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Latest:
High-Touch Care Leads to Better Outcomes and Lower Costs in a Senior PopulationEvaluating the impact of a high-touch primary care model among a Medicare Advantage population in comparison with a standard practice–based model. Check out our website’s new table/figure pop-up feature! Click on the name of a table or figure in the text to see it in your browser.
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Clinical Characteristics and Treatment Patterns Among US Patients With HIVIt is important to take into account individual complexities such as comorbidities and pill burden when selecting antiretroviral therapy regimens for individuals living with HIV.
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Developing a Composite Weighted Quality Metric to Reflect the Total Benefit Conferred by a Health PlanThe authors developed a weighted quality measure to reflect the total health benefit conferred by a health plan annually to its members.
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ACA Marketplace Premiums and Competition Among Hospitals and Physician PracticesPremiums in federally facilitated Affordable Care Act Health Insurance Marketplaces are higher in geographic areas with more concentrated hospitals and physician practices and fewer insurers.
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Care Coordination for Children With Special Needs in Medicaid: Lessons From MedicareAs increasing numbers of children with special healthcare needs move into Medicaid managed care, health plans can improve care coordination using evidence from Medicare.
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Physician-Specific Variation in Medication Adherence Among Diabetes PatientsPhysician-specific, aggregate patient medication adherence data vary significantly and provide an expanded focus for interventions to improve patient adherence to treatment.
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Opportunities to Improve the Value of Outpatient Surgical CareOutpatient surgeries in the United States account for roughly 7% of annual healthcare expenditures. To exploit substantial opportunities to improve the value of outpatient surgical care, the authors composed an evidence-based care delivery composite for national discussion and pilot testing.
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The Presurgical Episode: An Untapped Opportunity to Improve ValueExpansion of episode of care measurement models to include presurgical care is an added opportunity to improve quality, value, and efficiency in healthcare delivery.
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Shared Medical Appointments for Patients with Type 2 DiabetesGlycemic control in patients with type 2 diabetes was improved through a shared medical appointment program focusing on lifestyle education and behavior change.
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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.
