Coverage of our peer-reviewed research and news reporting in the healthcare and mainstream press.
An article by Skilled Nursing News, titled “Researchers Find ‘Perverse Incentives’ for Skilled Nursing Operators Under PDPM,” cited a study published in the April 2020 issue of The American Journal of Managed Care® (AJMC®) titled “The Patient-Driven Payment Model: Addressing Perverse Incentives, Creating New Ones.” In the study, researchers indicated that although the Patient-Driven Payment Model (PDPM) addresses perverse incentives in Medicare’s previous payment system for skilled nursing facilities (SNFs), it includes new incentives that may be problematic. The study authors recommended that regulators should maintain close oversight of billing by SNFs and patient outcomes as the PDPM takes effect to mitigate potential unintended consequences.
A piece reported by Healio referenced a study published in the November 2019 issue of AJMC®, “CKD Quality Improvement Intervention With PCMH Integration: Health Plan Results.” The study results supported innovation in chronic kidney disease (CKD) by commercial health plans, as a scalable CKD quality improvement intervention demonstrated feasibility, decreased hospitalization, and reduced costs.
Urticaria Diagnosis Challenged by Overlapping Pruritic Skin Conditions
April 23rd 2025Urticaria is complicated to diagnose by its symptomatic overlap with other skin conditions and the frequent misclassification in literature of distinct pathologies like vasculitic urticaria and bullous pemphigus.
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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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Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
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ACOs’ Focus on Rooting Out Fraud Aligns With CMS Vision Under Oz
April 23rd 2025Accountable care organizations (ACOs) are increasingly playing the role of data sleuths as they identify and report trends of anomalous billing in hopes of salvaging their shared savings. This mission dovetails with that of CMS, which under the new administration plans to prioritize rooting out fraud, waste, and abuse.
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