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LDL Cholesterol Response and Statin Adherence Among High-Risk Patients Initiating TreatmentNonadherence is common among high-risk patients initiating statins and is associated with suboptimal low-density lipoprotein cholesterol (LDL-C) reduction. LDL-C should be monitored to identify suboptimal response and medication nonadherence.
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Cost Sharing and Branded Antidepressant Initiation Among Patients Treated With GenericsHigher cost sharing is associated with reduced branded antidepressant initiation among patients trying generic therapy. Dynamic benefit designs could enhance access to branded medications when appropriate.
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Patients Discharged From the Emergency Department After Referral for Hospitalist AdmissionHospitalization is costly and associated with the potential for adverse medical events. Hospitalists are uniquely positioned to help avoid unnecessary emergency department admissions through consultation.
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Performance of the Adapted Diabetes Complications Severity Index Translated to ICD-10We present an International Classification of Diseases, Tenth Revision (ICD-10) translation of the adapted Diabetes Complications Severity Index and show its performance in predicting hospitalizations, mortality, and healthcare-associated costs.
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Medicare Advantage Customer Service Is Used Most by Higher-Need PatientsMedicare Advantage customer service supports a less healthy, higher-need population, indicating that it should be designed and staffed to effectively serve complex, high-need patients.
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Cost Burden of Hepatitis C Virus Treatment in Commercially Insured PatientsRates of hepatitis C virus (HCV) treatment in a commercially insured population doubled after availability of new direct-acting antivirals. Member out-of-pocket spending was kept low while the health plan bore 99% of spending on HCV medications.
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Health Plan—Provider Accountable Care Partnerships: How Have They Evolved?Although health plan accountable care models have evolved provider readiness, data, analytics, and the use of performance measurement are important components of plan-provider partnerships.
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Does CAC Testing Alter Downstream Treatment Patterns for Cardiovascular Disease?This article provides an assessment of the downstream impact of coronary artery calcium scanning on the subsequent treatment patterns of non—high-risk patients.
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Comparative Effectiveness Research: Challenges for Medical JournalsIn order to encourage dissemination, this commentary is freely available in PLoS Medicine, and will also be published in Medical Decision Making, Croatian Medical Journal, The Cochrane Library, Trials, and Journal of Clinical Epidemiology.
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The Value of Decreasing Health Cost VolatilityEven if they leave average cost the same, interventions that decrease cost variability have economic value.
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Relationship Between Short-Acting β-Adrenergic Agonist Use and Healthcare CostsOveruse of rescue medication among asthma patients is associated with increased exacerbations and higher total and asthma-related healthcare costs.
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Benchmarking Health-Related Quality-of-Life Data From a Clinical SettingHealth-related quality-of-life data are often collected during routine clinical care. We present a method to create nationally representative benchmarks for clinical subspecialties.
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Lessons Learned in Implementing Behavioral Screening and InterventionThis article describes lessons learned over the past 10 years while helping several dozen primary care settings implement evidence-based, cost-saving behavioral screening and intervention.
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Flunking Asthma? When HEDIS Takes the ACTAsthma control, rather than compliance with the HEDIS asthma measure, is the most useful quality indicator of asthma care.
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Comparative Efficacy of Ezetimibe/Simvastatin, Rosuvastatin, and Atorvastatin in Uncontrolled Hyperlipidemia PatientsEfficacy of switching statin therapy from generic simvastatin was examined in a VA population. Ezetimibe/simvastatin was more potent than atorvastatin or rosuvastatin in lowering LDL.
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ED-Based Care Coordination Reduces Costs for Frequent ED UsersResults of our pilot randomized controlled intervention involving emergency department (ED)-based care coordination and community health workers demonstrated a trend toward fewer ED visits, fewer hospitalizations, and lower costs among intervention patients.
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Out-of-Plan Pharmacy Use: Insights Into Patient BehaviorPrescription cost and pharmacy convenience were identified as the most significant drivers of out-of-plan pharmacy use.
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The Value of Ambulatory Care Measures: A Review of Clinical and Financial Impact from an Employer/Payer PerspectiveThis review suggests that only a few primary care quality measures, which usually are not found in claims data, have significant clinical and financial impact.
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E-Consult Implementation: Lessons Learned Using Consolidated Framework for Implementation ResearchThis paper identified 4 factors associated with implementation success of e-consults in 8 VA medical centers, with implications for implementing similar health IT initiatives elsewhere.
