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Characteristics of Self-Triaged Emergency Department Visits by Adults With CancerAdults with cancer may have difficulty self-assessing the clinical severity of their acute care needs, yet they rarely use a telephone triage line available to them.
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How State Surprise Billing Protections Increased ED Visits, 2007-2018: Potential Implications for the No Surprises ActState surprise billing protections decreased emergency department (ED) out-of-pocket payments to such an extent that ED visits actually increased.
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Artificial Intelligence in Medicare: Utilization, Spending, and Access to AI-Enabled Clinical SoftwareThis 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.
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Health Plan Switching and Satisfaction in a Medicaid MLTSS ProgramHealth plan dissatisfaction was higher among Medicaid managed long-term services and supports (MLTSS) beneficiaries who did not follow through with an intention to change health plans.
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Evaluating Alternative Methods of Comparing Antihypertensive Treatment IntensityMedication dose captures modification of hypertension treatment intensity more precisely than medication count, and this measure should be preferred in studies that aim to improve hypertension management.
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Cost Savings From an mHealth Tool for Improving Medication AdherenceThe Wellth smartphone app significantly increased medication adherence and lowered unnecessary health care utilization and costs over 9 months among Medicaid beneficiaries who were self-managing chronic conditions.
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Contributor: The Complexity Concern in Value-Based CareThis is the fifth and final article in a series on value-based care and the 4 challenges health care organizations must overcome.
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Updated Clinical Guidelines Outline Optimal Treatment of Helicobacter pylori InfectionFor pharmacists wondering whether bismuth quadruple therapy still reigns as the gold standard, the wait is over—the latest recommendations are here.
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Assessing Opportunities to Advance Quality Measures in Adult ObesityObesity is a serious chronic disease and risk factor for a broad range of outcomes. This study identifies opportunities for improving quality in obesity care.
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Discharge Prescribing and Subsequent Opioid Use After Traumatic Musculoskeletal InjuryThe authors use surgical resident assignment as an instrumental variable for discharge opioid prescribing and estimate the impact of discharge opioid supply on subsequent use.
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Projected US Savings From Biosimilars, 2021-2025Projected savings from biosimilars from 2021 to 2025 were $38.4 billion vs conditions as of quarter 4 of 2020 and were driven by new biosimilar entry. Savings were $124.5 billion under an upper-bound scenario.
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Tacking Upwind: Reducing Spending Among High-risk Commercially Insured PatientsAlthough commercial accountable care organization populations are healthy on average, some individuals might benefit from programs for high-risk patients to mitigate high levels of health care utilization.
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Using Telemedicine Interventions During COVID-19 to Expand Care Post COVID-19The Patient-Centered Rheumatology Collaborative identified several critical areas for further intervention to improve the delivery of high-quality, patient-centered care during the COVID-19 pandemic and beyond.
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Building Better Collaboration: Reducing Care Delays in Managing mCRCExperts discuss proactive steps health care teams, including pharmacists, can take to minimize delays and overcome payer-related barriers when prescribing third-line therapies for metastatic colorectal cancer (mCRC) and how collaboration between health care teams, payers, and manufacturers can be improved to reduce care delays.
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Evaluating Proactive Outreach for Prior Authorization Recertifications in Medicaid PatientsImplementing a proactive provider outreach program resulted in significantly more prior authorization recertifications and a reduction in time to submission.
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The Price Paradox of Biosimilar-Like Long-Acting InsulinFindings suggest that Basaglar was not less expensive for patients than Lantus. Empirical evaluation of biosimilar costs prior to automatic substitution is necessary.
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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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Implementing Team-Based Telemedicine Workflows in Safety-Net Primary CareTelemedicine in safety-net primary care faces particular challenges. Consistent, team-based workflows can support video visit implementation and health care maintenance in telemedicine visits.
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Contingency Management: Promises, Gaps, and Philosophical LimitationsThis editorial reviews the promises, gaps, and philosophical limitations of contingency management for pregnant people who use drugs.
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Contributor: Reflections on World AIDS Day 2023—A Call to Increase Research Funding on HIV and AgingResearch on HIV and aging should be the focus of future research as World AIDS Day brings the chronic illness to the forefront.
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Expanding Access to Clinical Trials Through Community PartnershipsKaren Winkfield, MD, PhD, addresses the importance of meeting patients where they are to expand clinical trial participation and remove barriers to trial access.
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Identifying Complex Patients Using Adjusted Clinical Groups Risk Stratification ToolIn this study, the authors developed a method for use in primary care to identify a group of patients with complex care needs using Aggregated Diagnosis Groups.
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Opioid Safety Initiative Associated With Decreased Emergency Department Opioid PrescribingA scalable health system–wide emergency physician education and feedback initiative was associated with decreased opioid prescribing, in excess of background temporal decline.
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Receiving NADT for 6 Months Doesn’t Impact Outcomes in Intermediate-Risk Prostate Cancer After EBRTAdding 6 months of neoadjuvant deprivation therapy (NADT) doesn’t seem to add any benefit for patients with intermediate-risk prostate cancer treated with external-beam radiation therapy (EBRT), according to 15-year outcomes presented by Barry Goy, MD, of Kaiser Permanente.
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Association Between Screening for Suspected COVID-19 Cases and Outcomes of Patients Revisiting the Emergency DepartmentPatients who revisit the emergency department shortly after discharge are at high risk for complications and death, exacerbated by COVID-19 screening workload. Detection efforts impact outcomes.
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Persistence of Provider Directory Inaccuracies After the No Surprises ActRelying on a 2-stage secret shopper survey, the authors found that inaccuracies in provider directories often persisted for well over 1 year.
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The Essential Role of Population Health During and Beyond COVID-19The authors detail how population health management enables health systems to promote public health, strengthen health system resiliency, and support financial recovery during and beyond coronavirus disease 2019 (COVID-19).
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Post-SNF Outcomes and Cost Comparison: Medicare Advantage vs Traditional MedicarePatients enrolled in Medicare Advantage had better outcomes and lower cost following skilled nursing facility (SNF) discharge than patients enrolled in traditional fee-for-service Medicare.
