linked to Health Savings Accounts (HSA-HDHPs) must include all care under the deductible except for select preventive services. Some employers and insurers have adopted Preventive Drug Lists (PDLs) that exempt speci ... Full text Link to item Cite

Addressing Loneliness in the Era of COVID-19.

Journal Article JAMA Health Forum · June 1, 2020 Full text Link to item Cite

Trends in Diagnostic Imaging Utilization among Medicare and Commercially Insured Adults from 2003 through 2016.

Journal Article Radiology · February 2020 Background Trends in noninvasive diagnostic imaging (NDI) utilization rates have predominantly been reported in Medicare enrollees. To the authors' knowledge, there has been no prior direct comparison of utilization rates between Medicare and commercially ... Full text Link to item Cite

Risk of Operative and Nonoperative Interventions Up to 4 Years After Roux-en-Y Gastric Bypass vs Vertical Sleeve Gastrectomy in a Nationwide US Commercial Insurance Claims Database.

Journal Article JAMA Netw Open · December 2, 2019 IMPORTANCE: There are few nationwide studies comparing the risk of reintervention after contemporary bariatric procedures. OBJECTIVE: To compare the risk of intervention after Roux-en-Y gastric bypass (RYGB) vs vertical sleeve gastrectomy (VSG). DESIGN, SE ... Full text Link to item Cite

Uptake and use of a diabetes management program with a mobile glucometer.

Journal Article Prim Care Diabetes · December 2019 OBJECTIVE: Innovative mobile health technologies (mHealth) may facilitate self-management of blood glucose. This study evaluates uptake, use, and predictors of uptake and long-term use of a diabetes mHealth intervention, which comprises an FDA-approved mob ... Full text Link to item Cite

High-Deductible Insurance and Delay in Care.

Journal Article Ann Intern Med · August 6, 2019 Full text Link to item Cite

Opportunities to encourage mail order pharmacy delivery service use for diabetes prescriptions: a qualitative study.

Journal Article BMC Health Serv Res · June 25, 2019 BACKGROUND: Medication non-adherence is a major contributor to poor outcomes in diabetes. Previous research has shown an association between use of mail order pharmacy delivery and better medication adherence, but little is known about the barriers and fac ... Full text Link to item Cite

Provider Perspectives on Quality Payment Programs Targeting Diabetes in Primary Care Settings.

Journal Article Popul Health Manag · June 2019 Public and private insurers increasingly use quality payment programs as a tool to improve quality of care in primary care settings. However, little is known about primary care providers' perspectives on whether and how quality payment programs improve dia ... Full text Link to item Cite

Trends in advanced imaging and hospitalization for emergency department syncope care before and after ACEP clinical policy.

Journal Article Am J Emerg Med · June 2019 OBJECTIVES: To describe recent trends in advanced imaging and hospitalization of emergency department (ED) syncope patients, both considered "low-value", and examine trend changes before and after the publication of American College Emergency Physician (AC ... Full text Link to item Cite

Association of Federal Mental Health Parity Legislation With Health Care Use and Spending Among High Utilizers of Services.

Journal Article Med Care · April 2019 BACKGROUND: Decades-long efforts to require parity between behavioral and physical health insurance coverage culminated in the comprehensive federal Mental Health Parity and Addiction Equity Act. OBJECTIVES: To determine the association between federal par ... Full text Link to item Cite

Vulnerable And Less Vulnerable Women In High-Deductible Health Plans Experienced Delayed Breast Cancer Care.

Journal Article Health Aff (Millwood) · March 2019 The effects of high-deductible health plans (HDHPs) on breast cancer diagnosis and treatment among vulnerable populations are unknown. We examined time to first breast cancer diagnostic testing, diagnosis, and chemotherapy among a group of women whose empl ... Full text Link to item Cite

Provider-level rates of HEDIS-consistent HPV vaccination in a regional health plan.

