Health Care Delivery

A value-based care team approach can be utilized to adequately treat patients’ medical problems, particularly by addressing the social, economic, and environmental challenges they’re facing in their everyday lives.

A desire to remove barriers to high-value care and provide services that would improve health and quality of life drove early adopters of value-based insurance design (VBID).

After Medicare Part D plans stopped covering a chronic obstructive pulmonary disease (COPD) therapy, patients had gaps in care and increased out-of-pocket costs, according to a recent study.

On this episode of Managed Care Cast, we speak with the chief medical officer for Virginia’s Medicaid program about 4 ways payers can make sure that those with opioid use disorder get the treatment they need; the strategies are outlined in the March issue of The American Journal of Managed Care.

A novel skin test was shown to detect metabolites that could predict the development of Parkinson disease, as well as delineate changes in lipid processing and mitochondria that can be leveraged to better understand how the disease develops.

With a marked increase in virtual care use amid the COVID-19 pandemic, several strategies can continue to evolve its effectiveness and adoption. This includes addressing disparities in usage among older populations and underserved communities, as well as improving home monitoring and interoperability.

More real-world evidence is needed to determine what role a score of 100 on the Psoriasis Area and Severity Index (PASI) might have in daily clinical practice, according to a recent review.

Medicare Advantage beneficiaries with type 2 diabetes (T2D) may be less likely than commercially insured individuals to be treated with newer medications to lower glucose levels, according to results of a retrospective cohort study published in JAMA Network Open.

During a session presented at the America’s Health Insurance Plans (AHIP) National Health Policy Conference, Michael Chernew, PhD, the director of Healthcare Markets and Regulation Lab at Harvard Medical School, and Mark McClellan, MD, PhD, founding director at Duke Margolis Center for Health Policy, discussed the potential for Medicare innovation and reforms in 2021 and beyond.

The $1.9 trillion spending package aimed at providing COVID-19 relief for those with low and middle incomes also represents the biggest investment in the exchange marketplaces created by the Affordable Care Act (ACA) since the landmark law was passed 11 years ago.

Social risks (food insecurity, housing instability, financial strain, health insurance type) are associated with patients’ decisions to avoid/delay health care and increased utilization of the emergency department.

Investigators sought to better understand increasing price trends, including those seen among disease-modifying drugs to treat multiple sclerosis (MS) and other neurological diseases.

More than a year into the COVID-19 pandemic, a new study suggests that individuals recovering from acute kidney injury stemming from COVID-19 will require kidney monitoring after they leave the hospital.

Length of stay outliers are associated with hospital-acquired infections, complications, and discharge to facility, as opposed to nonmodifiable risk factors like age and comorbidities.

In a session presented at America’s Health Insurance Plans (AHIP’s) National Health Policy Conference, federal health officials and health plan representatives highlighted successes of the country’s ongoing COVID-19 vaccine rollout, placing particular emphasis on the role equity plays in distribution.

On this episode of Managed Care Cast, Sarah Carroll, MPH, director of the Center for Care Transformation at AVIA, discusses the challenges of implementing digital health in underserved populations and the potential of these solutions to better address health disparities in the United States.

Citing 2021 as the year of the pharmacist, this year's CVS Health’s Health Trends Report discusses pressing issues for pharmacists to monitor, including availability of COVID-19 vaccines to communities nationwide, as well as integration of telehealth and behavioral health services.

Robin Gelburd, JD, president of FAIR Health, discusses the dramatic increase in telehealth claims throughout 2020.

Researchers describe the case of an older patient who underwent myeloma drug sensitivity testing as part of an effort to identify the therapies most likely to produce a response in this difficult-to-treat population.

According to new research, 88% of trials initially matched to patients were eventually classified as false positives when manually screened by a provider.

A retrospective study looking at pediatric patients hospitalized in 4 New York hospitals in 2020 with COVID-19 or multisystem inflammatory syndrome in children (MIS-C) found that acute kidney injury (AKI) occurred in 11.8% of patients.

Asthma and immunology specialists responding to a survey about physical activity for patients with asthma were mostly unaware of any guidelines but seemed willing to learn more about how to incorporate them into practice.

In preparing for the upcoming implementation of the Interoperability and Patient Access final rule by CMS, best practices for health plans include prioritizing data mapping, sensitivity codes for privacy, and consumer-friendly language in accessible data for patients.

Despite benefitting from organ transplants similarly to other patients with kidney failure, a new study found patients with kidney failure associated with sickle cell disease (SCD) are less likely to receive transplants.

Patients with multiple myeloma (MM) often relapse over time despite initially achieving a complete response without minimal residual disease following induction treatment, leaving questions about changes in the immune system and the prognosis of the disease.

A lack of pharmacies in rural America could complicate COVID-19 vaccine rollout; over 200,000 Americans enrolled in Affordable Care Act plans during special period; wealthy, older residents in Florida receive COVID-19 vaccines.

Individuals at high risk of contracting HIV and with commercial health insurance adhered to their pre-exposure prophylaxis (PrEP) regimens more than twice as long as persons covered by Medicaid.

The disorder known as molybdenum cofactor deficiency (MoCD) Type A presents shortly after birth, often with severe encephalopathy and intractable seizures.

On this episode of Managed Care Cast, we speak with Sheri Winsper, the senior vice president for quality measurement at the National Quality Forum, to discuss how the forum plans to devise national telehealth quality metrics.

Research published in JAMA Ophthalmology supports the continued implementation of preschool-based vision screening programs, as nearly 3 of 4 preschool students consistently wore their glasses at school during the first year of use.