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Background: In the United States, Medicare beneficiaries diagnosed with cancer often face significant financial challenges due to the expensive nature of cancer treatments and increased cost-sharing responsibilities. However, there is limited knowledge regarding the financial hardships and healthcare utilizations faced by those enrolled in Medicare Advantage (MA) compared to those in traditional fee-for-service Medicare (TM) during the COVID-19 pandemic. Our study aims to investigate the subjective financial hardships experienced by individuals enrolled in TM and MA and to determine whether these two Medicare programs exhibit differences in healthcare utilization during the pandemic. Methods: We utilized data from the 2020–2022 National Health Interview Survey (NHIS), focusing on nationally representative samples of cancer survivors aged 65 or older. Financial hardship was categorized into three distinct groups: material (e.g., problems with medical bills), psychological (e.g., worry about paying), and behavioral (e.g., delayed care due to cost). Healthcare utilization included wellness visits (preventive care), emergency care services, hospitalizations, and telehealth. We used survey design-adjusted analysis to compare the study outcomes between MA and TM. Results: Among a weighted sample of 4.4 million Medicare beneficiaries with cancer (mean age: 74.9), 76% were enrolled in MA plans. Cancer survivors with a college degree (59.3% vs. 49.8%) and high family income (38.2% vs. 31.1%) were more likely to enroll in MA plans. There were no significant differences in any material, psychological, or behavioral financial hardship domains between beneficiaries with MA and TM plans except forgone counseling due to cost. For healthcare utilization measures, cancer survivors in MA were more likely than those in TM to have flu vaccination (77.2% vs. 70.1%) and experience lower hospitalizations (16.0% vs. 20.0%). However, there were no differences in other health service utilizations between MA and TM. Conclusion: While no significant differences were observed in any materialized, psychological, or behavioral financial hardships, older cancer survivors enrolled in MA plans were more likely to receive vaccinations and lower hospitalization rates during COVID-19. Although other preventive or primary care visits (i.e., wellness visits) were higher, their difference did not reach statistical significance. As MA grows in popularity, it is essential to consistently monitor and evaluate the performance and outcomes of Medicare plans for cancer survivors as we navigate the post-pandemic landscape. [ABSTRACT FROM AUTHOR]

This study examines a method to decrease social loafing in a group examination. Students who met in teams during the semester took an exam in groups. Rules for the exam, based on the Jeopardy game show, facilitated both group and individual accountability. Feedback from students indicated that compared to a class that did not have group exams, students taking the group exam had less social loafing and had higher perceived levels of learning. Furthermore, among students taking the group exams, higher group participation was related to higher perceived performance and more positive attitudes about the exam. We developed a model for how the environment affects group processes which, in turn, affects group and individual outcomes.

The authors investigated the effect of midterm student feedback on final ratings of college teaching and courses. Five classes including 142 students participated in pre- and posttests with the intervention of a midterm group feedback process known in the literature as Bare Bones Questions (or BBQ). Three of the four hypotheses tested were supported. Students reported increases in both their learning and satisfaction, and their ratings of both instructors and courses increased. This research expands current knowledge by demonstrating quantitatively that midterm student feedback is likely to have a positive effect on students' evaluations and is a beneficial addition to other types of evaluations of teaching performance. (Contains 3 tables.)

Objective: It is unclear how well palliative care teams are staffed at US cancer centers. Our primary objective was to compare the composition of palliative care teams between National Cancer Institute (NCI)-designated cancer centers and non-NCI-designated cancer centers in 2018. We also assessed changes in team composition between 2009 and 2018. Methods: This national survey examined the team composition in palliative care programs at all 61 NCI-designated cancer centers and in a random sample of 60 of 1252 non-NCI-designated cancer centers in 2018. Responses were compared to those from our 2009 survey. The primary outcome was the presence of an interprofessional team defined as a palliative care physician, nurse, and psychosocial member. Secondary outcomes were the size and number of individual disciplines. Results: In 2018, 52/61 (85%) of NCI-designated and 27/38 (71%) non-NCI-designated cancer centers in the primary outcome comparison responded to the survey. NCI-designated cancer centers were more likely to have interprofessional teams than non-NCI-designated cancer centers (92% vs 67%; P =.009). Non-NCI-designated cancer centers were more likely to have nurse-led teams (14.8% vs 0.0%; P =.01). The median number of disciplines did not differ between groups (NCI, 6.0; non-NCI, 5.0; P =.08). Between 2009 and 2018, NCI-designated and non-NCI-designated cancer centers saw increased proportions of centers with interprofessional teams (NCI, 64.9% vs 92.0%, P <.001; non-NCI, 40.0% vs 66.7%; P =.047). Conclusion: NCI-designated cancer centers were more likely to report having an interprofessional palliative care team than non-NCI-designated cancer centers. Growth has been limited over the past decade, particularly at non-NCI-designated cancer centers. [ABSTRACT FROM AUTHOR]

