A review of our peer-reviewed research in the healthcare and mainstream press.
RevenueCycle Intelligence included a June study from The American Journal of Managed Care (AJMC) in its recent story, “Key Ways to Succeed Under MACRA’s Quality Payment Program.” The AJMC study, “Risk Contracting and Operational Capabilities in Large Medical Groups During National Healthcare Reform,” found that only one-third of providers have linked at least 50% of revenue to a risk-based alternate payment model. This slow pace of reform has limited the pace of progress in value-based care, even though CMS has set aggressive goals for Medicare.
A new study in AJMC showing the value of nonclinical benefits for patients with chronic diseases, such as increased productivity and “peace of mind,” received attention this week in news outlets, including Yahoo Finance. Diseases like multiple sclerosis (MS) cause patients fatigue and memory problems, which can limit productivity. Payers that cover newer therapies for MS create value for society, but these benefits often go unrecognized, the study asserted.
What's at Stake as Oral Arguments Are Presented in the Braidwood Case? Q&A With Richard Hughes IV
April 21st 2025Richard Hughes IV, JD, MPH, spoke about the upcoming oral arguments to be presented to the Supreme Court regarding the Braidwood case, which would determine how preventive services are guaranteed insurance coverage.
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New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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Comparing Breast Cancer Treatment Outcomes Between Fee-for-Service and Medicare Advantage
April 4th 2025This study examined postdiagnosis breast cancer treatment outcomes for Medicare Advantage vs fee-for-service (FFS) Medicare in Ohio and found no significant differences overall but disparities for Black patients with FFS Medicare.
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