In Medicare Part D, generic drug coverage was cost saving compared with no coverage in bipolar disorder and schizophrenia while improving health outcomes.
Predictive models from diagnostic or medication data identify care management candidates who are more amenable to clinical interventions than groups identified using prior cost alone.
This study describes a widespread variation in medication adherence, pharmacy cost sharing, and medical spending. Increased cost sharing may decrease adherence and increase total diabetes spending.
Value-based payment improved fidelity to key elements of the Collaborative Care Model—an evidence-based mental health intervention—and improved patient depression outcomes in Washington state.
This article compares clinical and utilization profiles of Medicare patients who are attributed to provider groups with those of patients unattributed to any provider group in accountable care organization models.
Health information technology that is implemented as part of a multifaceted quality improvement initiative can lead to improvements in hypertension care and outcomes.
The authors found that comorbidity burden and the direction of behavioral change influence the relationship between adherence and medical spend. This could affect the cost-benefit considerations of medication adherence programs.
This article describes the positive impact that actively managing functional recovery has on postacute placement for patients undergoing coronary artery bypass surgery.
Adjusting for patients' covariates, postoperative complications and mortality among geriatric surgical patients exhibited an age-dependent, illness-related, and preoperative medical expense“associated pattern under universal healthcare coverage.
Elderly Medicare Advantage members with multiple chronic conditions attained a survival benefit from more cost-effective care when a private plan developed gainshare and monetary risk-bearing arrangements with its contracted providers.
The objective of this work is to improve the quality of patient care in the admission office service of the University Hospital Virgen del Rocío (HUVR) by standardizing and systematizing its procedures using Lean methodology. The results have allowed HUVR to achieve continuous improvement in the process, eliminating the elements that do not add value.
Patients, caregivers, and providers need education on immunotherapy treatment, support in patient-provider communications as well as support in mitigating the financial impact of immunotherapy treatment.
Implementing systemwide dissemination of feedback reports to primary care physicians in an integrated delivery system may be associated with changes in medical resource use.
Disease management programs for diabetes can improve some processes of care, but they do not improve intermediate outcomes beyond doubt.
This study quantified the trends over time in utilization of, spending on, and access to CT fractional flow reserve, the first artificial intelligence (AI)–enabled clinical software reimbursed by Medicare.
Patients with atrial fibrillation receiving routine medical care within a large managed care organization were found to have suboptimal anticoagulation control.
Marketplace consumers desire more health plan measures on how well plans support long-term patient—physician relationships. Consumers are skeptical of measures about rewarding providers for high quality.
The authors discuss how more efforts need to ensure the methods used to measure the “value” of new therapies include factors that reflect patient heterogeneity.