Journal Article Hum Vaccin Immunother · 2019 Background. Health insurers are well-positioned to address low HPV vaccination coverage in the US through initiatives such as provider assessment and feedback. However, little is known about the feasibility of using administrative claims data to assess pro ... Full text Link to item Cite

Peripartum Maternal Hepatitis B Care in a US Nationwide Data Set.

Journal Article J Clin Gastroenterol · 2019 BACKGROUND: Hepatitis B virus (HBV) screening during pregnancy is standard of care to prevent vertical transmission to infants, yet the mothers themselves may not receive appropriate follow-up. GOALS: Using a national database, we sought to determine rates ... Full text Link to item Cite

High-Deductible Insurance and Delay in Care for the Macrovascular Complications of Diabetes.

Journal Article Ann Intern Med · December 18, 2018 BACKGROUND: Little is known about the long-term effects of high-deductible insurance on care for chronic medical conditions. OBJECTIVE: To determine whether a transition from low-deductible to high-deductible insurance is associated with delayed medical ca ... Full text Link to item Cite

Advancing Health Policy and Program Research in Diabetes: Findings from the Natural Experiments for Translation in Diabetes (NEXT-D) Network.

Journal Article Curr Diab Rep · November 20, 2018 PURPOSE OF REVIEW: To advance our understanding of the impacts of policies and programs aimed at improving detection, engagement, prevention, and clinical diabetes management in the USA, we synthesized findings from a network of studies that used natural e ... Full text Link to item Cite

Total and out-of-pocket expenditures among women with metastatic breast cancer in low-deductible versus high-deductible health plans.

Journal Article Breast Cancer Res Treat · September 2018 PURPOSE: High-deductible health plan (HDHP) enrollment is expanding rapidly and might substantially increase out-of-pocket (OOP) payment burden. We examined trends in total and OOP health service expenditures overall and by insurance coverage type among wo ... Full text Link to item Cite

Impact of high-deductible insurance on adjuvant hormonal therapy use in breast cancer.

Journal Article Breast Cancer Res Treat · August 2018 OBJECTIVE: High-deductible health plans (HDHPs) have become the predominant commercial health insurance arrangement in the US. HDHPs require substantial out-of-pocket (OOP) costs for most services but often exempt medications from high cost sharing. We exa ... Full text Link to item Cite

Four States With Robust Prescription Drug Monitoring Programs Reduced Opioid Dosages.

Journal Article Health Aff (Millwood) · June 2018 State prescription drug monitoring programs (PDMPs) aim to reduce risky controlled-substance prescribing, but early programs had limited impact. Several states implemented robust features in 2012-13, such as mandates that prescribers register with the prog ... Full text Link to item Cite

Effect of High-Deductible Insurance on High-Acuity Outcomes in Diabetes: A Natural Experiment for Translation in Diabetes (NEXT-D) Study.

Journal Article Diabetes Care · May 2018 OBJECTIVE: High-deductible health plans (HDHPs) are now the predominant commercial health insurance benefit in the U.S. We sought to determine the effects of HDHPs on emergency department and hospital care, adverse outcomes, and total health care expenditu ... Full text Link to item Cite

Breast Cancer Diagnosis and Treatment After High-Deductible Insurance Enrollment.

Journal Article J Clin Oncol · April 10, 2018 Purpose High-deductible health plans (HDHPs) require substantial out-of-pocket spending and might delay crucial health services. Breast cancer treatment delays of as little as 2 months are associated with adverse outcomes. Methods We used a controlled prep ... Full text Link to item Cite

EFFECT OF HIGH-DEDUCTIBLE INSURANCE ON MYOCARDIAL INFARCTION, STROKE, AND AMPUTATION

Conference JOURNAL OF GENERAL INTERNAL MEDICINE · April 1, 2018 Link to item Cite

Drivers of Low-Value Care-Reply.

Journal Article JAMA Intern Med · March 1, 2018 Full text Link to item Cite

Introductory Overview of the Natural Experiments for Translation in Diabetes 2.0 (NEXT-D2) Network: Examining the Impact of US Health Policies and Practices to Prevent Diabetes and Its Complications.

