The American Journal of Managed Care | June 2014


Initiation of guideline-preferred first-line antiretroviral therapy (ART) was associated with better ART adherence and persistence and similar total healthcare expenditures among Medicaid-insured HIV patients.
This study examines whether patients treated with specialty pharmaceuticals have improved outcomes compared with patients treated with conventional therapies, and evaluates costs associated with these treatments.


Type of health insurance plays a significant role in the likelihood of receiving the recommended treatment among women diagnosed with early-stage breast cancer.


Small practices with NCQA patient-centered medical home recognition perform better on quality measures, especially those related to chronic conditions.
Patient financial incentives are a potential mechanism to improve health. In a South African health plan, a patient incentive program is associated with increased prevention.


The authors evaluated a new “big data” analytic predictive platform that quickly and accurately analyzes large data sets to identify populations at risk of developing conditions such as metabolic syndrome.
Using a system for primary care management of patients with diabetes may reduce the risk of myocardial infarction, stroke, and retinopathy over a 3-year period.
The authors examine the association between advanced electronic health record (EHR) use and cost in hospitals. Patients treated in hospitals with advanced EHRs cost 9.66% less.
Most 30-day readmissions are experienced by patients who have multiple hospital stays. Efforts to reduce readmissions must look beyond a single 30-day period.
In 2001, Maryland began to reimburse hospitals for excess volume at full case rates. The authors investigated the impact on hospital utilization and finances.
In conjunction with provider-oriented payment reform, tools like VBID that change the focus from how much to how well we spend our healthcare dollars.
The authors found no consistent pattern in the concordance between CER evidence and subsequent utilization patterns.
Value-based insurance design for prescription drug coverage increases drug adherence in patients with chronic disease, though their effect on clinical outcomes and health spending remain uncertain.

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