The fiscal pool that funds Delivery System Reform Incentive Payment (DSRIP) projects has four interlinking categories, Categories I – IV. DSRIP that was adopted in nine counties of southeast Texas detected a decrease in Preventable Hospitalization (PH) rates formulating the problem statement: What were the proposed factors that influenced the detected decrease? The article is a delineation of the presumable influencers within DSRIP that may have resulted in decrease in PH rates, those likely being physician-hospital collaboration, mechanisms of reimbursements, types of measures leveraged to report quality initiatives and interplaying healthcare externalities within the implemeted counties. The paper explains functioning of the four aforementioned influencers, examines how those may have impacted DSRIP and thereafter elucidates mechanisms these influencers in a detailed discussion. Physician-hospital collaboration propagated relationship centered care geared towards patients. State reimbursements provided a fiscal ballast to initiate and continue DSRIP activities. DSRIP's Categories itself were designed in a systematic way so as to procure health outcomes in a continual process. And lastly, interplaying healthcare externalities such as the presence of Medicaid Managed Care/Health Maintanence Organizations may have impacted patient health in the implemented areas. At large, DSRIP may have exemplified coordination of physicians, administrators and the state so as to likely procure outcomes in healthcare quality as described herewith. [ABSTRACT FROM AUTHOR]

Byline: Lee Revere, Sukran N. Kadipasaoglu, Faiza Zalila This pilot research explores the critical success factors of Six Sigma to gain insight into the gaps between Six Sigma theory and execution, and to understand the primary drivers of financial improvements. The findings demonstrate the key aspects that seem to be consistent among Six Sigma organisations. Results show organisations cite Six Sigma for cost reduction, notoriety of its success and increased revenues. Chi-square analyses indicate gaps exist between theory and actual practice across the three critical success factors of team selection, project selection and project implementation. A larger percent of respondents agree on the criticality of key tasks/issues, yet fewer companies execute them in practice. Regression results demonstrate the factors of team selection and project selection significantly impact the financial improvement performance of the responding organisations. These results are beneficial for researchers investigating Six Sigma, business leaders considering its implementation and for existing companies seeking to achieve even greater improvement gains.

Academic hospitals contribute to health care through patient care, research, and teaching; however, their outcomes may not be equivalent to nonacademic hospitals. Multivariate analysis of variance is used to compare publicly reported data on patient satisfaction, readmission rates, mortality rates, and hospital-acquired injury scores between 1906 academic and nonacademic hospitals, while controlling for hospital-level covariates. Results show that academic hospitals have higher levels of patient satisfaction on 7 of the 11 measures and are equivalent to nonacademic hospitals on the remaining 4 measures. Academic hospitals have lower pneumonia mortality rates than nonacademic hospitals, with no difference for other mortality or disease-specific readmissions. However, academic hospitals have a slightly higher overall readmission rate. Infection rates were equivalent between academic and nonacademic hospitals for central line-associated bloodstream infections, pressure ulcers, and wound dehiscence for abdominal and pelvic injuries, but academic hospitals have higher catheter-associated urinary tract infection rates. [ABSTRACT FROM AUTHOR]

Providing quality healthcare is one of the topmost priorities in the care delivery system. Quality is recognized as value added to the healthcare system. Healthcare policies and programs are innovated and designed to reform delivery of patient care, an example is the Delivery System Reform Incentive Payment (DSRIP) program. In this paper, we leverage three assessment models in healthcare quality namely, Donabedian's model, the Institute of Medicine's Patient Care Aim model and the Institute of Healthcare Improvement's Triple Aim model. The paper shows how DSRIP likely interrelates with and is congruent to the aforementioned assessment models. DSRIP's goals are likely designed in such a way that they supposedly intertwine with the goals of these models. The article aims at showing how DSRIP is attempting to operationalize its own goals with those of the above models. Nonetheless, the article explains DSRIP's inner workings and conclusively analyzes how its systemic design aligns with and conforms to these models. Lastly, the paper explains DSRIP's logistics, project cohorts and categories, outcome reporting techniques and state reimbursement methods as parts of its systemic design so as to prospectively assist/serve policymakers and analysts whilst designing new policies for procuring outcomes in quality and health in future. [ABSTRACT FROM AUTHOR]