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The 340b Program, Contract Pharmacies And Hospitals: An Examination Of The First 25 Years Of Their Increasingly Complex Relationship, David P. Paul Iii, Morgan Cathlene Ludado, Morgan Ruley, Hannah Sayre, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

The 340B Drug Pricing Program, created by Congress in 1992 through the Veterans Health Care Act, has provided discounted drug prices to hospitals and other health care organizations serving a wide population of low-income patients. Some 340B programs use contract pharmacies, an arrangement whereby the hospital or health care organization signs a contract directly with a pharmacy to provide covered pharmacy services at discounted prices.

The federal 340B Drug Pricing Program has provided access to reduced price prescription drugs to over 35,000 individual healthcare facilities and sites certified by the U.S. Department of Health and Human Services (HHS), and clinics …

Telepsychiatry: Access In Rural Areas, David P. Paul Iii, Brianna Washington, Annie Robinson, Mike Tonnie, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Rural areas have experienced higher than average healthcare workforce problems, especially concerning limited access to mental health services. Telepsychiatry may provide at least a partial solution, as it has improved access and quality of care available in rural environments despite implementation problems. As technology continues to advance access, telepsychiatry will also need to strengthen making access more readily available. Additional research is required to identify modalities and diverse methods that can be used to increase access to mental health services further and improve outcomes in rural and underserved areas.

The Continuing Epidemic Of Hepatitis C In The United States: The Case Of West Virginia, David P. Paul Iii, Neha Botre, Maggie Phillips, Jumana Abboud, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Hepatitis C virus (HCV) is one of the most significant public health problems currently facing the U.S. If it is left untreated, the likelihood of sustaining a treatment response decreases. While early identification has been identified as a critical focus in trying to obtain better health outcomes, new drug treatments appear quite promising.

Macra And Rural Hospitals, Erica Kelley, Rhea Lipscomb, Jennifer Valdez, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

The purpose of this research was to study MACRA (Medicare Access & CHIP Reauthorization Act) and to determine how its implementation would financially impact rural hospitals. Although the long-term effects of MACRA have not been able to be studied, MACRA has the prospective to negatively impact rural hospitals financially. MACRA has potential risks and benefits for physicians associated with its two reimbursement payment methods. The estimated negative reimbursements and set reductions to hospital reimbursement have supported the idea that physicians and all healthcare organizations need to be aware and prepared for MACRA.

Hospital Nurse Burnout: A Continuing Problem, David P. Paul Iii, Lama Bakhamis, Harlan M. Smith Ii, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

RNs are a critically important component of the U.S. healthcare system. RN burnout – the feeling of exhaustion from working long hours without rest – is a real concern, having been reported in many hospitals. We examine the background, causes and consequences of burnout among RNs in U.S. hospitals, in order to identify solutions to this problem. Findings indicate that Burnout Syndrome in RNs can be analyzed in terms of four clusters of characteristics: individual, management, organizational, and work. The consequences of burnout include increased RN turnover rates, poor job performance, and threats to patient safety. RN burnout in hospitals …

Organizational Culture Change In A Texas Hospital, Alberto Coustasse-Hencke M.D., M.B.A., M.P.H.

Alberto Coustasse, DrPH, MD, MBA, MPH

Coustasse-Hencke, Alberto, MD, MBA, MPH, Organizational Culture Change in a Texas Hospital. Doctor of Public Health (Health Behavior), June 2004, 329 pp., 11 tables, 8 illustrations, bibliography, 198 titles. The purpose of this research was to analyze a Balanced Scorecard (BSC) approach in a Texas hospital with a main focus in Patient Satisfaction (PS), and to measure organizational change and its impact on PS. This dissertation also applied a "Shared Vision" of the organization as the central process in bringing forth the knowledge shared by members of the community hospital who were both subjects and research participants. The development of …

The Effectiveness Of Needle Exchange Programs In The United States And West Virginia, Margie J. Phillips, Alberto Coustasse, Sara Johnson, Briana Washington

Alberto Coustasse, DrPH, MD, MBA, MPH

Needle Exchange Programs (NEPs) have been controversial aspects of public health care due to conflicting beliefs and opinions for public policies. NEPs have allowed Injection Drug Users the ability to exchange their used equipment for clean, unused supplies. Research into the effectiveness of needle exchange programs and the impact it has had on the reduction of HIV and viral hepatitis infections in people who inject drugs. Injection Drug Users have accounted for 10% of HIV transmission cases in West Virginia, and this state has been ranked as the highest in the whole United States for incidents of Hepatitis C. NEPs …

Trends And Effects Of Pharmaceutical Dtca, Alberto Coustasse, P. Sathorn, William K. Willis

Alberto Coustasse, DrPH, MD, MBA, MPH

Purpose – The purpose of the review is to investigate the current trend of pharmaceutical Direct-to-Consumer Advertising (DTCA) in the US and its effect on patients, physicians, and drug utilization. DTCA by pharmaceutical firms may be defined as an attempt by pharmaceutical companies to advertise products directly to patients.

Design/methodology/approach – Methodology for this paper is a literature review approach.