Journal Article Curr Diab Rep · February 5, 2018 PURPOSE OF REVIEW: Diabetes incidence is rising among vulnerable population subgroups including minorities and individuals with limited education. Many diabetes-related programs and public policies are unevaluated while others are analyzed with research de ... Full text Link to item Cite

Association between the 2012 Health and Social Care Act and specialist visits and hospitalisations in England: A controlled interrupted time series analysis.

Journal Article PLoS Med · November 2017 BACKGROUND: The 2012 Health and Social Care Act (HSCA) in England led to among the largest healthcare reforms in the history of the National Health Service (NHS). It gave control of £67 billion of the NHS budget for secondary care to general practitioner ( ... Full text Link to item Cite

Clinician-Level Predictors for Ordering Low-Value Imaging.

Journal Article JAMA Intern Med · November 1, 2017 IMPORTANCE: Clinicians who order unnecessary radiographic imaging may cause financial harm to patients who have increasing levels of cost sharing. Clinician predictors of low-value imaging are largely unknown. OBJECTIVE: To characterize clinician predictor ... Full text Link to item Cite

Trends in Receipt of Buprenorphine and Naltrexone for Opioid Use Disorder Among Adolescents and Young Adults, 2001-2014.

Journal Article JAMA Pediatr · August 1, 2017 IMPORTANCE: Opioid use disorder (OUD) frequently begins in adolescence and young adulthood. Intervening early with pharmacotherapy is recommended by major professional organizations. No prior national studies have examined the extent to which adolescents a ... Full text Link to item Cite

Small Decline In Low-Value Back Imaging Associated With The 'Choosing Wisely' Campaign, 2012-14.

Journal Article Health Aff (Millwood) · April 1, 2017 Choosing Wisely was launched by the American Board of Internal Medicine in April 2012 as a patient- and clinician-targeted campaign to reduce potentially unnecessary "low-value" medical services. The campaign's impact on low- and high-value care beyond its ... Full text Link to item Cite

Diabetes Outpatient Care and Acute Complications Before and After High-Deductible Insurance Enrollment: A Natural Experiment for Translation in Diabetes (NEXT-D) Study.

Journal Article JAMA Intern Med · March 1, 2017 IMPORTANCE: High-deductible health plans (HDHPs) have expanded under the Affordable Care Act and are expected to play a major role in the future of US health policy. The effects of modern HDHPs on chronically ill patients and adverse outcomes are unknown. ... Full text Link to item Cite

Racial disparities in all-cause mortality among younger commercially insured women with incident metastatic breast cancer.

Journal Article Breast Cancer Res Treat · July 2016 Racial disparities in breast cancer mortality persist and are likely related to multiple factors. Over the past decade, progress has been made in treating metastatic breast cancer, particularly in younger women. Whether disparities exist in this population ... Full text Link to item Cite

Variation in Postpartum Glycemic Screening in Women With a History of Gestational Diabetes Mellitus.

Journal Article Obstet Gynecol · July 2016 OBJECTIVE: To assess patterns and predictors of postpartum diabetes screening in a commercially insured, geographically and sociodemographically diverse sample of women with gestational diabetes mellitus. METHODS: Using commercial insurance claims (2000-20 ... Full text Link to item Cite

Colorectal Cancer Screening in a Nationwide High-deductible Health Plan Before and After the Affordable Care Act.

Journal Article Med Care · May 2016 BACKGROUND: Little is known about the effect of the Affordable Care Act's (ACA) elimination of out-of-pocket costs for preventive services. This policy likely reduced out-of-pocket colonoscopy costs most for high-deductible health plan (HDHP) members. OBJE ... Full text Link to item Cite

The Association between High-Deductible Health Plan Transition and Contraception and Birth Rates.

Journal Article Health Serv Res · February 2016 OBJECTIVE: To evaluate the association between employer-mandated enrollment into high-deductible health plans (HDHPs) and contraception and birth rates among reproductive-age women. DATA SOURCES/STUDY SETTING: Using data from 2002 to 2008, we examined 1,55 ... Full text Link to item Cite

Opioid Prescribing After Nonfatal Overdose and Association With Repeated Overdose: A Cohort Study.

