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Characteristics of Home-Based Care Provided by Accountable Care OrganizationsAccountable care organizations (ACOs) deliver a diverse array of home-based services, but many of the services are not reimbursed. ACOs may not expand these programs without strong evidence of cost savings.
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Development and Pilot Testing of Guidelines to Monitor High-Risk Medications in the Ambulatory SettingPilot testing of guidelines for the laboratory monitoring of high-risk medications shows that monitoring is highly variable and that there is room for improvement.
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Medicaid Prior Authorization and Opioid Medication Abuse and OverdoseEnrollees in Medicaid plans employing prior authorization policies for opioid medications may have lower rates of opioid medication abuse and overdose.
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Medical Care Costs Among Patients With Established Cardiovascular DiseaseThe economic burden of providing care to patients with cardiovascular disease, driven by secondary hospitalizations, may be substantially greater than current American Heart Association estimates.
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Relationship of Diabetes Complications Severity to Healthcare Utilization and Costs Among Medicare Advantage BeneficiariesThis retrospective cohort study in a Medicare Advantage population posits that type 2 diabetes mellitus complications pose an excess burden on healthcare resource use and related costs.
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Changes in Premiums of Cancelled Nongroup Plans Under the Affordable Care ActSubscribers migrated to Affordable Care Act—compliant plans with modestly higher costs, but had higher levels of insurance coverage and stronger consumer protections.
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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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Current Evidence and Controversies: Advanced Practice Providers in HealthcareThe authors compare advanced practice providers’ education, training, scope of practice, and quality of care with that of physicians. A framework is essential to promote team-based primary care.
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Medicare’s Bundled Payment Model Did Not Change Skilled Nursing Facility Discharge PatternsHospital participation in Medicare’s Bundled Payments for Care Improvement model was not associated with changes in number of skilled nursing facility (SNF) partners or in SNF discharge concentration.
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Prognostic Factors of Mortality Among Patients With Severe HyperglycemiaSepsis, renal impairment with electrolyte imbalance, and low blood pressure were independent prognostic factors of mortality among patients with severe hyperglycemia in the emergency department.
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Evaluating a Hepatitis C Quality Gap: Missed Opportunities for HCV-Related CareManagement of hepatitis C screening results can be optimized to ensure that patients receive high-quality care, reducing morbidity and costs related to the virus.
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Do Electronic Medical Records Improve Diabetes Quality in Physician Practices?Policy makers should not expect public sector electronic medical record investments to yield substantial short-term improvements in publicly reported measures.
