- Center on Health Equity & Access
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Latest:
Will Regional Differences in Family Practice Procedures Impact Reimbursement Rates? A National Study of Medicare Part BAnalysis of 77,462 family practice providers showed large regional differences in types of procedures performed, and significant differences in submitted charges and payments, across regions.
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Cost-Effectiveness of 21-Gene Assay in Node-Positive, Early-Stage Breast CancerA decision-analytic model was used to estimate cost-effectiveness of adopting a 21-gene assay in treatment decisions for women with early-stage N (1-3)/ER HER2-negative breast cancer.
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Medicare Advantage Coverage Restrictions for the Costliest Physician-Administered DrugsFour large Medicare Advantage insurers manage access to expensive physician-administered drugs with a combination of prior authorization, step therapy, and Part D formulary design.
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Health Information Technology and Physicians' Knowledge of Drug CostsHigh rates of health information technology use by physicians were only modestly associated with better knowledge of drug costs.
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Making Measurement MeaningfulA discussion on meaningful measurement and driving greater value in healthcare, and the role of the National Quality Forum.
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Improving Pneumococcal and Herpes Zoster Vaccination Uptake: Expanding Pharmacist PrivilegesStates offering pharmacists full immunization privileges have significantly higher vaccination uptake rates for pneumococcal disease and herpes zoster than states with restricted or no authorization.
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A Comparison of Relative Resource Use and Quality in Medicare Advantage Health Plans Versus Traditional MedicareCompared with traditional Medicare, relative resource use for those with diabetes or cardiovascular disease is lower in Medicare Advantage, while quality of care is higher.
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Rising Out-of-Pocket Costs Threaten an Already Vulnerable Population: An Introduction to the PAN Foundation and AJMC® Collaborative SupplementThis supplement showcases the winning papers from the PAN Challenge, which aimed to foster conversations about how to rein in out-of-pocket costs to eliminate barriers between patients and their critical medical treatments.
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Oncology Alternative Payment Models: Lessons From Commercial InsuranceDeveloping alternative payment models for commercial populations in specialties such as oncology is rife with practical challenges. Leading payers and practices share lessons to date.
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Cost of Pharmacotherapy for Opioid Use Disorders Following Inpatient DetoxificationThe mean 24-week cost per participant was $5416 for extended-release injectable naltrexone (57% detoxification, 37% medication, 6% provider/patient) and $4148 for buprenorphine-naloxone (64% detoxification, 12% medication, 24% provider/patient).
Latest:
Final Insights on Current Bladder Cancer Clinical TrialsNeal Shore, MD, FACS, shares his final thoughts on the current landscape of clinical trials for both non-muscle-invasive bladder cancer and muscle-invasive bladder cancer, providing insights into the potential impact and future directions of these studies.
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A Claims-Based Algorithm to Reduce Relapse and Cost in SchizophreniaImplementing a claims-based algorithm and disease management program may be an effective strategy to reduce relapse and cost among patients with schizophrenia.
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Screening Cardiac Surgery Patients for MRSA: An Economic Computer ModelRoutine preoperative MRSA screening of cardiac surgery patients could provide substantial economic value to third-party payers and hospitals under a wide range of circumstances.
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Managing Inappropriate Requests of Laboratory Tests: From Detection to MonitoringThis study shows automatic, practical, simple, and effective strategies designed in the laboratory, in consensus with requesting clinicians, to improve laboratory test appropriateness.
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Return on Investment for Bariatric SurgeryThis editorial discusses the cost implication of bariatric surgery and whether or not return on investment analysis should be used to make coverage decisions.
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Implementing a Hybrid Approach to Select Patients for Care Management: Variations Across PracticesHybrid approaches allow for clinician input into case finding for care management, but training and monitoring is required to protect against unintentional biases.
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Promoting Electronic Health Record Adoption Among Small Independent Primary Care PracticesSubstantial outreach efforts are needed in addition to offering subsidies or incentives in engaging primary care providers to adopt electronic health records.