Journal Article Ann Intern Med · January 5, 2016 BACKGROUND: Nonfatal opioid overdose is an opportunity to identify and treat substance use disorders, but treatment patterns after the overdose are unknown. OBJECTIVE: To determine prescribed opioid dosage after an opioid overdose and its association with ... Full text Link to item Cite

Mobile Phone and Smartphone Technologies for Diabetes Care and Self-Management.

Journal Article Curr Diab Rep · December 2015 Mobile and smartphone (mHealth) technologies have the potential to improve diabetes care and self-management, but little is known about their effectiveness and how patients, providers, and payers currently interact with them. We conducted a systematic revi ... Full text Link to item Cite

Comparing Medical Costs and Use After Laparoscopic Adjustable Gastric Banding and Roux-en-Y Gastric Bypass.

Journal Article JAMA Surg · August 2015 IMPORTANCE: There is conflicting evidence about how different bariatric procedures impact health care use. OBJECTIVE: To compare the impact of laparoscopic adjustable gastric banding (AGB) and laparoscopic Roux-en-Y gastric bypass (RYGB) on health care use ... Full text Link to item Cite

Trends in opioid prescribing and co-prescribing of sedative hypnotics for acute and chronic musculoskeletal pain: 2001-2010.

Journal Article Pharmacoepidemiol Drug Saf · August 2015 PURPOSE: Characterize trends in opioid prescribing and co-prescribing of sedative hypnotics at acute and chronic musculoskeletal pain visits from 2001 to 2010. METHODS: We conducted a repeated cross-sectional analysis of 15 344 visits for acute pain and 19 ... Full text Link to item Cite

Evaluating diabetes health policies using natural experiments: the natural experiments for translation in diabetes study.

Journal Article Am J Prev Med · June 2015 The high prevalence and costs of type 2 diabetes makes it a rapidly evolving focus of policy action. Health systems, employers, community organizations, and public agencies have increasingly looked to translate the benefits of promising research interventi ... Full text Link to item Cite

Rates of opioid dispensing and overdose after introduction of abuse-deterrent extended-release oxycodone and withdrawal of propoxyphene.

Journal Article JAMA Intern Med · June 2015 IMPORTANCE: In the second half of 2010, abuse-deterrent extended-release oxycodone hydrochloride (OxyContin; Purdue Pharma) was introduced and propoxyphene was withdrawn from the US market. The effect of these pharmaceutical market changes on opioid dispen ... Full text Link to item Cite

Mammography rates 3 years after the 2009 US Preventive Services Task Force Guidelines changes.

Journal Article J Clin Oncol · March 20, 2015 PURPOSE: In November 2009, the US Preventive Services Task Force (USPSTF) changed its mammography recommendations from every 1 to 2 years among women age ≥ 40 years to personalized screening decisions for women age 40 to 49 years and screening every 2 year ... Full text Link to item Cite

National Trends and Disparities in Mammography Among Commercially Insured Women, 2001-2010.

Journal Article J Public Health Manag Pract · 2015 CONTEXT: Prior research suggests that mammography declined from 2000 to 2005 and that socioeconomic disparities remained wide. OBJECTIVE: To assess national trends and disparities in mammography among commercially insured women from 2001 to 2010. DESIGN, S ... Full text Link to item Cite

Effect of Massachusetts health reform on chronic disease outcomes.

Journal Article Health Serv Res · December 2014 OBJECTIVE: To determine whether Massachusetts Health Reform improved health outcomes in uninsured patients with hyperlipidemia, diabetes, or hypertension. DATA SOURCE: Partners HealthCare Research Patient Data Registry (RPDR). STUDY DESIGN: We examined 1,4 ... Full text Link to item Cite

National trends and disparities in cervical cancer screening among commercially insured Women, 2001-2010.

