Comparison of Two Systems for Clinical Practice Profiling in Diabetic Care: Medical Records Versus Claims and Administrative Data

Among hospitalized patients with traumatic brain injury, Medicaid fee-for-service was associated with longer hospital stays than private insurance and Medicaid managed care organizations.

To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes reflections from a thought leader on what has changed over the past 3 decades and what’s next for managed care. The February issue features a retrospective by Richard J. Gilfillan, MD, former director of the Center for Medicare and Medicaid Innovation; and Donald M. Berwick, MD, MPP, former administrator of CMS.

This letter discusses previously published research that paves the way for deeper exploration of the ethical and human aspects of artificial intelligence in health care.

This analysis demonstrated significant variability in medical policy determinations and evidence cited for clinically relevant pharmacogenetic tests among major US health insurers and laboratory benefit managers.

Dementia was more prevalent in older patients with some cancer types, and comorbid dementia in this population was associated with unplanned or unnecessary hospitalization.

Longer appointment duration was associated with lower likelihood of missed appointments for patients receiving care at a federally qualified health center network.