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Latest:
Comparison of Primary Payer in Cancer Registry and Discharge DataEnrollment in managed care among Medicaid enrollees presents challenges to classifying Medicaid coverage in cancer registries.
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How Do Primary Hospitals Enact Early Response to the Relaxation of COVID-19 Prevention and Control Measures? The Experience From Chengdu, ChinaThis article examines how primary hospitals in Chengdu, China, responded to the relaxation of COVID-19 prevention and control measures in December 2022.
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Contributor: For Complex Cases, Continuity in Acute Care Is NecessaryFor patients with complex needs and social challenges like unstable housing, the hospital has become their de facto medical home—yet each visit is a fragmented restart, without continuity, context, or a clear path forward.
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Experts Push to Preserve Telehealth, Payment Parity Post PandemicExperts agree that the expansion of telehealth was one of the most significant positive outcomes of the COVID-19 pandemic.
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Addressing STIs Through Managed Care: Opportunities in Medicaid and BeyondMedicaid and other managed care organizations could take several key steps to respond to the sexually transmitted infection (STI) epidemic in the US, including congenital syphilis.
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Managed Care COVID-19 Outcomes in a Population Health ProgramData from 38,193 patients showed that managed care patients have COVID-19 risk factors similar to those of the general population and that a population health program decreased mortality.
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Outcomes in Patients With IBD Stratified by Risk of Disease ProgressionThis study validates criteria to identify patients with inflammatory bowel disease (IBD) at risk of worsening disease who may benefit from early treatment with advanced therapies.
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Cost Savings Associated With a Web-Based Physical Activity Intervention for COPDThe authors modeled costs associated with a pedometer-based, web-mediated physical activity intervention compared with a pedometer alone for chronic obstructive pulmonary disease (COPD) management. The intervention was cost-saving.
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Screening for Health Literacy, Social Determinants, and Discrimination in Health PlansThis study provides insight on the experiences of patients of a national health plan with 2 structural determinants of health—health care discrimination and health literacy—and how those interact with social determinants of health and patient demographics.
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Pain, Anxiety Represent Barriers to Anti-VEGF Therapies for Costly Eye ConditionsPain and fear/anxiety were the most common barriers to anti–vascular endothelial growth factor (VEGF) therapy for neovascular age-related macular degeneration and diabetic macular edema. Another study found that those conditions had a significant impact on patients’ quality of life and Medicare costs.
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Preventing Tomorrow’s High-Cost Claims: The Rising-Risk Patient Opportunity in MedicaidFor Medicaid care management, focusing on rising-risk patients is more effective than targeting high-cost claimants, whose spending tends to decrease over time due to regression to the mean.
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High-Risk Care Management Impact on Medicaid ACO Utilization and SpendingIn Massachusetts’ largest Medicaid accountable care organization (ACO), high-risk care management significantly reduced spending, emergency department visits, and hospitalizations, demonstrating that targeted strategies can manage health care costs amid budget constraints.
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AHA Telemetry Guidelines Improve Telemetry Utilization in the Inpatient SettingUsing Plan-Do-Study-Act cycles, the studied intervention reduced hospital inpatient telemetry time by 51.25% while increasing American Heart Association (AHA) guideline–based usage.
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Characteristics, Utilization, and Concentration of Outpatient Care for Dual-Eligible Medicare BeneficiariesOutpatient care for dual-eligible beneficiaries is concentrated among a small group of physicians, and these beneficiaries receive less subspecialty care despite having more chronic conditions.
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Part D Coverage Gap Reform: Trends in Drug Use and ExpendituresThis study analyzed annual trends in the distribution of beneficiaries entering each benefit phase, drug utilization, and expenditures among Part D beneficiaries from 2008 to 2015.
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Using Electronic Health Records and Claims Data to Identify High-risk Patients Likely to Benefit From Palliative CareDeep learning algorithms could improve palliative care by predicting mortality from electronic health records and claims data.
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Telehealth Use in 2022 Among US Adults by Sexual OrientationIn a 2022 survey representative of US adults, sexual minority individuals reported greater rates of telehealth use, especially for mental health visits, than heterosexual individuals.
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Bridging the Gap Between Biomarker Testing and Treatment in Community OncologyMcKesson's Precision Care Companion initiative enhances biomarker testing and targeted therapies in community oncology, improving patient outcomes and cost efficiency.
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Metronomic Chemotherapy a Key Aspect of KEYNOTE-B96 Regimen: Nicoletta Colombo, MD, PhDNicoletta Colombo, MD, PhD, of the University of Milan-Bicocca, discussed key aspects of the KEYNOTE-B96 trial of paclitaxel with bevacizumab and pembrolizumab in ovarian cancer.
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Disconnects Between Provider Network Directories and Patient PreferencesThis study found widespread instances of disconnect in online provider directories between information needed by patients and data availability.
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Future of MS ManagementKey opinion leaders in MS provide closing thoughts on the future of MS treatment including digital therapeutics, new generics, and pipeline drugs on the horizon.
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ACA Dependent Coverage Extension and Young Adults’ Substance-Associated ED VisitsThis study examines the impact of the Affordable Care Act (ACA) on substance-associated emergency department (ED) visits among young adults, revealing reduced alcohol-associated visits but unchanged opioid-associated visits.
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Building a Payment Model for Health Coaching in Primary Care: Lessons From TennesseeThis case study describes Tennessee’s process for convening key stakeholders to develop uniform payment guidelines to encourage increased preventive service delivery.
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MRD Status Guides Consolidation With Cema-Cel in ALPHA3 Trial: Fred Locke, MDThe ALPHA3 trial is exploring cemacabtagene ansegedleucel's (cema-cel) potential to enhance outcomes in patients who have relapsed/refractory large B-cell lymphoma, particularly those positive for minimal residual disease.
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Real-World Value of Direct-Acting Antivirals for Hepatitis C at Kaiser Permanente Southern CaliforniaThis analysis demonstrates value and innovation of direct-acting antivirals for the treatment of chronic hepatitis C in the US Kaiser Permanente health system.
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Promoters of Therapeutic Inertia in Managing Hypertension: A Consensus-Based StudyThe authors identified consensus-based promoters of clinical inertia in managing hypertension. Policy makers should address these promoters to improve health-related outcomes in hypertension.
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Mental Health Diagnoses and Services Utilization Vary by Wage LevelInsured lower-wage employees had lower prevalence of mental health conditions but greater severity, with more hospital admissions and emergency department visits than high-wage employees.
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Oncologists’ Perceptions and Utilization of US Therapeutic Oncology BiosimilarsBiosimilar use in clinical practice is determined by oncologists’ perceptions of and willingness to prescribe them. The authors investigated US oncologists’ perceptions and use of biosimilars.
