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Dual-Eligible Beneficiaries and Inadequate Access to Primary Care ProvidersStates with the most restrictive scope-of-practice laws have an inadequate supply of primary care clinicians to serve a high concentration of dual-eligible beneficiaries.
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Experience Incentivizing Reduction of Racial and Ethnic Disparities in a Medicaid Hospital Quality Incentive ProgramConstruction of a composite measure, use of a summary disparity statistic, and measure selection are key considerations in the design of equity-focused payment programs.
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Modeling Financial Outcomes and Quantifying Risk in Episode-Based Payment ModelsThis 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.
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Trends in Electronic Health Record Capabilities for Tracking Documentation TimeThis study examines trends in hospitals’ access to and use of data from electronic health record (EHR) developers that quantify clinicians’ time spent documenting clinical care in EHRs.
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Recent Cohorts Aging Into Medicare Use More Counseling and Psychotherapy Than Past CohortsAdults currently aging into Medicare utilized counseling and psychotherapy services at higher rates than those in prior cohorts at the same age.
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Insurer Costs of COVID-19 by Disease Severity and DurationPayer costs for COVID-19 ranged from a mean of $505 for asymptomatic cases to $126,094 for severe cases with post–COVID-19 condition.
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Digital Musculoskeletal Program Is Associated With Decreased Joint Replacement RatesAdults with osteoarthritis who took part in a digital musculoskeletal program had lower rates of knee and hip arthroplasty at 12 months vs those using traditional care.
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Patient Satisfaction With Letter-Based Communication of LCS Pulmonary Nodule ResultsPatients 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.
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Predicting Hospitalizations for Patients With Chronic Kidney DiseaseThe authors developed an algorithm that uses medical claims to identify patients with chronic kidney disease who are at greatest risk of being hospitalized within 90 days.
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Rheumatoid Arthritis Medication Adherence in a Health System Specialty PharmacyIntegrated health system specialty pharmacies provide specialized services to patients, resulting in high rates of adherence to and financial assistance with specialty disease-modifying antirheumatic drugs.
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Service Line Care Delivery Model for COVID-19 Patient-Centric CareThe authors provide steps hospitals can take to align their care delivery model to effectively meet the demands of a public health crisis such as the current pandemic.
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Treatment Patterns for Patients With Advanced/Metastatic Cancers by Site of CareTreatment patterns and overall survival were similar regardless of site of care between patients receiving anticancer therapy in the hospital outpatient vs physician office setting.
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The Relationship Between Preventive Dental Care and Overall Medical ExpendituresUsing an instrumental variable approach, this study is the first to present causal estimates of the effect of preventive dental visits on overall medical expenditures.
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Primary Care Case Conferences to Mitigate Social Determinants of Health: A Case Study From One FQHC SystemThis article describes perceived benefits, facilitators, and challenges of conducting interprofessional team case conferences in primary care settings to address patients’ complex social needs.
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Cold Agglutinin Disease: Clinical PearlsTake-aways from a discussion on the management of cold agglutinin disease, with expert insight on navigating the healthcare system to optimize patient care.
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Hospitals’ Strategies to Reduce Costs and Improve Quality: Survey of Hospital LeadersHospitals pursue a broad range of efforts to improve quality, with those participating in bundled payments attempting to reduce postacute care to a greater degree than nonparticipants.
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A Data-Based Foundation for Managing Hypertension ServicesAnalysis of more than 16 million visits for hypertension care suggests that a large fraction of face-to-face care is low value and could be provided differently or potentially eliminated.
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Intersection of Complexity and High Utilization Among Health Center Patients Aged 18 to 64 YearsThis paper utilizes latent class analysis to identify subgroups of complex conditions and of super-utilizers among health center patients to inform clinically tailored efforts.
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Association of 340B Contract Pharmacy Growth With County-Level CharacteristicsThe growth of 340B contract pharmacies since 2010 is unprecedented. This study’s findings suggest that patterns of growth differ between safety-net clinics and hospitals.
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Merck Files Lawsuit to Halt Medicare Drug Price NegotiationsAccording to a spokesperson, Merck is prepared to take the lawsuit to the Supreme Court as it challenges drug price negotiations as part of the Inflation Reduction Act.
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It’s Time to Address Our Nation’s Health Care Price CrisisThis commentary introduces Catalyst for Payment Reform’s and the Employers’ Forum of Indiana’s new campaign, Price Crisis, which will mobilize individuals, employers, and policy makers with evidence, guidance, and resources to take meaningful actions.
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Integrating Primary Care and Public Health for Advance Care PlanningThis article proposes a new model, Public-Primary ACP, that leverages coordination between primary care and public health workforces to improve delivery of advance care planning.
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Safety vs Price in the Generic Drug Market: MetforminThe 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.
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Population-Based Return on Investment of Deploying Transient ElastographyDeploying vibration-controlled transient elastography/controlled attenuation parameter devices at the population level is a financially advantageous solution to address the epidemic of fatty liver disease.
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Challenges With Implementing the Diabetes Prevention Program for Medicare Beneficiaries in an Integrated Health SystemThis study presents challenges of implementing the CDC-approved Diabetes Prevention Program for Medicare beneficiaries at a large, integrated health care delivery system.
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Approaches for Overcoming Barriers to Cross-Sector Data SharingThe authors identified challenges to cross-sector data sharing and the approaches used to overcome these challenges in the Mid-Ohio Farmacy, a partnership to address food insecurity.
