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Patients’ Access to 2018 FDA-Approved Drugs 1 Year Post Approval2018 was a landmark year for new drug approvals. However, patients’ access to these novel drugs varied by drug category and enrolled health plan.
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Medical Home Visit Programs During COVID-19 State of EmergencyThis report highlights the unique challenges faced by home health programs in addition to discussing how technology and policy changes have helped the elderly homebound during the coronavirus disease 2019 (COVID-19) pandemic.
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Eliminating Defects in Value: Turnaround of an MSSP ACOA health system transformational leadership framework and management system made visible and eliminated defects in value and was associated with reduced annual Medicare expenditures and increased quality between 2017 and 2020.
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Implementation of Early Follow-up Care After Heart Failure HospitalizationAn early heart failure follow-up intervention succeeded in increasing referral to and completion of cardiology appointments within 7 days of discharge. The intervention was associated with lower risk of 30-day all-cause emergency department visits, all-cause hospitalizations, or death.
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Hospital Discharge Diagnosis Position: Impact on Adult Pneumonia Burden EstimatesDisease burden estimates of pneumonia-associated hospitalizations are more sensitive when including pneumonia coded in any diagnosis field vs in only the first discharge diagnosis field.
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Mortality Risk Stratification Helps Identify Patients With COVID-19 at Risk of Adverse OutcomesMortality risk stratification can identify patients with COVID-19 who are at higher risk of mortality, discharge to skilled nursing facility, and readmission, and may benefit from focused intervention strategies.
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Contributor: How Medication Risk Scores Improve Health for Medicare BeneficiariesMedication risk scores analyze an individual’s medication regimen to look for the potential for simultaneous, multi-drug interactions, which can cause adverse drug events and other medication-related harms.
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A Machine Learning Technology for Addressing Medication-Related Risk in Older, Multimorbid PatientsA novel machine learning system effectively stratifies emergency department use and hospitalization risk of older patients with multimorbidity who take multiple medications and provides appropriate medication recommendations.
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Leveraging Longitudinal Clinical Laboratory Results to Improve Prenatal CareCollaboration between a clinical laboratory and a managed care organization improved prenatal care and outcomes through real-time, actionable, laboratory-derived insights and care coordination.
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Quantifying the Insurance Value for Rare Diseases: Duchenne Muscular DystrophyThe degree to which novel value elements such as insurance value impact estimated treatment value for rare, severe genetic diseases such as Duchenne muscular dystrophy is unclear.
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Impact of Payment Models on Medical Specialist Physician Practice PatternsThis article explores the impact of payment models (fee for service vs salary based) on practice patterns, including wait times and care for patients with chronic diseases.
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Care Fragmentation Predicts 90-Day Durable Ventricular Assist Device OutcomesThis analysis evaluates the relationship between hospital care delivery network fragmentation and in-hospital and 90-day outcomes. These networks may be novel targets for improving outcomes.
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Regulation of Provider Networks in Response to COVID-19The authors describe federal and state provider network adequacy standards and discuss how regulators should adapt these standards and accompanying monitoring processes in response to coronavirus disease 2019 (COVID-19).
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Activation, Physical Activity, and Outcomes Among Individuals With T2DThis study presents an integrated, exploratory assessment of physical activity, patient activation, health-related quality of life, and clinical outcomes among older adults with type 2 diabetes (T2D) using survey, wellness, and claims data.
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Operating Room Efficiency of Orthopedic Surgery During the COVID-19 EraThe authors analyzed the impacts of COVID-19 on orthopedic operating room efficiency via comparison of 14,856 surgeries performed before, during, and after the pandemic.
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Outcomes of Antiviral Treatment for Influenza in Type 2 DiabetesAntiviral treatment was associated with lower health care resource utilization and costs in patients with type 2 diabetes and a diagnosis of influenza.
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A Cue-to-Action Pilot Project to Increase Screening MammographyA targeted cue-to-action campaign of outreach, education, and incentive can improve uptake of screening mammography.
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Medical Home Visit Programs During COVID-19 State of EmergencyThis report highlights the unique challenges faced by home health programs in addition to discussing how technology and policy changes have helped the elderly homebound during the coronavirus disease 2019 (COVID-19) pandemic.
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Senate Introduces Bill to Extend 5% Incentives for APMsThe bipartisan bill would help lower Medicare costs and improve quality of care, according to the National Association of ACOs.
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Medicare Advantage–Pharmacy Partnership Improves Influenza and Pneumococcal Vaccination RatesPatients whose pharmacy receives notification of their immunization gap have twice the odds of receiving immunizations compared with those whose pharmacy does not receive the notification.
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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.
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Improving Glycemic Control in Diabetes Through Virtual Interdisciplinary RoundsPatients with diabetes whose providers received advice from remote, virtual interdisciplinary rounds had a greater 1-year reduction in hemoglobin A1c than comparable patients.
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Perspectives on Nonmedical Switching and the COVID-19 Pandemic: A Narrative ReviewThis review describes the impact of nonmedical switching of biologic therapies on US patients and providers, with a focus on switching to in-class alternatives.
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Contributor: CMS Can Seize Opportunities to Fix the Rural Glitch, Risk Adjustment Caps in MSSPThe Medicare Shared Savings Program (MSSP) has seen its growth slow, but CMS has an opportunity to act on proposals that would address benchmarking and more fairly allocate savings to accountable care organizations in the program.
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Appropriate ED Utilization Leading to Better Care CoordinationAddressing avoidable emergency department (ED) utilization takes interventions in partnership with providers.
