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Impact of Expanded Carrier Screening on Health Care UtilizationThis study shows little evidence of harms or increased health care utilization for people receiving negative (normal) results of expanded carrier screening through genome sequencing.
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Dallas Nephrology Associates’ Journey to Value-Based CarePreventing or delaying the onset of end-stage kidney disease is vital. By implementing a results-driven, value-based approach, Dallas Nephrology Associates has demonstrated improved patient outcomes and value for payers.
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Insurance Payer Is Associated With Length of Stay After Traumatic Brain InjuryAmong hospitalized patients with traumatic brain injury, Medicaid fee-for-service was associated with longer hospital stays than private insurance and Medicaid managed care organizations.
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Health Care Resource Utilization, Quality Metrics, and Costs of Bladder Cancer Within the Oncology Care ModelSpending on novel therapies in high-risk bladder cancer had minimal impact on Oncology Care Model payments to practices, according to this cohort study and an average performance estimation.
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A “Sludge Audit” for Health System Colorectal Cancer Screening ServicesA systematic, mixed methods “sludge audit” identified novel health system delivery targets for improving colorectal cancer screening services.
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Accountable Care Organizations and HPV Vaccine Uptake: A Multilevel AnalysisThe authors evaluated whether adolescents receiving care at accountable care organizations (ACOs) vs non-ACOs were more likely to initiate and complete the human papillomavirus (HPV) vaccination series.
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A Standardized Care Pathway Increases Optimal Dialysis StartsThe authors observed a significant increase in optimal starts for dialysis and in peritoneal dialysis rates after implementing a standardized end-stage renal disease transition pathway.
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Disparities in Biomarker Testing Impact Nonsquamous NSCLC Outcomes: Surbhi Singhal, MDSurbhi Singhal, MD, of the University of California Davis, discussed disparities in biomarker testing among patients diagnosed with stage IV nonsquamous non–small cell lung cancer (NSCLC).
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CAAP Rule and Prescription Drug PricesThis article describes a recently finalized CMS rule addressing the permissibility of co-pay accumulator adjustment programs (CAAPs) when no generic is available.
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Cost-effectiveness of a 3-Year Tele-Messaging Intervention for Positive Airway Pressure UseLong-term tele-messaging was more effective than no messaging and short-term messaging for positive airway pressure use, and it was highly likely to be cost-effective with an acceptable willingness-to-pay threshold.
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What’s Next for Real-World Evidence in Oncology?Recent steps by FDA to promote the use of real-world evidence are to be commended, but the future demands a broader vision that makes greater use of growing sources of health care information.
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Teamwork Enhances Patient Experience: Linking TEAM and Net Promoter ScoresIn 1386 providers, better teamwork related to higher patient Net Promoter Score (NPS), and the relationship between provider experience and NPS was mediated by teamwork.
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Contributor: More Informed Management of Preeclampsia Is NecessaryAt present, it is difficult for clinicians to identify patients at greatest risk for developing preeclampsia with severe features and tailor treatment plans for them; this difficulty increases costs significantly.
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Roflumilast Delivers Speedy Improvement, Significant Itch Reduction in Younger Pediatric Patients: Lawrence F. Eichenfield, MDRoflumilast 0.05% cream significantly reduces itch and improves atopic dermatitis in young children, explains Lawrence F. Eichenfield, MD.
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Comparing Spending Across Medicare ProgramsAs Medicare Advantage increasingly becomes the dominant form of Medicare coverage, Congress must improve transparency of programmatic costs and benefits to promote beneficiary choice.
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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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Inappropriate Wrist MRI: Did Guidelines Have an Impact?This article analyzes the use of MRI in a national sample of patients with wrist pain before and after consensus guideline publication.
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Tailoring HS Treatment: The Path to Better Patient OutcomesA panelist discusses how clinicians should systematically adopt evidence-based hidradenitis suppurativa (HS) guidelines while maintaining flexibility to tailor treatments to individual patient needs, severity levels, and comorbidities. This involves regular monitoring of updated recommendations, implementing standardized assessment tools, and considering patient-specific factors such as lifestyle, preferences, and treatment response history to optimize therapeutic outcomes through a personalized medicine approach.
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Service Utilization by High-Need, High-Cost Patients Following Emergency Department VisitsThis article provides insights into patterns of health care use following emergency department visits by high-need, high-cost patients with different types of California Medicaid primary care providers.
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Communication of Launch Prices by Drug Companies, 2022-2024Two-thirds of pharmaceutical companies did not proactively release the launch price of their medications from 2022 to 2024.
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Use of Voluntary Alignment in the Next Generation ACO ModelUse of voluntary alignment attribution by Next Generation Accountable Care Organization (ACO) participants was limited. The authors highlight the reasons and describe organizational use cases via a mixed-methods approach.
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COVID-19 Control in the United States: The Case for MaskingIn the control of COVID-19, the future perfect of the vaccine should not be the enemy of the present good, which is masking.
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Behavior-Based Diabetes Management: Impact on Care, Hospitalizations, and CostsThe Diabetes Care Rewards program offers a business case for health plans to promote engagement through use of contingent incentives, thus improving health outcomes and lowering costs.
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An Accelerated Hospital Observation Pathway to Reduce Length of Stay for Patients With COVID-19For select patients hospitalized due to COVID-19, an academic urban hospital implemented an observation pathway that incorporated mobile health technology, reducing hospital length of stay by more than 2 days.
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Price Transparency and Patient Engagement: Social Messaging MattersThis study examined the impact of price transparency and prosocial messaging on patient engagement of price-protected consumers in seeking value-based care.
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Contributor: The Future of Prior Authorization Under the Improving Seniors’ Timely Access to Care ActStreamlining the prior authorization process can improve care accuracy and patient access to care, writes Siva Namasivayam, CEO of Cohere Health.
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Insurance-Related Differences in Chronic Conditions Data Warehouse Comorbidities of Medicare BeneficiariesChronic Conditions Data Warehouse comorbidity data vary by insurance status. Analyses using these data that fail to account for insurance status are subject to information bias.
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New First-in-Class ITP Therapy May Transform Clinical Practice: David Kuter, MD, DPhilRilzabrutinib (Wayrilz; Sanofi) may improve immune thrombocytopenia (ITP) outcomes, enable early intervention, and enhance patient quality of life.
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The Biosimilar Shift: Trending Infliximab Biosimilar Utilization and Associated Cost Savings for Commercial InsuranceInfliximab biosimilars created price competition causing insurance claims costs for infliximab originator and infliximab biosimilars to decrease, generating significant savings to the health care system.
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Preventive Care: Vaccines MatterA database of information about more than 30,000 patients verified improved morbidity and mortality due to vaccines and preventive health care in prospective trials.
