- Center on Health Equity & Access
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Risk Stratification and the Importance of Patient-Centered Care
Panelists discuss how disease progression monitoring requires integrating multiple data points including symptoms, six-minute walk tests, biomarkers like BNP/NT-proBNP, and imaging studies, with risk stratification tools helping guide treatment decisions while considering individual patient characteristics.
EP: 1.Pathophysiology of Pulmonary Arterial Hypertension
EP: 2.Differential Diagnosis of Pulmonary Arterial Hypertension
EP: 3.Importance of Early Detection and Monitoring for Disease Progression
EP: 4.Risk Stratification and the Importance of Patient-Centered Care
EP: 5.Strengths and Limitations of Current Therapeutic Options
EP: 6.Overview of Different Therapies for Patients with Pulmonary Arterial Hypertension
EP: 7.Sotatercept for Patients with Pulmonary Arterial Hypertension
EP: 8. The Role of the Prostacyclin Pathway
EP: 9.Important Clinical Considerations for Pulmonary Arterial Hypertension
EP: 10.Economic Impact of Pulmonary Arterial Hypertension
EP: 11.Barriers to Care for Patients with Pulmonary Arterial Hypertension
EP: 12.Utilizing Health Economic Outcomes in Clinical Practice
EP: 13.Outlining the Need for Equitable Access to Care
EP: 14.Final Panelist Thoughts on the Management of Pulmonary Arterial Hypertension
Barriers to Early Detection and Diagnosis
Common barriers to early PAH detection include the nonspecific nature of symptoms, which often leads to misattribution to more common conditions like deconditioning or asthma. Primary care physicians frequently prescribe asthma inhalers as initial treatment, which is reasonable given the rarity of PAH compared to common respiratory conditions. However, the lack of improvement with standard treatments should prompt deeper investigation and consideration of alternative diagnoses.
The complexity of PAH evaluation presents another significant barrier, as diagnosis requires a multi-layered assessment rather than simple testing procedures. Unlike straightforward conditions diagnosed through chest X-rays or basic tests, PAH evaluation involves comprehensive testing to determine disease classification among five different pulmonary hypertension groups. This complexity necessitates expertise not only in ordering appropriate tests but also in high-quality interpretation of results.
Timely referral to expert care centers represents a critical factor in overcoming diagnostic barriers. Specialized pulmonary hypertension centers possess the experience and resources necessary for comprehensive evaluation and accurate diagnosis. Educational initiatives targeting community practitioners and primary care physicians, combined with emphasis on screening high-risk populations such as patients with connective tissue diseases, can help reduce diagnostic delays and improve patient outcomes.
Integrated Care for Chronic Conditions: A Randomized Care Management Trial
December 3rd 2025The authors sought to understand the differential impact of payer-led community-based care management approaches on stakeholder-oriented outcomes for publicly insured adults with multiple chronic conditions.
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Managed Care Reflections: A Q&A With A. Mark Fendrick, MD, and Michael E. Chernew, PhD
December 2nd 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The December issue features a conversation with AJMC Co–Editors in Chief A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design and a professor at the University of Michigan in Ann Arbor; and Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and the director of the Healthcare Markets and Regulation Lab at Harvard Medical School in Boston, Massachusetts.
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