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Authors
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Eliminating Defects in Value: Turnaround of an MSSP ACOA health system transformational leadership framework and management system made visible and eliminated defects in value and was associated with reduced annual Medicare expenditures and increased quality between 2017 and 2020.
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Clinical Profile of COVID-19 Infection in Postvaccination IndividualsThis article describes the findings of an observational study carried out in India to examine the clinical profile of individuals detected to be COVID-19 positive post vaccination.
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Cyclosporine Ophthalmic Solution Safe, Accessible in Uncontrollable Dry EyeMichelle Hessen, OD, discusses how cyclosporine ophthalmic solution 0.09% is safe to use in patients with dry eye, as well as where future research should turn.
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Impacts of Community-Based Care Program on Health Care Utilization and CostA community-based care management program in Rhode Island reduced hospitalizations and inpatient costs. There were stark differences across subgroups based on intensity of care.
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High-Risk Care Management Impact on Medicaid ACO Utilization and SpendingIn Massachusetts’ largest Medicaid accountable care organization (ACO), high-risk care management significantly reduced spending, emergency department visits, and hospitalizations, demonstrating that targeted strategies can manage health care costs amid budget constraints.
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Longitudinal, Relationship-Based Case Management: A Prospective Cohort TrialA longitudinal, relationship-based case management approach significantly reduced health care costs and improved quality of life for Medicaid enrollees with complex needs over 1 year.
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Opportunities and Obstacles Associated With the Medicare Diabetes Prevention ProgramThis study describes the current opportunities and obstacles associated with Medicare Diabetes Prevention Program implementation from the novel perspective of program suppliers across the US.
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Hospital Performance in a Statewide Commercial Insurer Episode-Based Incentive ProgramSome hospitals were able to outperform others in a commercial insurer episode-based incentive program, but there was little evidence of global reductions in episode spending.
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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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Experts Say FDA Approval of Perioperative Durvalumab Plus FLOT Sets New Standard of Care for Early-Stage Gastric, GEJ CancersAs the first immunotherapy option in this setting, the approval sets a new standard for resectable early-stage gastric and gastroesophageal junction (GEJ) cancers.
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Cost Savings Associated With a Web-Based Physical Activity Intervention for COPDThe authors modeled costs associated with a pedometer-based, web-mediated physical activity intervention compared with a pedometer alone for chronic obstructive pulmonary disease (COPD) management. The intervention was cost-saving.
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Contributor: The “VET PFAS Act 2023” Promises Disability Benefits to PFAS-Exposed VeteransThe VET PFAS Act could help older veterans with toxic exposure attain the medical treatment they need by expanding eligibility.
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ACA Medicaid Expansion Association With Racial Disparity Reductions in Timely Cancer TreatmentMedicaid expansion was associated with a reduction in the racial disparity in timely treatment of patients with advanced cancer in the United States.
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Clinical and Economic Outcomes of a Collaborative Cardiology Care ProgramPatients with chronic cardiac conditions benefited from a health care program that strengthened collaboration between general practitioners and cardiology specialists in Baden-Wuerttemberg, Germany.
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Predicting Mortality Risk Using the PREVENT Equation Across Diverse Racial GroupsThis study validates the Predicting Risk of CVD Events (PREVENT) score across diverse racial and ethnic populations, highlighting its effectiveness in predicting cardiovascular risk and mortality, regardless of race or ethnicity.
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Medication Adherence Star Ratings Measures, Health Care Resource Utilization, and CostFor patients prescribed diabetes, hypertension, and hyperlipidemia medications, nonadherence to CMS Star Ratings quality measures of medication adherence was associated with increased health care resource utilization and costs.
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Glucose-Lowering Treatment Patterns in Patients With Diabetic Kidney DiseaseReal-world treatment of diabetic kidney disease in the United States, based on national-level health care claims and electronic health records data, is inconsistent with the current guidelines.
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Managed Care Reflections: A Q&A With Charles N. (Chip) Kahn III, MPHTo mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The August issue features a conversation with Charles N. (Chip) Kahn III, MPH, the president and CEO of the Federation of American Hospitals and a longtime member of the AJMC editorial board.
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Reducing Delays in Breast Cancer Care Using an Innovative Digital Health PlatformThe use of a novel digital health platform achieved a 55% reduction in time to treatment among women with a new diagnosis of breast cancer.
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Amazon Pharmacy: Distraction or Disruption?After years of anticipation, Amazon Pharmacy launched in November 2020. The question is now: Is this market entry a disruption, a distraction, or something in between?
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Medication Persistence and Its Impact on Type 2 DiabetesMost newly treated patients with type 2 diabetes exhibit suboptimal medication persistence, which is associated with higher risk of hospitalization and increased medical costs.
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Higher-Dose Nusinersen Meets Primary End Point in Phase 2/3 DEVOTE Study for Spinal Muscular AtrophyBased on the positive topline data, the company plans to submit for regulatory approval for a higher dose of nusinersen for spinal muscular atrophy (SMA) treatment.
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Assessing Utilization of a Marketwide Price Transparency ToolConsumers strategically used a price transparency tool by searching more often in procedure markets with provider-specific information, higher charges, and more out-of-network claims and provider competition.
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Financial Impact of Telehealth: Rural Chief Financial Officer PerspectivesInterviews with chief financial officers of rural hospitals revealed that they perceived telehealth to have some financial advantages; however, they did not believe that telehealth improved their hospitals’ financial situations.
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Specialty and Operator Status Influence Electronic Health Record Use VariationOperators demonstrated specialty-specific differences in electronic health record efficiency, timeliness, and after-hours use, highlighting how workflow and training shape documentation behaviors across medical disciplines.
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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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Redesigning Trials for Real-World Patient Complexity: A Q&A With Prerna Mewawalla, MDPrerna Mewawalla, MD, discusses innovative strategies to enhance cancer care access, reduce clinician burden, and improve clinical trial diversity in real-world settings.
