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Authors
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Optimizing Outcomes for Patients With CKD and T2DMSteps that need to be taken to address unmet needs and optimize outcomes for patients who have chronic kidney disease and type 2 diabetes.
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Primary Care Referrals to Nephrology in Patients With Advanced Kidney DiseasePrimary care physicians did not refer the majority of patients with severe nephropathy to specialists; nonreferred patients had fewer comorbidities and might be better kidney transplant candidates.
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Contributor: Employers Are Turning to Virtual Care Options to Mitigate CostsVirtual care not only means saved time and costs for employees, but improvements to employers' bottom lines, through more proactive management of health concerns, notes UCM Digital Health CEO and co-founder Keith Algozzine.
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Clinical and Economic Outcomes of a Collaborative Cardiology Care ProgramPatients with chronic cardiac conditions benefited from a health care program that strengthened collaboration between general practitioners and cardiology specialists in Baden-Wuerttemberg, Germany.
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Statin Prescribing Patterns in Patient-Centered Medical Home Patients With NAFLDIn this study, authors assessed the proportion of patients with nonalcoholic fatty liver disease (NAFLD) receiving prescriptions for statins in primary care.
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Association of Physician Coordination With Interfacility Transfer Acceptance TimelinessThe authors reviewed physician-to-physician conversations during emergency transfer of patients with ST-segment elevation myocardial infarction and found that higher-quality physician coordination was associated with faster time to acceptance.
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Remote Monitoring Saves Costs in Outpatient Negative Pressure Wound TherapyHealth insurance records of patients using negative pressure wound therapy (NPWT) revealed lower adjusted 90-day wound-related costs with remote therapy monitoring vs NPWT alone.
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An Analysis of Medicare Accountable Care Organization Expense ReportsThe authors of this study examined expense reports to understand how participants in Medicare’s Accountable Care Organization Investment Model spent to achieve program goals.
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Out-of-Pocket Costs for Diabetes Medications in Employer-Sponsored Health Insurance PlansOut-of-pocket costs of diabetes medications other than insulin can be quite high for individuals with employer-sponsored health insurance.
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Empowering Women's Health: Integrated Care and Education With Jessica Horwitz, MPH, FNP-CJessica Horwitz, MPH, FNP-C, emphasizes the importance of accessible preventive care and health education, the interconnectedness of mental and physical well-being, and the need for women, providers, and policymakers to prioritize comprehensive and depoliticized women's health care.
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ACA Dependent Coverage Extension and Young Adults’ Substance-Associated ED VisitsThis study examines the impact of the Affordable Care Act (ACA) on substance-associated emergency department (ED) visits among young adults, revealing reduced alcohol-associated visits but unchanged opioid-associated visits.
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Impact of Food Affordability on Diabetes-Related Preventable HospitalizationMedicaid enrollees residing in counties with greater food affordability had lower odds of preventable hospitalization related to diabetes.
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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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Care Quality Metrics in Medicare During COVID-19 PandemicMedicare Advantage outperformed traditional Medicare on clinical quality measures before and during the COVID-19 pandemic; mid-pandemic, however, traditional Medicare narrowed the gap on some in-person screenings.
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Primary Care Visit Cadence and Hospital Admissions in High-Risk PatientsPatients with congestive heart failure and/or chronic obstructive pulmonary disease who had more quarterly primary care visits had lower rates of hospitalizations during the COVID-19 pandemic.
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Managed Care Cast Presents: Leveraging Topical Therapies for Pediatric Atopic DermatitisExperts discuss how topical therapies effectively manage atopic dermatitis in pediatric patients, enhancing outcomes and addressing unique challenges.
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Scaling Care Coordination Through Digital Engagement: Stepped-Wedge Trial Assessing ReadmissionsThis evaluation looks at a postdischarge digital engagement (PDDE) program using causal inference methods to examine the impact of PDDE on readmission.
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Service Line Care Delivery Model for COVID-19 Patient-Centric CareThe authors provide steps hospitals can take to align their care delivery model to effectively meet the demands of a public health crisis such as the current pandemic.
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Leveraging Patient Activation to Improve Kidney Health in High-Risk PatientsFrequency of patient-provider conversations and patient activation are the 2 most significant predictors of a high-risk patient’s behaviors to prevent kidney disease.
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The Impacts of Supplemental Benefits on Medicare Advantage Plan CompositionAfter evaluating the association between the expanded Medicare Advantage supplemental benefits and plan composition, authors determined that adoption was not associated with large demographic shifts in enrollment.
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The Implementation of Opioid Prescribing Report Cards in Medicaid Managed Care: A Community Quality CollaborativeThis article describes the Philadelphia Medicaid Opioid Prescribing Initiative that was launched by a multidisciplinary team and mailed local Medicaid providers individualized prescribing report cards.
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Managed Care Reflections: A Q&A With Ge Bai, PhD, CPATo mark the 30th anniversary of The American Journal of Managed Care, each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The October issue features a conversation with Ge Bai, PhD, CPA, professor of accounting at Johns Hopkins Carey Business School and professor of health policy and management at Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland.
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Barriers to Adoption of SC TherapiesPanelists discuss how overcoming logistical and perceptual barriers will drive wider adoption of SC therapies in NSCLC.
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Contributor: Objective Documentation Protects Patient Access to Home Oxygen TherapyFacing the challenges created by the COVID-19 pandemic, the US medical community has been forced to rapidly change and modernize the manner in which it delivers health care over the last year-and-a-half.
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Advanced Care at Home at Scale in an Integrated Health Care SystemAdvanced care at home (otherwise known as hospital at home) can be scaled and provide care for a sizable portion of a hospital’s inpatient census, creating hospital capacity in an integrated delivery system.
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A Case-Control Study of Length of Stay OutliersLength of stay outliers are associated with hospital-acquired infections, complications, and discharge to facility, as opposed to nonmodifiable risk factors like age and comorbidities.
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Impact of COVID-19 Pandemic on Accessibility of Taiwanese Medical CareThe COVID-19 pandemic disrupted access to routine medical care in community populations in Taiwan. The unmet needs should be emphasized as normal life resumes.
