A retrospective claims analysis showed that synchronized refill schedules were associated with better medication adherence among Medicare Advantage patients taking multiple maintenance medications.
A decision-making framework that can be used to harmonize the evidence payer's desire for coverage and formulary decisions with the evidence generated by researchers.
In order to live up to their potential, ACOs should ensure that clinical staff possess the professional skills necessary to effectively coordinate care.
This article provides a description of prospective financial simulation methodology and use cases with empirical data for episode-based bundled payments, including implications for contract negotiations and value-based care redesign.
Omission of radiation therapy after breast-conserving surgery leads to poor outcomes. Geographic isolation and scarcity of healthcare specialists correlate with low adjuvant radiation therapy use.
Postacute care partners are required for successful patient transitions. Collaboration among multidisciplinary teams and community resources is critical for discharge planning and partnership alignment.
In this reply to the commentary, “A Call for a Statewide Medication Reconciliation Program,” published in the October 2016 issue of The American Journal of Managed Care®, authors discuss a proven and scalable solution to improve medication reconciliation that is already available to, and used by, clinicians.
Costly new breast cancer therapies augment the significant burden this disease places on healthcare resources, but in context they may still provide value to society.
Atrial fibrillation patients with mental health conditions are less likely to be eligible for warfarin receipt, and those who are eligible receive warfarin at lower rates.
Improving adherence to long-term medication therapy remains a challenge. Health information technology interventions that leverage electronic medical records are promising, low-cost approaches for increasing adherence.
Findings suggest that some at-risk patients may not be receptive to in-home transition interventions and that opting out may be associated with higher odds of hospital readmission.
Researchers calculated savings available to healthcare insurers if providers of obstetrical services avoided the performance of early elective deliveries. The calculations illustrate a considerable savings.
The authors' study identifies a key factor, management quality, which modifies the association between electronic health record adoption and hospital performance.
Through literature review and collaborative design, we propose the Focus, Activity, Statistic, Scale type, and Reference (FASStR) framework to provide a systematic approach to health care operation metric definition and use.
Financial barriers to behavioral health integration in Oregon Medicaid accountable care organizations (ACOs) limit opportunities to expand integrated care, but state and organizational opportunities exist.
Arkansas has implemented multi-payer payment reform incorporating both episodic and Patient-Centered Medical Home models. Early perceptions of a sample of stakeholders were largely positive to date.
Institution of paperless credentialing is analyzed on a pre-/post-implementation basis to understand the impact on business and productivity.
Small practices with NCQA patient-centered medical home recognition perform better on quality measures, especially those related to chronic conditions.
New value frameworks should incorporate real-world evidence that reflects patient treatment behavior, adherence to medication, and equity concerns arising from disparities in care.
The authors investigated multi-sectoral healthcare alliance responses to the ACA and whether these responses differed between states supportive and unsupportive of health reform.