The American Journal of Managed Care

Pilot of Decision Support to Individualize Colorectal Cancer Screening Recommendations
Colorectal cancer screening involves balancing immediate harms with longer-term benefits; electronic medical record decision support may facilitate personalized benefit/harm assessment.
Clinical Efficacy: A Cost Containment Weapon for the 21st Century
Mitigating cost increases through preemptive care and clinical efficacy to reduce the disease burden of clinically at-risk patients.
Low-Value Care for Acute Sinusitis Encounters: Who’s Choosing Wisely?
Acute sinusitis is a common acute illness and offers an opportunity to eliminate low-value care. The authors describe current practices, comparing primary care, urgent care, and the emergency department.

The American Journal of Pharmacy Benefits

Is PBM Transparency an Answer to Controlling Rising Drug Costs?
With continued increases in the US drug spend, the evolution of fully transparent PBM programs has introduced an alternative approach to traditional PBM structures aimed at enhanced utilization and cost control.
Lessons Learned From Zac
Taking steps to improve medication adherence, starting with simple outreach efforts.
Opioid-Induced Constipation: Considerations for Formulary Decision Makers
This activity reviews the incidence and impact of opioid-induced constipation (OIC), discusses available treatment options, and what factors should be considered during formulary decisions for OIC.

The American Journal of Accountable Care

Communication and Accountable Care
As the US healthcare system transitions from volume to value, there is some concern that while new payment models and reforms may be neither conceptually flawed nor badly designed, the implementation of these reforms may be insufficient to fully achieve any potential success. If we get the architectural plan right but our building materials and methods are flawed, we wind up with a disappointing result.

Evidence-Based Series

Chemoprevention With Oral Contraceptives Could Be a Reality
Evidence provided by a study published in The Lancet Oncology affirms that oral contraceptives provide long-term protection against endometrial cancer.
Need for Palliative Care for Improved Performance at the End of Life
An article published in JAMA Oncology underscores the need for efforts to improve quality of life for cancer patients.
Links Found Among Higher Co-Payments, Lower Adherence, Higher Medical Costs in T2DM Medicare Patients
The study presented at the ADA Scientific Sessions found that raising out-of-pocket costs for diabetics with Medicare could reduce adherence and ultimately raise healthcare spending.
Multiple Teams Move to Testing Phase of the Artificial Pancreas
Years of work has moved technology to the point of large-scale testing that is required before FDA approval and commercialization.
Medicare’s Failure to Cover CGM at Odds With Other  Health, Research Agencies
A leading voice on diabetes care asks why Medicare still will not cover CGM technology.
Latest News
Novartis has announced that Zarxio will be available at 15% of the cost of its reference product Neupogen.
The difference between "heart age" and chronological age indicates risk of events like heart attacks and strokes, and could motivate younger patients to improve unhealthy lifestyles.
CMS will test whether providing Medicare Advantage plans with the ability to integrate value-based insurance design increases enrollee satisfaction, improves enrollee clinical outcomes, reduces overall plan expenditures, and results in lower plan bids, thus saving money for Medicare and beneficiaries.
The peak year for avoiding medical care for costs reasons was 2009-2010, just after the recession hit and before the ACA took effect.
Men are opting for preventive breast surgery when diagnosed with unilateral invasive disease, a study published in JAMA Surgery has found.

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