Several physician and payer characteristics are associated with physician satisfaction with health plans. There is opportunity to improve physician satisfaction with payers, specifically in pharmacy.
Telemedicine in safety-net primary care faces particular challenges. Consistent, team-based workflows can support video visit implementation and health care maintenance in telemedicine visits.
Pharmacy benefit designs that mandate mail pharmacy use interfere with prescription drug access, particularly for individuals without previous mail pharmacy experience.
Caregivers' presence during patient recruitment is associated with a greater rate of completion of a post hospital transitional care coaching intervention, particularly among men.
Patient-centered medical homes in Maryland’s multipayer demonstration disrupted the pattern of recurrently high expenditure among the costliest patients and improved continuity of care.
Work relative value units (wRVUs) correlate with operative duration of common surgical procedures. Reimbursement for physicians depending on wRVUs is fair for commonly performed surgeries.
A patient-centered medical home with intensive case management and a payer partner can significantly improve hospital utilization and may decrease total medical costs for a Medicare population.
The authors examined 2 high-risk classification methods to compare and contrast the patient populations, and to identify the preferred method for predicting subsequent emergency department visits.
Super-utilizers place a significant clinical and financial burden on the healthcare system. The authors investigated the effectiveness of community navigators in reducing hospital utilization and costs.
As personalized medicine rapidly becomes an effective tool for combating cancer, payers are exploring new, value-based payment paradigms. These trends will soon intersect, and depending on how they are structured, the new payment models could accelerate or stifle personalized medicine's progress.
The authors provide a framework to capture additional benefits that may result from VBID programs, extending beyond utilization and outcomes to productivity, engagement, and talent.
This study highlights the potential value of innovative ways of collecting information about adverse drug events directly from patients.
Higher intensity of care management in an all-condition program addressing care coordination and care barriers was associated with increased healthcare utilization among Medicaid and Medicare patients.
A consumer-directed health plan with a health savings account was associated with reduced adherence for 4 of 5 conditions.
One possible way to reduce overall cost, improve patient experience, and improve outcomes in cancer care is to shift the focus of healthcare delivery away from volume and toward value. Patient-centered cancer care holds the promise of addressing these issues.