The majority of orphan drugs are subject to utilization controls in Medicare Part D plans. The use of utilization controls varies by certain drug characteristics.
Some of the nation’s strictest provider network regulations have led to neither high rates of provider directory accuracy nor timely access to mental health care.
In this discussion, panelists offer their final thoughts.
Generic use has increased over time in Medicare Part D, but substantial variation across plans persists in a number of common classes.
This article presents a detailed descriptive analysis of how Massachusetts and Minnesota implemented Medicaid accountable care organization (ACO) models for their managed care population.
Home administration of oral paclitaxel and encequidar is associated with potential cost savings for payers compared with clinic administration of intravenous chemotherapy in metastatic breast cancer patients.
Long-term tele-messaging was more effective than no messaging and short-term messaging for positive airway pressure use, and it was highly likely to be cost-effective with an acceptable willingness-to-pay threshold.
Ethical analysis of population health management calls for a communitarian vs individual approach, starting with reconceiving “covered lives” as “patient communities.”
This analysis of health insurance claims data demonstrates rapid increase and sustained high utilization of telemedicine services during the COVID-19 pandemic.
Medicaid expansion was associated with a reduction in the racial disparity in timely treatment of patients with advanced cancer in the United States.
Few eligible individuals apply for the Advance Premium Tax Credit due to knowledge barriers. Additionally, specific sociodemographic characteristics appear to predict applying status.
Antiviral treatment was associated with lower health care resource utilization and costs in patients with type 2 diabetes and a diagnosis of influenza.
This counterfactual simulation study on a nationally representative sample of the working population with musculoskeletal conditions estimated the value of patient-initiated virtual physical therapy.
Patients with chronic cardiac conditions benefited from a health care program that strengthened collaboration between general practitioners and cardiology specialists in Baden-Wuerttemberg, Germany.
COVID-19 vaccine hesitancy is not associated with health literacy. Personal perception of threat was associated with reduced vaccine hesitancy.
Direct access of primary care physicians to dermatologists via asynchronous teledermatology improves a health system’s ability to increase patient access to dermatologic care.
Private negotiated facility fees at hospitals are on average double the ambulatory surgery center facility fees for common outpatient procedures.
When comparing risk-adjustment approaches based on Medicaid status of Medicare beneficiaries, this analysis found that predicted spending levels varied depending on states’ Medicaid eligibility criteria.
Research presented at CHEST 2024 examined the effect of steroid choice on individuals who have a dual diagnosis of heart failure and chronic obstructive pulmonary disease (COPD).
An investigation of management patterns after initial radiographic diagnosis of small renal masses showed that early urologist referral was associated with guideline-concordant care.
Our hospital is a primary hospital in Chengdu, China. Since February 5, our hospital has been listed as the primary designated medical unit for treating new patients with coronavirus disease 2019 (COVID-19) in Jinniu District. In this letter, we share our COVID-19 experience with readers.
The authors developed and validated an accurate, well-calibrated, easy-to-implement COVID-19 hospitalized patient deterioration index to identify patients at high or low risk of clinical deterioration.
Diverse patients experience disparities in care transitions. A survey of 224 patients showed differences by race, ethnicity, and language in technology access and in patient worries post discharge.
Construction of a composite measure, use of a summary disparity statistic, and measure selection are key considerations in the design of equity-focused payment programs.
The cost avoidance of heart failure–related hospitalizations and emergency department visits may outweigh the additional drug cost in Medicaid members adherent to sacubitril/valsartan.
A survey completed by 100% of leaders of diverse care systems in Minnesota participating in an observational study showed little difference in approach to care coordination.