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Authors
Latest:
Electronic Health Record Problem Lists: Accurate Enough for Risk Adjustment?Electronic health record (EHR)-based comorbidity assessment had low sensitivity for identifying major comorbidities and poorly predicted survival. EHR-based comorbidity data require validation prior to application to risk adjustment.
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The Hospital Tech Laboratory: Quality Innovation in a New Era of Value-Conscious CareTechnology innovation drives expenditures. A Michigan Medicine, IBM, and AirStrip partnership demonstrates the hospital’s role in developing transformative technologies that deliver value.
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Care Coordination for Veterans With COPD: A Positive Deviance StudyImproving relational coordination and reducing structural barriers to collaboration may enhance quality of care for chronic obstructive pulmonary disease (COPD) and other chronic conditions.
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Cost Minimization of Medicare Part D Prescription Drug Plan ExpendituresStudy results indicate that outreach interventions performed by trained student pharmacists assist Medicare beneficiaries to effectively navigate their Part D benefit, thereby reducing out-of-pocket costs.
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Medicare Inpatient and Postdischarge Outcomes of Elective Percutaneous Coronary InterventionsAn understanding of risk-adjusted outcomes for percutaneous coronary interventions for both inpatient and 90-day postdischarge events is necessary for the redesign of care outcomes.
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Are Medical Offices Ready for Value-Based Reimbursement? Staff Perceptions of a Workplace Climate for Value and EfficiencyThis study surveyed 840 clinical and nonclinical staff in 96 medical offices regarding workplace policies and procedures that facilitate a climate for value.
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Understanding the Social Risk Factor Adjustment’s Effect on Star RatingsThis article examines how CMS’ adjustment for social risk factors affects the Medicare Advantage Star Ratings and the type of contracts affected by the adjustment.
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CHAPTER 3. Guideline for Detection and Management of Diabetes in PregnancyFrom the Adult Diabetes and Clinical Research sections, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts
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Automating Care Quality Measurement With Health Information TechnologyThe authors discuss the design and evaluation of a health information technology platform that enables comprehensive, automated assessment of care quality in electronic medical records.
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Characteristics and Medication Use of Veterans in Medicare Advantage PlansVeterans enrolled in Medicare Advantage plans differed from fee-for-service sector enrollees in several demographic, geographic, and clinical characteristics and in patterns of medication use.
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Understanding Factors Associated With Increases in Medicare Advantage Enrollment, 2007-2018Increases in Medicare Advantage market share over the past 10 years are largely caused by an increased preference for managed care among Medicare beneficiaries.
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The Diagnosis for Diagnostics: Changes to Medicare Payment and Coverage of Clinical Laboratory TestsThe basis for determining Medicare payment rates for clinical diagnostic laboratory tests is changing. These changes will be important for all payers and providers to follow for future reimbursement and contract negotiations.
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Moving Pharma Contracting Into the Era of AccountabilityA chief medical officer for a major payer outlines the challenges making sure that certain high-cost therapies are directed to the patients who need them.
