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The American Journal of Managed Care January 2015
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Disease-Modifying Therapy and Hospitalization Risk in Heart Failure Patients
Fadia T. Shaya, PhD, MPH; Ian M. Breunig, PhD; and Mandeep R. Mehra, MD, FACC, FACP, FRCP
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Disease-Modifying Therapy and Hospitalization Risk in Heart Failure Patients

Fadia T. Shaya, PhD, MPH; Ian M. Breunig, PhD; and Mandeep R. Mehra, MD, FACC, FACP, FRCP
Substantive outcome improvement and savings to Medicaid may be achieved with small changes in prescribing rates or comorbidity prevalence among patients with heart failure.
Overall, our findings inform the discussions on healthcare reform by focusing on HF, which is one of the highest morbidity and cost conditions in state enrollees. The results suggest potentially parallel patterns in other highly prevalent chronic conditions, equally poised to have an impact on population health and large health program budgets. There are also important policy implications, in light of the potential outcomes of optimizing therapies on patient function, which may stimulate patients’ return to work and their disenrollment from Medicaid.

Acknowledgments

The Medicaid staff at the Maryland Department of Health and Mental Hygiene provided invaluable assistance with the Medicaid enrollment and claims data used in this study.

Author Affiliations: Pharmaceutical Health Services Research, University of Maryland School of Pharmacy (FTS, IMB), Baltimore, MD; Heart and Vascular Center, Center for Advanced Heart Disease, Brigham and Women’s Hospital, and Harvard Medical School (MRM), Boston, MA.

Source of Funding: None.

Author Disclosures: Dr Mehra is a board member for the International Society for Heart and Lung Transplant and is a consultant for Johnson & Johnson, St Jude Medical Inc, Boston Scientific, and Thoratec. Drs Shaya and Breunig report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article.

Authorship Information: Concept and design (FTS, IMB, MRM); acquisition of data (FTS, IMB); analysis and interpretation of data (FTS, IMB, MRM); drafting of the manuscript (FTS, IMB, MRM); critical revision of the manuscript for important intellectual content (FTS, IMB, MRM); statistical analysis (FTS, IMB); provision of study materials or patients (FTS); administrative, technical, or logistic support (FTS, IMB); supervision (FTS, MRM).

Address correspondence to: Mandeep R. Mehra, MD, FACC, FACP, Medical Director, Heart and Vascular Center, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115. E-mail: mmehra.harvard@gmail.com.
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