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Social Determinants of Health Score: Does It Help Identify Those at Higher Cardiovascular Risk?Calculating a social score is feasible and it predicts cardiovascular outcomes. In order to do this, institutions have to collect social determinants of health.
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Intersection of Complexity and High Utilization Among Health Center Patients Aged 18 to 64 YearsThis paper utilizes latent class analysis to identify subgroups of complex conditions and of super-utilizers among health center patients to inform clinically tailored efforts.
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Timely Preterm-Birth Prediction Among Pregnant Women in Medicaid Without Preterm-Birth HistoryA novel prediction model is developed that accurately predicts preterm birth in a timely manner among pregnant women in Medicaid without preterm-birth history.
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Medicaid Expansion, Managed Care Plan Composition, and Enrollee ExperienceMedicaid expansion was associated with substantial changes in Medicaid managed care plan composition, which may influence a plan’s performance on enrollee experience metrics.
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Prior Authorization Requirements for Calcitonin Gene-Related Peptide AntagonistsThis quantitative and qualitative analysis highlights differences in prior authorization requirements for migraine drugs from nearly 50 managed care organizations and summarizes broad types of criteria used.
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Final Panel Thoughts on Uncomplicated UTI ManagementPanelists discuss how the management of uncomplicated urinary tract infections (UTIs) is evolving, with promising new therapies that address antibiotic resistance concerns, while emphasizing the continued importance of antimicrobial stewardship, personalized treatment approaches, preventive strategies, and comprehensive patient education to reduce recurrence rates and improve outcomes in this common but burdensome condition.
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Use of Voluntary Alignment in the Next Generation ACO ModelUse of voluntary alignment attribution by Next Generation Accountable Care Organization (ACO) participants was limited. The authors highlight the reasons and describe organizational use cases via a mixed-methods approach.
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Stuck in Prior Auth Purgatory: The Hidden Costs of Health Care DelaysDelays, denials, and endless paperwork—prior authorization isn’t just a headache for providers; it’s a barrier for patients who need timely care, explains Colin Banas, MD, MHA, chief medical officer with DrFirst.
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Differences in Spending for Diabetes and Multiple Chronic Conditions in Michigan Medicare BeneficiariesDiabetes and multiple chronic conditions increase overall Medicare spending, but spending increases even more in minority beneficiaries compared with White beneficiaries with similar comorbidity combinations.
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Rituximab Reference vs Biosimilar Utilization for Oncology vs Nononcology IndicationsReporting on the real-world utilization of reference rituximab and its biosimilars can help show prescribing habits and reveal cost-saving opportunities.
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Relationships Between Patient Portal Activation and Patient Satisfaction Scores Among CG-CAHPS and HCAHPS RespondentsPatients with activated patient portal accounts report higher patient satisfaction in respective dimensions of the Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) and Hospital CAHPS (HCAHPS) surveys compared with patients without portal accounts.
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Patient-Centered Communication, Disparities, and Patient Portals in the US, 2017-2022From 2017 to 2022, patients with better communication with providers were more likely to report being offered and accessing a patient portal, but disparities persist.
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TPIP a Potential Game-Changer for Prostanoid Therapy in PAHTreprostinil palmitil inhalation powder (TPIP) for pulmonary arterial hypertension (PAH) showed promising results in a midstage clinical trial, significantly improving key measures of heart and lung function.
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Management of MPN: Benchmarks For Quality CareRuben Mesa, MD, leads a discussion on key benchmarks and final thoughts about good-quality care programs for patients with MPNs, including parameters for judging efficacy and safety.
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Contributor: Beyond the Sloganeering—A Data-Driven Analysis of Recent 340B GrowthThis contributor column discusses a recent study that shows the 340B Program’s explosive growth is overwhelmingly due to utilization increases, not price.
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Assessment of Variation in Ambulatory Cardiac Monitoring Among Commercially Insured PatientsAmbulatory cardiac monitors’ clinical and economic outcomes vary; one long-term continuous monitor brand showed greater arrhythmia diagnosis, fewer retests and cardiovascular events, and lower health care resource use and costs.
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An Accelerated Hospital Observation Pathway to Reduce Length of Stay for Patients With COVID-19For select patients hospitalized due to COVID-19, an academic urban hospital implemented an observation pathway that incorporated mobile health technology, reducing hospital length of stay by more than 2 days.
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GPBCH Annual Conference Will Feature Innovation and Policy InsightsEmployers explore innovative strategies at the Greater Philadelphia Business Coalition on Health (GPBCH) Annual Conference, focusing on GLP-1 policies to enhance health care quality and manage costs effectively.
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Leveraging Longitudinal Clinical Laboratory Results to Improve Prenatal CareCollaboration between a clinical laboratory and a managed care organization improved prenatal care and outcomes through real-time, actionable, laboratory-derived insights and care coordination.
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Biosimilar Adoption, Legislative Action With PBMs: JC ScottJC Scott, CEO and president of The Pharmaceutical Care Management Association, discusses current efforts in increasing biosimilar adoption and pharmacy benefit manager (PBM) reform.
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Final Thoughts on Bronchiectasis ManagementPanelists discuss how bronchiectasis is more common than previously thought, with growing awareness, research, and specialized centers improving diagnosis and treatment options, though challenges remain in standardizing care and securing insurance coverage for therapies.
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A Learning Health Care Community: Integrating Research and Practice at ScaleThis article presents a case study of how stakeholders in one state came together to integrate practice and research that is a step beyond a learning health care system.
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Exploring Amivantamab's Potential in Colorectal Cancer: Dirk Arnold, MD, PhDDirk Arnold, MD, PhD, medical director, Asklepios Tumour Biology Centre, discusses the trial design of a study comparing amivantamab with standard chemotherapy to potentially improve treatment outcomes.
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Contributor: Top 3 Future Therapies to Drive Hemophilia Treatment Market GrowthThe trends in the hemophilia treatment market are gaining momentum with increasing incidences of hemophilia A and B and staggering need for their treatments, including gene, anti-tissue factor pathway inhibitor, and factor replacement therapies.
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Proposed Framework for Patient-Centered Outcomes-Based Measures in Alternative Payment ModelsSynthesis of multistakeholder perspectives from a mixed-methods study identifies guiding characteristics for outcomes-based quality measures in future, more patient-centered alternative payment models.
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Contributor: How Health Care Companies Can Use Upskilling to Navigate the Great ResignationThe Great Resignation is sending health care workers out of the industry in massive numbers, and this, coupled with the ongoing transformation of health care, is creating the perfect storm. Alleviating their stress, burnout, and disengagement is a necessary first step. But the proper development, training, and upskilling is also crucial.
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Knowledge, Attitude, and Practices Regarding ChatGPT Among Health Care ProfessionalsThis web-based cross-sectional study indicated that health care professionals in China had poor knowledge, positive attitudes, and proactive practices in regard to ChatGPT.
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Out-of-Pocket Spending for Cardiac Rehabilitation and Adherence Among US AdultsAmong commercial and Medicare supplemental beneficiaries with cost sharing, higher out-of-pocket spending for the first cardiac rehabilitation session was associated with lower program adherence.
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Distinct Health Care Use Patterns of Patients With Chronic Gastrointestinal DiseasesPatients with complex chronic disease can be grouped by varying propensity for health care continuity patterns, which could be harnessed to personalize health care utilization interventions.
