This year, The American Journal of Managed Care® (AJMC®) published peer-reviewed research on a multitude of managed care topics, including benefit design, health information technology, and clinical pathways.
This year, The American Journal of Managed Care® (AJMC®) published peer-reviewed research on a multitude of managed care topics, including benefit design, health information technology, and clinical pathways.
Here are the most-read papers published in AJMC® in 2016.
5. The Promise and Perils of Big Data in Healthcare
Amidst the rampant optimism surrounding the use of big data, the authors of this commentary urged researchers to be cautious when drawing conclusions about causality. They advocated for the use of falsification tests to help identify outside factors contributing to seemingly causal relationships between variables.
4. Physician Perceptions of Choosing Wisely and Drivers of Overuse
A survey of practitioners found that primary care physicians had the highest rates of awareness of the “Choosing Wisely” campaign that aims to reduce the overuse of health services. Respondents identified a number of suspected drivers of overuse, including pressure from patients to order tests, but ultimately agreed that they as physicians have a responsibility to help control healthcare costs.
3. Coverage for Hepatitis C Drugs in Medicare Part D
At least 1 new hepatitis C virus (HCV) drug is covered under every Medicare Part D plan, but barriers to access remain, according to this analysis. Beneficiaries without subsidies spend a mean of $6297 to $10,889 in out-of-pocket costs for the expensive but life-saving HCV medications under these plans, which generally require prior authorization and charge coinsurance.
2. Care Pathways in US Healthcare Settings: Current Successes and Limitations and Future Challenges
The authors of this research predicted that the continued implementation of care pathways will help improve patient outcomes and healthcare quality. Their findings suggested that the processes of pathway development, implementation, and evaluation should be conducted with high levels of transparency in accordance with evidence-based standards.
1. Variation in US Outpatient Antibiotic Prescribing Quality Measures According to Health Plan and Geography
As the nation attempts to curtail unnecessary antibiotic prescribing, this analysis of quality measures data reveals wide variations in health plan performance on the metrics related to antibiotics. Plans in the South Central Census area performed worse on these measures than plans in other regions, indicating there are geographic differences in prescribing. The authors suggested that the high-performing plans could share lessons and advice to help bring the lower-performing plans up to par.
Impact of Amivantamab-Lazertinib on EGFR, MET Resistance Alterations in NSCLC: Danny Nguyen, MD
September 15th 2025The combination of amivantamab and lazertinib in first-line non–small cell lung cancer (NSCLC) significantly reduces resistance mechanisms with implications for second-line treatment, said Danny Nguyen, MD, of City of Hope.
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AI in Health Care: Balancing Governance, Innovation, and Trust
September 2nd 2025In this conversation with Reuben Daniel, associate vice president of artificial intelligence at UPMC Health Plan, we dive into how UPMC Health Plan builds trust with providers and members, discuss challenges of scaling AI effectively, and hear about concrete examples of AI's positive impact.
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ACA Dependent Coverage Extension and Young Adults’ Substance-Associated ED Visits
September 15th 2025This study examines the impact of the Affordable Care Act (ACA) on substance-associated emergency department (ED) visits among young adults, revealing reduced alcohol-associated visits but unchanged opioid-associated visits.
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