Journal Article Cancer Epidemiol Biomarkers Prev · November 2014 BACKGROUND: Previous surveys reported declining cervical cancer screening rates from 2000 to 2010, but trends by key demographic and age groups are less clear. METHODS: We examined 3-year Papanicolaou (Pap) test rates among 4.2 million women enrolled in a ... Full text Link to item Cite

Impact of a high-deductible health plan on outpatient visits and associated diagnostic tests.

Journal Article Med Care · January 2014 BACKGROUND: By shifting a greater share of out-of-pocket medical costs to consumers, high-deductible health plans (HDHP) might discourage use of essential outpatient services. OBJECTIVE: The objective of the study was to examine the impact of an HDHP on ou ... Full text Link to item Cite

Low-socioeconomic-status enrollees in high-deductible plans reduced high-severity emergency care.

Journal Article Health Aff (Millwood) · August 2013 One-third of US workers now have high-deductible health plans, and those numbers are expected to grow in 2014 as implementation of the Affordable Care Act continues. There is concern that high-deductible health plans might cause enrollees of low socioecono ... Full text Link to item Cite

The impact of high-deductible health plans on men and women: an analysis of emergency department care.

Journal Article Med Care · August 2013 BACKGROUND: Prior studies show that men are more likely than women to defer essential care. Enrollment in high-deductible health plans (HDHPs) could exacerbate this tendency, but sex-specific responses to HDHPs have not been assessed. We measured the impac ... Full text Link to item Cite

Impact of emerging health insurance arrangements on diabetes outcomes and disparities: rationale and study design.

Journal Article Prev Chronic Dis · 2013 Consumer-directed health plans combine lower premiums with high annual deductibles, Internet-based quality-of-care information, and health savings mechanisms. These plans may encourage members to seek better value for health expenditures but may also decre ... Full text Link to item Cite

Two-year trends in cancer screening among low socioeconomic status women in an HMO-based high-deductible health plan.

Journal Article J Gen Intern Med · September 2012 BACKGROUND: Cancer screening is often fully covered under high-deductible health plans (HDHP), but low socioeconomic status (SES) women still might forego testing. OBJECTIVE: To determine the impact of switching to a HDHP on breast and cervical cancer scre ... Full text Link to item Cite

The promise and peril of healthcare forecasting.

Journal Article Am J Manag Care · March 1, 2012 Health plans and physician groups increasingly use sophisticated tools to predict individual patient outcomes. Such analytics will accelerate as US medicine enters the digital age. Promising applications of forecasting include better targeting of disease m ... Link to item Cite

High-deductible insurance: two-year emergency department and hospital use.

Journal Article Am J Manag Care · October 1, 2011 OBJECTIVES: To determine the 2-year impact of high-deductible health plans (HDHPs) on high-acuity, expensive medical care. STUDY DESIGN: Retrospective pre-post, with propensity score-matched comparison group. METHODS: We studied emergency department visits ... Link to item Cite

Effect of switching to a high-deductible health plan on use of chronic medications.

Journal Article Health Serv Res · October 2011 OBJECTIVE: To examine whether high-deductible health plans (HDHPs) that exempt prescription drugs from full cost sharing preserve medication use for major chronic illness, compared with traditional HMOs with similar drug cost sharing. DATA SOURCES/STUDY SE ... Full text Link to item Cite

Two-year trends in colorectal cancer screening after switch to a high-deductible health plan.

Journal Article Med Care · September 2011 BACKGROUND: Recent health reform laws might accelerate high-deductible health plan (HDHP) growth. The impact of HDHPs on long-term colorectal cancer screening rates and low socioeconomic status (SES) members is unknown. METHODS: We studied colorectal cance ... Full text Link to item Cite

Emergency department utilization after the implementation of Massachusetts health reform.

Journal Article Ann Emerg Med · September 2011 STUDY OBJECTIVE: Health care reform in Massachusetts improved access to health insurance, but the extent to which reform affected utilization of the emergency department (ED) for conditions potentially amenable to primary care is unclear. Our objective is ... Full text Link to item Cite

"Pay-for-performance" as a quality improvement tool: perceptions and policy recommendations of physicians and program leaders.

