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The Value of Virtual Physical Therapy for Musculoskeletal CareThis counterfactual simulation study on a nationally representative sample of the working population with musculoskeletal conditions estimated the value of patient-initiated virtual physical therapy.
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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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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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Pharmacists Leading the Charge in Real-World Evidence–Driven Contracting: Clayton Irvine, PharmD, MBA, MSClayton Irvine, PharmD, MBA, MS, discusses how pharmacists are essential to advancing payer–provider collaboration in value-based care by shaping formularies, standardizing drug reviews, leveraging real-world evidence, and leading pilot programs to optimize patient outcomes and cost-effectiveness.
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Learnings From Key Clinical Trials in Ovarian CancerExperts explore the evolving landscape of ovarian cancer treatment, emphasizing the need for targeted therapies and biomarker-driven approaches.
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An Assessment of Nurse Practitioner Low-Value Care Use in Primary CarePrimary care nurse practitioners were found to use low-value care at lower or relatively similar rates compared with the general clinician population.
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Unmet Needs and the Future of Treatment in SMAExperts in SMA provide closing thoughts on unmet needs in SMA including the importance of research into treatment combinations and sequencing as well as multidisciplinary care and healthcare equity.
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Sex Differences in Medicare Beneficiaries’ Experiences by Low-Income StatusOnly low-income male Medicare beneficiaries had worse patient experience than their female counterparts. The authors discuss opportunities to improve experiences for all patients.
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Implementing Clinical Informatics Tools for Primary Care–Based Diabetic Retinopathy ScreeningThe authors describe a primary care–based diabetic retinopathy screening program incorporating telemedicine, strong health information technology engagement, and development of clinical informatics tools.
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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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Comprehensive Genomic Profiling in Community OncologyRecommendations to address limitations in more widespread use of reflex testing in community oncology.
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Health Outcomes Under Full-Risk Medicare Advantage vs Traditional MedicarePhysician groups under 2-sided risk–based Medicare Advantage provide care associated with higher quality and efficiency compared with care by these same groups under fee-for-service Medicare.
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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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Impact of Telemedicine Use on Outpatient-Related CO2 Emissions: Estimate From a National CohortTelemedicine was associated with a monthly avoidance of greenhouse gas emissions equivalent to the emissions of 61,255 to 130,076 passenger vehicles.
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Targeting the Root of gMG With Inebilizumab: A Q&A With Richard Nowak, MD, MSIn this interview, Richard J. Nowak, MD, MS, principal investigator of the MINT trial of inebilizumab for generalized myasthenia gravis (gMG), discusses the trial’s key findings, including significant improvements in patient- and physician-assessed outcomes, as well as longer-term implications and future areas of investigation.
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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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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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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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How Do Infusion Pharmacies Support Financial Sustainability in Oncology?Jorge García, PharmD, MS, MBA, MHA, highlights the need for infusion pharmacy optimization to sustain oncology care amid rising costs and evolving value-based reimbursement models.
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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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Mandatory Medicare Bundled Payment and the Future of Hospital ReimbursementThe authors evaluate features of the Transforming Episode Accountability Model and discuss its benefits and limitations.
