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Authors
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Contributor: How Medication Risk Scores Improve Health for Medicare BeneficiariesMedication risk scores analyze an individual’s medication regimen to look for the potential for simultaneous, multi-drug interactions, which can cause adverse drug events and other medication-related harms.
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A Machine Learning Technology for Addressing Medication-Related Risk in Older, Multimorbid PatientsA novel machine learning system effectively stratifies emergency department use and hospitalization risk of older patients with multimorbidity who take multiple medications and provides appropriate medication recommendations.
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Leveraging Longitudinal Clinical Laboratory Results to Improve Prenatal CareCollaboration between a clinical laboratory and a managed care organization improved prenatal care and outcomes through real-time, actionable, laboratory-derived insights and care coordination.
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Mandatory Medicare Bundled Payment and the Future of Hospital ReimbursementThe authors evaluate features of the Transforming Episode Accountability Model and discuss its benefits and limitations.
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Factors That Increase Utilization Management Risk: A Proof of ConceptA score was developed to measure patient risk from payer utilization management policies and its relationship to real-world US commercial payer utilization management policies.
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Reducing Readmissions in the Safety Net Through AI and AutomationArtificial intelligence (AI) and electronic health record–based automation tools helped a safety-net health system meet performance-based readmission metrics, thereby retaining critical funding while improving clinical and equity outcomes.
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Impact of Payment Models on Medical Specialist Physician Practice PatternsThis article explores the impact of payment models (fee for service vs salary based) on practice patterns, including wait times and care for patients with chronic diseases.
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Collaboration to Transition Members to Preferred Formulary Dipeptidyl-Peptidase-4 InhibitorA collaboration between a drug plan and clinical pharmacists led to nearly 50% of members successfully switching to a preferred dipeptidyl-peptidase-4 inhibitor.
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Effects of Adjunctive Cariprazine Formulary Restrictions in Major Depressive DisorderPatients who experienced a formulary-related rejection of cariprazine for adjunctive treatment of major depressive disorder had significantly higher hospitalization rates than those with approved claims.
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From Niche to Mainstream: Transforming Physical Therapy by Refining Remote Therapeutic MonitoringMedbridge is working to refine remote therapeutic monitoring, or RTM, to transform physical therapy and enhance patient care.
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Care Fragmentation Predicts 90-Day Durable Ventricular Assist Device OutcomesThis analysis evaluates the relationship between hospital care delivery network fragmentation and in-hospital and 90-day outcomes. These networks may be novel targets for improving outcomes.
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Regulation of Provider Networks in Response to COVID-19The authors describe federal and state provider network adequacy standards and discuss how regulators should adapt these standards and accompanying monitoring processes in response to coronavirus disease 2019 (COVID-19).
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Activation, Physical Activity, and Outcomes Among Individuals With T2DThis study presents an integrated, exploratory assessment of physical activity, patient activation, health-related quality of life, and clinical outcomes among older adults with type 2 diabetes (T2D) using survey, wellness, and claims data.
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Improving Lupus Care Requires Addressing Social Determinants, Expanding Access: Margrit Wiesendanger, MD, PhDIn the final part of her interview, Margrit Wiesendanger, MD, PhD, discusses the need to improve lupus care by addressing social determinants of health and expanding access to treatment.
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Contributor: Data, Education, and Community: The Winning Formula for Addressing SDOH for Kidney Care PatientsAddressing patients with chronic kidney disease requires a commitment to data, education, and community, specifically in those affected by social determinants of health (SDOH).
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Operating Room Efficiency of Orthopedic Surgery During the COVID-19 EraThe authors analyzed the impacts of COVID-19 on orthopedic operating room efficiency via comparison of 14,856 surgeries performed before, during, and after the pandemic.
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Factors Associated With Unplanned Admissions Among Patients With Chronic ConditionsThis study identified risk factors for unplanned admissions among patients with multiple chronic conditions to inform focused interventions.
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Health Care Utilization and Cost of Diagnostic Testing for Respiratory InfectionsSyndromic reverse transcriptase–polymerase chain reaction tests for respiratory infections were associated with lower health care resource utilization and costs, implicating potential for improved value in patient care.
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Outcomes of Antiviral Treatment for Influenza in Type 2 DiabetesAntiviral treatment was associated with lower health care resource utilization and costs in patients with type 2 diabetes and a diagnosis of influenza.
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A Cue-to-Action Pilot Project to Increase Screening MammographyA targeted cue-to-action campaign of outreach, education, and incentive can improve uptake of screening mammography.
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Medical Home Visit Programs During COVID-19 State of EmergencyThis report highlights the unique challenges faced by home health programs in addition to discussing how technology and policy changes have helped the elderly homebound during the coronavirus disease 2019 (COVID-19) pandemic.
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Senate Introduces Bill to Extend 5% Incentives for APMsThe bipartisan bill would help lower Medicare costs and improve quality of care, according to the National Association of ACOs.
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Medicare Advantage–Pharmacy Partnership Improves Influenza and Pneumococcal Vaccination RatesPatients whose pharmacy receives notification of their immunization gap have twice the odds of receiving immunizations compared with those whose pharmacy does not receive the notification.
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Post-SNF Outcomes and Cost Comparison: Medicare Advantage vs Traditional MedicarePatients enrolled in Medicare Advantage had better outcomes and lower cost following skilled nursing facility (SNF) discharge than patients enrolled in traditional fee-for-service Medicare.
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Improving Glycemic Control in Diabetes Through Virtual Interdisciplinary RoundsPatients with diabetes whose providers received advice from remote, virtual interdisciplinary rounds had a greater 1-year reduction in hemoglobin A1c than comparable patients.
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Trends in Market Share Among Hospitals Participating in ACOs and NonparticipantsAccountable care organization (ACO) participation was associated with an increase in hospitals’ mean market share and with additional market share gains in more concentrated markets.
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Main Conference Takeaways Regarding cGVHD ManagementSergio A. Giralt, MD, discusses the key results from recent chronic graft-vs-host disease (cGVHD) research presented at ASH 2024 and how these findings will influence his clinical practice. He also shares his main takeaways on evolving strategies for cGVHD management.
