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Latest:
Impact of a Medical Home Model on Costs and Utilization Among Comorbid HIV-Positive Medicaid PatientsAmong HIV-positive Medicaid patients with comorbid medical and psychiatric disorders, there was increased outpatient service utilization, yet relative cost savings, for patients who were treated in patient-centered medical homes.
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Variations in the Service Quality of Medical PracticesService quality (appointment lags and wait times) of primary care physician practices varies tremendously across the country and is associated with the organization of practices.
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The Option Value of Innovative Treatments for Non–Small Cell Lung Cancer and Renal Cell CarcinomaOption value is the benefit a therapy provides patients by enabling them to survive to the next innovation.
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New Thinking on Clinical Utility: Hard Lessons for Molecular DiagnosticsThe authors describe 5 basic requirements for planning, implementing, and proving clinical utility for diagnostic tests, drawing on recent reimbursement decisions.
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Physician Satisfaction With Health Plans: Results From a National SurveySeveral physician and payer characteristics are associated with physician satisfaction with health plans. There is opportunity to improve physician satisfaction with payers, specifically in pharmacy.
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Relationship Between Quality Improvement Processes and Clinical PerformanceThis study examines the clinical effects of care management and quality improvement interventions implemented by physician groups on pay-for-performance success.
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Effectiveness of Care Coordination and Health Counseling in Advancing IllnessThis prospective trial suggests that specialized care coordination and health counseling for patients coping with advanced stages of 4 life-limiting illnesses can be beneficial.
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Hospital Readmission Rates in Medicare Advantage PlansHospital readmission rates in Medicare Advantage plans are considerably lower than those in Medicare's traditional fee-for-service program, after accounting for differences in risk.
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Prioritized Post-Discharge Telephonic Outreach Reduces Hospital Readmissions for Select High-Risk PatientsA randomized control study that analyzes the impact of a postdischarge prioritization case management strategy on readmissions for select high-risk patients that are commercially insured.
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Successful Implementation of APSO Notes Across a Major Health SystemIn this study, the authors demonstrate widespread adoption and satisfaction with the novel APSO (Assessment, Plan, Subjective, Objective) format for progress notes at a large, integrated health delivery network.
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Coverage With Evidence Development: Where Are We Now?Review of CMS’ coverage with evidence development program exposes a need to improve program transparency and clarify requirements and timetables for reporting to improve access to novel therapies.
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The Personal Financial Burden of Cancer for the Working-Aged PopulationBeing actively treated for cancer increases the mean annual out-of-pocket medical expenditures by $1170 compared with not having cancer.
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Economic Evaluation of an Internet-Based Weight Management ProgramAn Internet-based weight management program provides a cost-effective alternative for weight management.
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Predictive Model for Emergency Hospital Admission and 6-Month ReadmissionPredictive models for hospital admissions and readmissions in persons aged >65 years have been developed through a combination of comorbidity and previous healthcare use.
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Potential of Risk-Based Population Guidelines to Reduce Cardiovascular Risk in a Large Integrated Health SystemThe authors evaluated the clinical applicability, accuracy, and implications of using an automated risk calculator and risk-based decision tool in an integrated health system.
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High-Deductible Insurance: Two-Year Emergency Department and Hospital UseHigh-deductible health plan members had sustained reductions in emergency department visits over 2 years but initial reductions in hospital utilization and costs were not sustained.
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Biosimilars and Employers: Strategies for SuccessThis article first appeared on The Center for Biosimilars®.
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Impact of Clinical Oral Chemotherapy Program on Wastage and HospitalizationsAn oral chemotherapy cycle management program offers clinical support, reduces medication wastage, and provides management of adverse effects to realize cost savings for payers and patients.
