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Impact of Medical Care Coordination Intervention on Patient ActivationThis observational evaluation compared an adult medical care coordination intervention with usual care and found that the intervention was associated with significant improvements in patient activation.
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High-Need Beneficiary Enrollment Patterns in Medicare Advantage and Traditional MedicareAccounting for 32% of all Medicare enrollees in 2019, high-need beneficiaries were more likely to be in traditional Medicare than Medicare Advantage.
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Navigating Value, Efficacy in Modern CLL Treatment: Pierluigi Porcu, MDPierluigi Porcu, MD, speaks to the considerations clinicians need to account for to balance cost, patient experience, and outcomes for those with chronic lymphocytic leukemia (CLL).
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Mortality Risk Stratification Can Predict Readmissions but Not Length of StayMortality risk stratification can identify patients at higher risk of mortality and readmissions for prevention strategies. Other patients should be the focus of length-of-stay reduction strategies.
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Workforce Innovation Reduces Medicaid Costs in Chronic CareThis study of community health workers as clinical extenders demonstrates significant cost savings in managing chronic conditions among Medicaid beneficiaries.
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Expert Perspectives on the Role of Real-World Evidence, Patient-Reported Outcomes, and Economic Models in Oncology Formulary Decision and Regulatory Submissions for FDA ApprovalA Q&A With Bhakti Arondekar, PhD, MBA; Alexander Niyazov, PharmD, MPH; and Jay Weaver, PharmD, MPH
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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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TROP2 ADC Shows Promise in Pretreated TNBC: Erika Hamilton, MDErika Hamilton, MD, reports early trial data showing DB-1305/BNT325, a TROP2-targeted ADC, produced encouraging responses in heavily pretreated TNBC patients.
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Future Directions and Unmet Needs in HER2+ Breast Cancer TherapyExperts discuss the challenges of integrating new cancer therapies, addressing multidisciplinary care, evolving guidelines, and the financial burden on patients.
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Managing Total Knee Replacement Under Value-Based PaymentsThis article describes the approach that a large primary care group at risk for value-based payments chose to deploy in managing clinical and financial outcomes of knee osteoarthritis jointly with orthopedic surgeons.
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Key Takeaways on Optimizing Glaucoma ManagementClosing out their discussion on glaucoma management, experts share practical advice for care providers and payers alike.
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COVID-19 Vaccine Hesitancy and Health Literacy in US Southern StatesCOVID-19 vaccine hesitancy is not associated with health literacy. Personal perception of threat was associated with reduced vaccine hesitancy.
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Racial/Ethnic Differences in Autoimmune Disease Prevalence in US Claims/EHR DataThis analysis uses claims and electronic health records from 2021 to examine racial and ethnic variations in immune-mediated inflammatory diseases in the United States.
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Advocacy, Access, and Awareness: Addressing Barriers in Hearing HealthDiscover how the Hearing Loss Association of America advocates for hearing loss awareness and hearing health integration through a dialogue with Barbara Kelley, executive director.
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ACA Medicaid Expansion Association With Racial Disparity Reductions in Timely Cancer TreatmentMedicaid expansion was associated with a reduction in the racial disparity in timely treatment of patients with advanced cancer in the United States.
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Multilevel Influences on Patient Engagement and Chronic Care ManagementHealth systems may be better able to support adoption of chronic care management processes, which have a strong evidence base for practice implementation, compared with patient engagement strategies, which have less evidence to guide effective implementation.
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Value-Based Management of Specialty Drugs: Practical Considerations and Implications for PharmacyPolicy makers and health plans seek value-based management of specialty drugs. This study examines real-world factors that favor some approaches over others and their potential impact.
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Congress Unlikely to Codify Executive Order on Drug Pricing: John Barkett, MBACongress is unlikely to codify the recent executive order to lower drug pricing as other US officials negotiate new prices, John Barkett, MBA, of Berkeley Research Group, explains.
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Hypoglycemia Upon Hospital Admission From Long-term Care: Health Care Resource UseThis analysis of a hospital billing database describes inpatient length of stay, intensive care unit length of stay, comorbidities, and costs for patients with diabetes after admission with hypoglycemia from long-term care or home.
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Contributor: COVID-19’s Impact on ACO REACH Deserves CMS' AttentionCMS must account for inclusion of COVID years in 2023 ACO REACH benchmarks to avoid unfairly penalizing REACH ACOs.
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Health Outcomes of Dually Eligible Beneficiaries Under Different Medicare Payment ArrangementsWithin the same physician groups, 2-sided risk in Medicare Advantage (MA) was associated with higher quality and lower utilization for dually eligible beneficiaries compared with fee-for-service MA and traditional Medicare.
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Challenges Faced by Medicaid Managed Care Coordinators Working With Members With Substance Use DisorderAccessing medical and social resources for patients, heavy administrative burden, and lack of data integration are barriers to Medicaid managed care organization care coordinators’ job performance.
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Dosage and Outcomes in a Complex Care InterventionAssociations between intervention dosage and hospital use outcomes were observed among patients enrolled in a care management program serving individuals with complex needs.
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Economic Burden of Joint Disease in Psoriasis: US Claims AnalysisThis retrospective claims analysis found that concomitant joint disease in psoriasis is associated with greater health care resource utilization and health care costs than psoriasis alone.
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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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Choosing Wisely Interventions to Reduce Antibiotic Overuse in the Safety NetThis study evaluates the impact of Choosing Wisely–based interventions on antibiotic prescribing for viral respiratory tract infections in a real-world safety-net setting.
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Strategies for Improving Transitions of Care for Patients With Diabetes: An Interview With Jennifer N. Clements, PharmDJennifer N. Clements, PharmD, is a clinical pharmacist in diabetes transition with Spartanburg Regional Healthcare System in Spartanburg, South Carolina. Clements is a board-certified pharmacotherapy specialist, board-certified ambulatory care pharmacist, and certified diabetes care and education specialist. She is currently developing a pharmacy service focused on the inpatient management of diabetes. An editor from The American Journal of Managed Care® recently conducted an interview with Clements to discuss strategies for improving transitions of care for patients with diabetes.
