- Center on Health Equity & Access
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Top 10 Ways to Improve Your Physician Quality Reporting System/Group Practice Reporting OptionPQRS and GPRO encompass patient experience, chronic condition management, and population health arenas so that physician reimbursement can be tied to performance. The authors describe how to accurately improve your quality metrics.
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Use of Postacute Care After Discharge in Urban and Rural HospitalsRural patients receive less postacute care after hospital discharge than urban patients, especially after elective joint replacement-a condition selected for bundled payments.
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Identifying Children at Risk of Asthma Exacerbations: Beyond HEDISAnalysis of insurance claims reveals that criteria other than the Healthcare Effectiveness Data and Information Set (HEDIS) persistent asthma definition can identify more at-risk patients with reasonable loss of specificity.
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Does Comparing Cesarean Delivery Rates Influence Women’s Choice of Obstetric Hospital?This randomized controlled trial finds that a hospital cesarean delivery rate comparison tool affects women’s perceptions but not where they choose to deliver.
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A Systematic Review of Reference Pricing: Implications for US Prescription Drug SpendingReference pricing is an effective cost-containment tool widely used in other countries; it may be an attractive policy strategy for the US healthcare system.
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Low-Cost Insulin for Socially At-Risk Patients: Evidence for EffectivenessHuman synthetic insulin may offer low-cost, effective treatment for certain patients with diabetes and financial constraints.
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Evaluation of a Packaging Approach to Improve Cholesterol Medication AdherenceA 7.6% improvement in 12-month cholesterol refill was observed among US military veterans randomized to an adherence blister packaging intervention versus an education-only intervention.
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Value-Based Payment in Implementing Evidence-Based Care: The Mental Health Integration Program in Washington StateValue-based payment improved fidelity to key elements of the Collaborative Care Model—an evidence-based mental health intervention—and improved patient depression outcomes in Washington state.
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Computed Tomography Scan Use Variation: Patient, Hospital, and Geographic FactorsWe observed small-area variation in computed tomography scan use for inpatients in New York State, even after controlling for relevant patient and hospital characteristics.
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Early Changes in VA Medical Home Components and UtilizationSignificant changes were found in patients' utilization of healthcare related to early implementation of medical home components in VA primary care clinics.
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Healthy State: Practicing What They Preach in LouisianaAn IVBM event cohosted by The American Journal of Managed Care focused on Healthy State, a multiyear, multistakeholder commitment to moving Louisiana ahead in America’s Health Rankings.
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Second-line and Third-line Chemotherapy for Lung Cancer: Use and CostUsing health insurance claims, we identified common first-, second-, and third-line chemotherapy regimens for patients with lung cancer and associated utilization and costs of care.
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The Price of Progress: Understanding Innovation and Affordability of Prescription DrugsEconomic incentives and patent protections drive development of innovative medications. Drug prices are determined by consumer demand, not production costs. Therefore, governmental regulation risks future investment in research and development.
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CHAPTER 3. Guideline for Detection and Management of Diabetes in PregnancyFrom the Adult Diabetes and Clinical Research sections, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts
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The Cost of Adherence Mismeasurement in Serious Mental Illness: A Claims-Based AnalysisThis study demonstrates that common pharmacy claims-based measures underestimate the effect of actual adherence on inpatient costs among patients with serious mental illness.
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Organizational Structure for Chronic Heart Failure and Chronic Obstructive Pulmonary DiseaseIn a nationwide cross-sectional comparison of organizational structure for chronic disease management, less attention was given to chronic obstructive pulmonary disease than chronic heart failure.
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Prospective or Retrospective ACO Attribution Matters for Seriously Ill PatientsThis study compared beneficiary characteristics and Medicare per capita expenditures among seriously ill Medicare accountable care organization (ACO) populations defined using prospective and retrospective claims-based attribution methods.
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Medicare Advantage Control of Postacute Costs: Perspectives From StakeholdersThis qualitative study examines the methods that Medicare Advantage plans use to control or reduce postacute spending and their associated unintended consequences.
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Survival and Cost-Effectiveness of Hospice Care for Metastatic Melanoma PatientsHospice care is associated with improved median survival time for the patients diagnosed with metastatic melanoma, accompanied by decreased end-of-life costs.
