Under preferred pharmacy networks, unsubsidized Part D beneficiaries faced substantial incentives and moderately switched toward preferred pharmacies, whereas subsidized beneficiaries were insulated and demonstrated little switching.
Small practices reduced their use of telemedicine during early stages of the COVID-19 pandemic. Technical support may help expand and maintain telemedicine in small practices.
The sustained, collaborative effort to expand Medicaid will improve the lives of working North Carolinians who, prior to enactment, earned too much to qualify for Medicaid, but not enough to afford insurance on the marketplace.
Longitudinal evaluation of an advanced primary care reform effort found some improvements in health information technology (IT) offerings and use as well as opportunities to improve future collaboration.
High-tier generic drug placement in Medicare Part D has increased over time, but it may be related to a drug’s clinical profile and availability of substitutes rather than preferred brand-name drug coverage.
Rising Medicare Advantage enrollment occurred alongside declines in enrollment in traditional Medicare with employer-sponsored supplemental coverage and traditional Medicare without supplemental coverage.
Promoting health equity isn’t only about consideration of underlying health risks; it’s also about using that data to inform population care as well as give clinicians and their teams more time with the patient in front of them.
Medicare Advantage members referred to home health after acute hospitalization who did not receive home health services had higher mortality at 30, 90, and 180 days.
The generic drug market focuses on price. However, multiple generic metformin drugs have been recalled due to poor drug quality. The authors examine price and quality after these recalls.
Patients were satisfied with receiving their lung cancer screening (LCS) pulmonary nodule results via letter and considered the amount of information provided in the letter appropriate.
The authors detail how artificial intelligence could be used in primary, secondary, and tertiary prevention to improve health outcomes and provide better value-based care.
The expert panel discusses the greater potential for private label biosimilars.
A targeted cue-to-action campaign of outreach, education, and incentive can improve uptake of screening mammography.
The authors of this study examined expense reports to understand how participants in Medicare’s Accountable Care Organization Investment Model spent to achieve program goals.
This article describes the findings of an observational study carried out in India to examine the clinical profile of individuals detected to be COVID-19 positive post vaccination.
Telephone visits may offer a simple and convenient option to address patient primary care needs without raising safety concerns.
Looking to the future of Alzheimer disease treatment, the panel discusses key takeaways on the evolving therapeutic landscape.
People experiencing homelessness face significant barriers to health care access, leading to higher rates of hypertension even among those with health insurance.
A health system transformational leadership framework and management system made visible and eliminated defects in value and was associated with reduced annual Medicare expenditures and increased quality between 2017 and 2020.
Baloxavir, compared with oseltamivir, was associated with lower health care resource utilization and costs in patients with influenza, particularly those at high risk of secondary complications.
2016-2018 Next Generation Accountable Care Organization (ACO) and Medicare Shared Savings Program cost and quality data show similar performance, suggesting that increasing financial risk to health systems may not affect performance.
Medicaid enrollees residing in counties with greater food affordability had lower odds of preventable hospitalization related to diabetes.
The Migraine Impact Model is an interactive calculator that estimates migraine prevalence within a workforce and the associated economic burden of migraine on the employer.
This article describes the Philadelphia Medicaid Opioid Prescribing Initiative that was launched by a multidisciplinary team and mailed local Medicaid providers individualized prescribing report cards.
This study observed a rapid increase in the integration of telehealth- and COVID-19–related apps with electronic health records during the COVID-19 pandemic.
Disease burden estimates of pneumonia-associated hospitalizations are more sensitive when including pneumonia coded in any diagnosis field vs in only the first discharge diagnosis field.
Prediction models combining claims data with social determinants of health and additional, more-timely data sources using artificial intelligence (AI) can better identify individuals with the highest future medical spending.
To deliver on the promise of value-based care, organizations need to return to the fundamental objective: to deliver high-quality, affordable care to our communities.