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

E-Prescribing Is Becoming a Standard of Care
E-prescribing adoption has increased dramatically over the past decade. This study provides empirical evidence that utilization among adopters continues to increase, suggesting application “stickiness.”
What Roles Do Patient Characteristics Play in Value-Based Performance?
Incorporating patient-related sociodemographic factors into performance measurement systems is essential for providing an accurate assessment of the quality of care delivered.

The American Journal of Accountable Care

The Arkansas Payment Improvement Initiative: Early Perceptions of Multi-Payer Reform in a Fragmented Provider Landscape
Arkansas has implemented multi-payer payment reform incorporating both episodic and Patient-Centered Medical Home models. Early perceptions of a sample of stakeholders were largely positive to date.

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
Research from The Commonwealth Fund found little indication that risk segmentation is causing adverse effects in the insurance market either in coverage sold on the exchanges and coverage sold off the exchanges.
Pharmacy cost trends are expected to increase 10% up from 6.3% the year before, with specialty pharmacy trends experiencing the largest increases, according to a survey from Aon Health.
Although hospital consolidation has not shown the benefits proponents had touted, it is inevitable that there will be consolidation in healthcare, because the environment is too challenging for smaller hospitals and many physician practices, explained Paul Ginsburg, PhD.
Although the fee-for-service model of reimbursement has been blamed as an reason for high healthcare costs in America, a report from HealthPocket found that eliminating this payment model in provider-owned health plans did not produce the cheapest health plans.
In Texas, a new law will allow more patients to get help negotiating lower bills from hospital-based doctors who are out of network instead of being stuck with huge bills even when the hospital is in their health insurer's provider network.

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