A strategic framework for payment reform needs to be developed to guide the growing momentum in order to mitigate unintended consequences and maximize coordination.

Tiering of networks cannot be viewed in isolation, but rather as a piece of a larger value agenda.

Electronic decision support for high-tech diagnostic imaging was associated with reduced volume and increased appropriateness, but had little impact on findings or patients.

Subacute lack of asthma control (SALAC) predicts subsequent asthma exacerbation and may improve health plan members’ asthma control and healthcare utilization associated with asthma exacerbation.

One-year persistence among new users of statins in Finland improved from 1995 to 1998, after which no substantial changes
were observed up to 2004.

A consumer survey on awareness, use, and trust of tiered provider networks indicated the need for increased consumer awareness of the networks.

Traditional Medicare and the large-firm commercial sector have a positive correlation in hospital utilization, but a lack of correlation in spending.

This study evaluated the effect of a multiple sclerosis disease therapy management program on medication adherence, therapy persistence, relapses, work productivity, and quality of life.

This study examined the effect of physician-specific pay-for-performance incentives on well-established ambulatory quality measures in a large group practice setting.

Medication adherence was lower for some drug classes among CDHP patients who enrolled in consumer-driven health plans compared with patients who continuously enrolled in traditional managed care plans.

An n - 1 deterministic linkage strategy was used successfully to merge dental and medical data from a healthcare plan and a dental insurance carrier.

Many older veterans do not receive appropriate nephrology care before beginning dialysis. Dual use of Veterans Affairs and Medicare-covered services was associated with better patterns of care.