Findings – Pharmaceutical DTCA demonstrated a reduction in total spending, while the online channel media experienced growth. DTCA has influenced the physician-patient relationship and patient satisfaction. Patients who received medication associated with DTCA showed higher satisfaction. DTCA of second-line drugs …

The 340b Program: Benefits And Limitations, Craig Kimble Pharmd, Mba, Ms, Bcacp, Alberto Coustasse Dr.Ph. Md, Mba, Mph

Alberto Coustasse, DrPH, MD, MBA, MPH

This in progress study reviews challenges and successes associated with implementing a 340B program at Marshall Health and Cabell Huntington Hospital (CHH) in Huntington, West Virginia. CHH qualified as a participant in the 340B program because it has met qualification as a disproportionate share hospital (DSH). The site has also been able to open two outpatient pharmacies to serve the targeted patient population. The pharmacies have also been able to use savings from the program to embed clinical pharmacists into the physician care areas to provide medication therapy management services including discharge counselling, disease state management services, patient financial assistance …

Healthcare Facilities: Another Target For Ransomware Attacks, David P. Paul Iii, Nikki Spence, Niharika Bhardwa, Alberto Coustasse Dr.Ph, Md, Mba, Mph

Alberto Coustasse, DrPH, MD, MBA, MPH

Ransomware is a type of malware used by cyber criminals who encrypt files and then extort money in return for unlocking those files. Without adequate disaster recovery and backup plans, many businesses are forced to pay the ransom. We examine recent ransomware infections in healthcare settings, the liabilities and cost associated with such infections, and discuss possible risk mitigation tactics. Risks associated with ransomware attacks on healthcare facilities include financial, future business loss and damage to reputation. Healthcare facilities should have a disaster plan with adequate data backups and educate employees who are the usual sources of ransomware attacks.

The Emerging Issue Of Hepatitis C Virus In The United States And In West Virginia, Alberto Coustasse Dr.Ph. Md,Mba, Mph, Maggie Phillips Rn, Bsn, Mha, Jumana Abboud Mha, Neha Botre Mha, David P. Paul Iii

Alberto Coustasse, DrPH, MD, MBA, MPH

Introduction:

Hepatitis C virus (HCV) is one of the most significant public health problems currently facing the U.S., Especially in West Virginia. If it is undetected and left untreated, the likelihood of sustaining a treatment response decreases. While early identification has been identified as a critical focus in trying to obtain better health outcomes, new drug treatments appear promising, although somewhat expensive. West Virginia, a predominantly rural state, is beginning to face a mounting financial crisis due to HCV.

Purpose of the Study:

The purpose of this study was to examine the effects of early identification and treatment for patients …

Burnout Syndrome And Nurse-To-Patient Ratio In The Workplace, Ekaterina Gutsan Msha, Jami Patton, William K. Willis, Alberto Coustasse Dr.Ph. Md, Mba, Mph

Alberto Coustasse, DrPH, MD, MBA, MPH

Introduction: Burnout among Registered Nurses has been a great concern within the U.S. healthcare system and has been reported in many hospitals. Nurse Burnout has been defined as a chronic response to work-related stress comprising three components or dimensions: emotional exhaustion, depersonalization, and personal accomplishment. The purpose of this research was to analyze the nurse-to-patient ratio to determine how it affects the psychological, mental, emotional health and the nurse overall productivity in the workplace.

Methodology: The methodology was a review of literatures and a semi-structured interview. There were four primary databases and one website used in this research, and 31 …

Medicare And The Affordable Care Act: Fraud Control Efforts And Results, Sarah Clemente, Ronald Mcgrady, Rob Repass, David P. Paul Iii, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Medicare fraud and abuse costs are estimated at 3%-10% of overall Medicare spending, which is expected to expand considerably until 2024 and as such the amount of fraud dollars would be expected to increase proportionally. The purpose of this research was to determine how recent reforms, especially the Patient Protection and Accountable Care Act, may affect Medicare fraud and abuse and to uncover the best strategies to combat Medicare fraud. The breadth of fraud and abuse within Medicare as well as recent reforms to fight fraud including legislative reforms, delivery system reforms, and other reforms including the formation of HEAT …

Maryland's All-Payer Health Care System: A Light At The End Of A Tunnel, Lama Bakhamis, Taeko Matsumoto, Mary Tran, David P. Paul Iii, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

The state of Maryland, in collaboration with the Centers for Medicare & Medicaid Services, developed the first all-payer system model in the Unites States in 1971 and 35 years later in response to financial pressures undertook to modernize this program. The focus of the modernized program was to improve overall per-capita expenditure, quality of care, and the outcome of Marylanders' health. The financial status of Maryland hospitals was declining because of the rate setting of the Health Services Cost Review Commission while hospital admission rates and spending were increasing. This study showed positive change in moving Maryland health care delivery …

Benefits Of The 340b Drug Discount Program, Jarrett Gerlach, Sarah Mcsweeney, Angela Swearingen, Nitesh Patil, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Introduction: The 340B Drug Discount Program required drug manufacturers provide discounted outpatient drugs to healthcare organizations which serve vulnerable patient populations to allow these institutions to offer more services to more people. As the 340B program expanded, controversy has centered on which entities have benefited from the program. Many healthcare organizations sold 340B drugs to well-insured patients at full price, and thus have been financially rewarded. Amendments to the program have permitted 340B providers to utilize contract pharmacies to dispense 340B medication, which has furthered the debate over which stakeholders are benefiting from the program. Purpose of the Study: The …