Health Care Delivery

By making diligent compliance efforts a priority in the years ahead, health plans can shore up existing processes to achieve financial success and ensure risk adjustment as regulatory bodies take aim at organizational missteps.

The National Clinical Care Commission (NCCC) issued 39 recommendations to improve diabetes prevention and care in the United States.

Rajini Katipamula-Malisetti, MD, a medical oncologist and hematologist with Minnesota Oncology who practices in Coon Rapids, has seen telehealth’s usefulness up close. During a pandemic, it can increase the number of touch points in areas such as survivorship care and nutrition, which would otherwise require a separate visit to the office.

The FDA delays its decision on Pfizer/BioNTech’s COVID-19 vaccine in young children; the Federal Trade Commission (FTC) will vote on whether to investigate pharmacy benefit managers (PBMs); nearly half of high-volume antibiotic prescribers are located in Southern states.

In this column, Calum Yacoubian, MD, outlines how artificial intelligence, specifically, natural language processing, can help address gaps in patient data.

Eosinophilic esophagitis is a complex disorder with significant health burdens and a recent review described how management strategies have changed over time.

This new study from investigators at University of Calgary investigated the potential of midwall striae fibrosis to predict hospital admission for heart failure.

More patients with moderate-to-severe psoriasis were found to be early responders to ixekizumab vs ustekinumab; all those who achieved early response were associated with stable skin clearance long-term.

The national coverage determination will help detect early non-small cell lung cancer, CMS said.

Coverage of our peer-reviewed research and news reporting in the health care and mainstream press.

CDC releases a draft of updated opioid prescribing rules; abortions in Texas drop 60% in first month of new law as patients travel out of state; COVID-19 infections can kill an unvaccinated mother's placenta.

Kenneth Cohen, MD, FACP, executive director of clinical research at UnitedHealth Group Research and Development and senior national medical director at OptumCare, discusses evidence-based education and other tools to address low-value care.

Researchers reviewed advances in the management of chronic rhinosinusitis, with and without nasal polyps, from 2020 to 2021.

Patients with chronic rhinosinusitis with nasal polyps who had elevated serum amyloid A (SAA) levels were more likely to achieve disease-controlled status vs those with low SAA levels after endoscopic sinus surgery.

A bipartisan congressional report estimates overdose deaths cost the United States $1 trillion yearly; 4 states announce plans to lift their statewide mask mandates for schools; study finds greater risk of pregnancy complications in expectant mothers with moderate COVID-19 symptoms.

On this episode of Managed Care Cast, Amy Moy, the chief external affairs officer at Essential Access Health, outlines measures needed to address the sexually transmitted infection (STI) epidemic in the United States.

A study from investigators at Fox Chase Cancer Center sought comparative outcomes data on adverse reactions from COVID-19 vaccination among patients with a history of cancer and those undergoing treatment and found equivalent safety outcomes.

Poor agreement was identified regarding MRI- and classification-defined axial spondyloarthritis (axSpA) and inflammatory back pain diagnoses in patients with psoriatic disease.

Part 1 of a 2-part webinar series by the National Alliance of Healthcare Purchaser Coalitions addressed issues in health care coverage affordability and how equitable health benefits and value-based design can reduce cost while improving employee engagement.

This retrospective study using administrative claims data examining health care resource utilization (HCRU) found that in the months before a diagnosis of eosinophilic esophagitis (EoE), other diseases were more commonly diagnosed.

Researchers discuss contributors to nasal polyp development in children, as well as the risk of co-occuring conditions and current methods of treatment.

The overdiagonsis identified in the current study also led to overtreatment in this population, authors found.

Researchers assess the role of cognitive behavioral therapy in treating pediatric migraine.

Researchers, as well as a patient who had chronic lymphocytic leukemia (CLL), hailed the findings as a cure, although more work needs to be done to see if the results persist in a larger group of patients.

The JAK1 inhibitor abrocitinib (Cibinqo) was recently approved by the FDA for the treatment of adults with refractory, moderate to severe atopic dermatitis.

On this episode of Managed Care Cast, we speak with Meghan Gutierrez, CEO of the Lymphoma Research Foundation, about financial toxicity, how the pandemic has affected patients’ financial needs when they have cancer, health care disparities and care gaps, and more.

Americans who are boosted are 95 times less likely than unvaccinated people to die of COVID-19, the FDA approved the first generic drug for Restasis to treat dry eye syndrome, and CMS is putting a greater focus on health equity for Medicare Advantage and Part D plans.

Sinonasal CT scores were associated with several prognostic features in the disease course of chronic rhinosinusitis with nasal polyps, including blood eosinophil counts and risk of relapse after endoscopic sinus surgery.

The rise in popularity of genetic testing brings along a myriad of challenges ranging from concerns on data privacy to insurance coverage, but, when utilized correctly, it could mark a step forward for significant advancements in individual and population health.