Health-Related Quality of Life and Quality of Care in Specialized Medicare-Managed Care Plans.
ABSTRACT Special needs plans (SNPs) were created under the Medicare Modernization Act of 2003 to focus on Medicare beneficiaries who required more coordination of care than most beneficiaries served through the Medicare Advantage program. This research indicates that beneficiaries in 3 types of SNPs show evidence of worse health-related quality of life. Special needs plans demonstrated worse plan performance on the HEDIS osteoporosis testing in older women measure compared with non-SNP Medicare Advantage beneficiaries, but better plan performance on the HEDIS fall risk management measure. Future research should consider broader measures of plan performance, quality of care, and cost.
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ABSTRACT: Establishing a Fracture Liaison Service (FLS) to identify and treat patients with a recent fragility fracture has been shown to be effective, save money, useful to document high quality of care, and makes good clinical sense. A FLS starts with an osteoporosis champion and encompasses identification of patients with a recent fracture, diagnostic workup, treatment, and follow-up. A FLS is most effective when it is able to function in multiple settings: the hospital, emergency department, and outpatient clinic. Implementation may be somewhat easier in a closed healthcare system but can be feasible even in an open system. There are many barriers to implementation which can be addressed. The future of FLS care lies in a collaborative systems-based approach with appropriate stakeholder engagement, leading to seamless integration of osteoporosis care.Current Osteoporosis Reports 10/2013; DOI:10.1007/s11914-013-0177-9