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Authors
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Psoriatic Arthritis Treatment Patterns and Costs Among Pharmacologic Treatment–Naïve PatientsWe present results of an analysis of IBM MarketScan databases that evaluates treatment patterns and health care costs for treatment-naïve patients with psoriatic arthritis.
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Can Managed Care Organizations Partner With Manufacturers for Comparative Effectiveness Research?Two case studies examine the benefits of manufacturers and managed care organizations partnering in pragmatic or practical clinical trials to generate real-world evidence.
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Guideline-Based Peer-to-Peer Consultation Optimizes Pegfilgrastim Use With No Adverse Clinical ConsequencesActive expert peer-to-peer consultation with prescribing oncologists can promote adherence to guidelines and lead to cost reductions without risk of neutropenic fever, with or without hospitalization, for patients with cancer.
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The Role of Retail Pharmacies in CVD Prevention After the Release of the ATP IV GuidelinesThe release of the ATP-4 guidelines meaningfully changes the way the authors manage cholesterol and prevent cardiovascular disease. The broad footprint of retail pharmacies, with their ability to assess risk, prescribe, and manage adherence, allow them to be unique partners in cholesterol management and cardiovascular disease prevention.
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State of Emergency Preparedness for US Health Insurance PlansHealth insurance plans serve a critical role in public health emergencies. The authors queried plans about issues related to emergency preparedness: infrastructure, adaptability, connectedness, and best practices.
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Impact of Electronic Prescribing on Medication Use in Ambulatory CareBoth potential benefits and unexpected consequences were found as a result of the rollout of electronic prescribing.
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Medication Adherence and Use of Generic Drug TherapiesGeneric prescribing was associated with improved medication adherence in 2 of 5 study conditions, but $0 copayments were associated with improved adherence across all conditions.
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Office Manager and Nurse Perspectives on Facilitators of Adult ImmunizationFactors significantly associated with adult vaccination rates in primary care practices were patients’ age, race, scheduled well-visit length, and nurses’ vaccination status.
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Periodic Health Examinations and Missed Opportunities Among Patients Likely Needing Mental Health CareAmong patients likely needing mental health care, two-thirds had no discussion or perfunctory discussion of mental health during periodic health exams.
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A Predictive Model of Hospitalization Risk Among Disabled Medicaid EnrolleesPredictive modeling can be used to identify disabled Medicaid beneficiaries at high risk of future hospitalizations who could benefit from appropriate interventions.
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A Web-Based Clinical Decision Support System for Depression Care ManagementThis article describes the development and capabilities of a Webbased decision support system for care managers working in the context of the chronic care model.
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Levers to Reduce Use of Unnecessary Services: Creating Needed Headroom to Enhance Spending on Evidence-Based CareHealth system leaders, policy makers, payers, and consumer advocates should use multiple synergistic levers to reduce the use of care that does not provide clinical benefit.
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Home Care Program for Patients at High Risk of HospitalizationRandomized controlled trial of a home care program for managed care patients resulted in lower probability of hospital admission and greater patient satisfaction with care.
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Changes in Marketplace Competition and Television Advertising by InsurersThis study provides the first evidence on how Marketplace insurers are altering their marketing in response to changes in competitive pressure over time.
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Treatment Decisions for Complex Patients: Differences Between Primary Care Physicians and Midlevel ProvidersMidlevel providers were significantly less likely than physicians to change blood pressure (BP) treatment for complex diabetic patients presenting with elevated BP at a single visit.
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The Effects of Antihypertensive Step-Therapy Protocols on Pharmaceutical and Medical Utilization and ExpendituresStep therapy with antihypertensives may lead to medication cost savings but may have unintended effects on other medical care utilization and spending.
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Comparison Between Guideline-Preferred and Nonpreferred First-Line HIV Antiretroviral TherapyInitiation of guideline-preferred first-line antiretroviral therapy (ART) was associated with better ART adherence and persistence and similar total healthcare expenditures among Medicaid-insured HIV patients.
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Small Practices' Experience With EHR, Quality Measurement, and IncentivesA study to assess clinician attitudes and experiences after participating in a New York City cardiovascular disease focused quality recognition and financial incentive program using health information technology.
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Comparison of Provider and Plan-Based Targeting Strategies for Disease ManagementThe authors compared targeting strategies and characteristics of chronic disease care management programs delivered by primary care practices with one administered by a large health plan.
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ACO Quality Over Time: The MSSP Experience and Opportunities for System-Wide ImprovementFrom 2013 to 2016, Medicare Shared Savings Program accountable care organizations (ACOs) improved quality. Continued infrastructure development funding, better relationships with postacute care facilities, and shared learnings among diverse ACOs would maximize quality improvement.
