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Latest:
Making Sense of Advanced Payment ModelsThe American Society of Clinical Oncology has developed the Patient-Centered Oncology Payment (PCOP) model with the hope that PCOP will be accepted by CMS as an advanced alternative payment model, and become available to medical oncologists as an alternative to the Merit-based Incentive Payment System.
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Managing Specialty Care in an Era of Heightened Accountability: Emphasizing Quality and Accelerating SavingsThe authors report on a conceptual "specialty ACO" design in cardiology in which cardiology-specific historic spending targets are created to capture cardiovascular disease—related reimbursement and a quality measurement system is introduced.
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Care Coordination to Increase Referrals to Smoking Cessation Telephone Counseling: A Demonstration ProjectAn intervention to increase tobacco treatment rates through care coordination for telephone counseling was effective in raising referral rates and in achieving excellent long-term abstinence.
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Removing a Constraint on Hospital Utilization: A Natural Experiment in MarylandIn 2001, Maryland began to reimburse hospitals for excess volume at full case rates. The authors investigated the impact on hospital utilization and finances.
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Modes of Delivery for Interventions to Improve Cardiovascular Medication AdherenceIn this review of randomized controlled trials designed to improve adherence to cardiovascular medications, electronic interventions and in-person, pharmacy-based interventions showed the highest success rates.
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Enhanced Risk Prediction Model for Emergency Department Use and Hospitalizations in Patients in a Primary Care Medical HomeAn enhanced risk model incorporating medication use, prior healthcare utilization, and mental health with comorbid health conditions predicts healthcare utilization better than health conditions alone.
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Maternal Mental Health and Infant Mortality for Healthy-Weight InfantsTo address infant mortality, focusing only on babies who were born prematurely or with a low birth weight will be missing an attention-worthy segment of the population.
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Functional Status and Readmissions in Unilateral Hip FracturesFunctional status is an important predictor of an acute care readmission in patients who have had a unilateral hip fracture.
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Scheduled and Unscheduled Hospital Readmissions Among Patients With DiabetesThis population-based study examines socioeconomic and clinical factors associated with scheduled and unscheduled readmissions after discharge among older patients with diabetes.
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State Restrictions on Prior AuthorizationMany states are enacting restrictions on insurers’ prior authorization policies, but these laws may increase costs and lead to other undesirable consequences.
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The Impact of Direct Oral Anticoagulants in the Managed Care EnvironmentParticipants will learn about the prevalence, incidence, and economic impact of venous thromboembolism and atrial fibrillation on patients, as well as the associated treatments and clinical data relating to efficacy, safety, and cost-efficacy.
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Analysis of 2016 Connecticut ACO Medicare Shared Savings Program Data to Identify Opportunities for Population Health Pharmacist ServicesPublicly reported Medicare Shared Savings Program accountable care organization (ACO) data can be analyzed to identify cost and medication-related quality performance improvement opportunities to support pharmacist integration into ACO population health services.
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Payer Effects of Personalized Preventive Care for Patients With DiabetesWe examine the effects of MD–Value in Prevention (MDVIP) enrollment on Medicare expenditures and utilization among fee-for-service beneficiaries with diabetes over a 5-year period.
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Leveraging Remote Behavioral Health Interventions to Improve Medical Outcomes and Reduce CostsSuccessful patient engagement in a nationally available, remotely delivered behavioral health intervention can significantly improve medical outcomes and lower healthcare costs.
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Two Steps Forward, One Step Back: 50 Years of Societal Value From LDL-C–Lowering TherapiesLow-density lipoprotein cholesterol (LDL-C)–lowering therapies have yielded significant value to society through reduced costs for both fatal and nonfatal cardiovascular disease events. The vast majority of this value has accrued to patients.
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Association Between Personal Health Record Enrollment and Patient LoyaltyPatients with online access to key components of their personal health records were 2.6 times more likely than nonusers to remain health plan members.
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Longitudinal Adherence to Colorectal Cancer Screening GuidelinesOver a 10-year time frame, longitudinal adherence to current colorectal cancer (CRC) screening guidelines was less than ideal in a large, continuously insured US population at average risk for CRC.
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Community-Based Asthma EducationA retrospective look at the impact of a community asthma education program reveals significant improvements in asthma management and knowledge and decreased healthcare utilization.
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Potential of Risk-Based Population Guidelines to Reduce Cardiovascular Risk in a Large Integrated Health SystemThe authors evaluated the clinical applicability, accuracy, and implications of using an automated risk calculator and risk-based decision tool in an integrated health system.