Journal Article Qual Manag Health Care · 2011 BACKGROUND: Although pay-for-performance (P4P) compensation is widespread, questions have arisen about its efficacy in improving health care quality and consequences for vulnerable patients. OBJECTIVE: To assess perceptions of general internists and P4P pr ... Full text Link to item Cite

High-deductible health plans and costs and utilization of maternity care.

Journal Article Am J Manag Care · January 2011 OBJECTIVE: To evaluate the impact of switching from an HMO to a high-deductible health plan on the costs and utilization of maternity care. STUDY DESIGN: Pre–post design, with a control group. METHODS: We compared 229 women who delivered babies before or a ... Link to item Cite

Use of well-child visits in high-deductible health plans.

Journal Article Am J Manag Care · November 2010 OBJECTIVE: To examine how enrollment in high-deductible health plans (HDHPs) affects use of well-child visits relative to traditional plans, when preventive care is exempt from the deductible. STUDY DESIGN: Pre-post comparison between groups. METHODS: We s ... Link to item Cite

Comparing simulation and threshold approaches when analysing data with probabilities of categories.

Journal Article J Eval Clin Pract · October 2010 OBJECTIVE: Constructing categories based on probabilities is not unusual in defining the outcome or the exposure. We compare the threshold approach and the simulation approach in making inferences. METHOD: We used a simple structured example as well as pub ... Full text Link to item Cite

High quality care and ethical pay-for-performance: a Society of General Internal Medicine policy analysis.

Journal Article J Gen Intern Med · July 2009 BACKGROUND: Pay-for-performance is proliferating, yet its impact on key stakeholders remains uncertain. OBJECTIVE: The Society of General Internal Medicine systematically evaluated ethical issues raised by performance-based physician compensation. RESULTS: ... Full text Link to item Cite

High-deductible health plans: are vulnerable families enrolled?

Journal Article Pediatrics · April 2009 OBJECTIVE: There is concern that high-deductible health plans may have negative effects on vulnerable groups. The objective of this study was to compare the characteristics of families who have children and switch to high-deductible health plans with those ... Full text Link to item Cite

Cancer screening before and after switching to a high-deductible health plan.

Journal Article Ann Intern Med · May 6, 2008 BACKGROUND: Health plans with high deductibles could lead patients to avoid preventive care, such as cancer screening. OBJECTIVE: To determine the effect of membership in a high-deductible health plan on cervical, breast, and colorectal cancer screening. D ... Full text Link to item Cite

Emergency department use and subsequent hospitalizations among members of a high-deductible health plan.

Journal Article JAMA · March 14, 2007 CONTEXT: Patients evaluated at emergency departments often present with nonemergency conditions that can be treated in other clinical settings. High-deductible health plans have been promoted as a means of reducing overutilization but could also be related ... Full text Link to item Cite

Polarized light propagation in corneal lamellae.

Journal Article J Refract Surg · 1999 The propagation of polarized light through the cornea is affected by the orientations of the corneal lamellae and by the refractive imbalance between the collagen fibrils and the ground substance. Thus, well-designed measurements and analyses of polarized ... Full text Link to item Cite

Prostate cancer metastasis-suppressor genes: a current perspective.

Journal Article In Vivo · 1998 Prostate cancers account for 43% of all cancers diagnosed in American men. It is estimated that in 1996, 317,000 new cases of prostate cancer were diagnosed and 41,000 men died of the disease. The challenge of treating prostate cancer lies in accurately di ... Link to item Cite

Development of a high-efficiency method for gene marking of Dunning prostate cancer cell lines with the enzyme beta-galactosidase.

Journal Article Prostate · July 1996 Although the bacterial enzyme beta-galactosidase has been used as a reporter gene in a variety of mammalian systems; the variability and instability of its expression has limited its use. Transfection of Dunning rat prostatic cell lines with beta-galactosi ... Full text Link to item Cite