The American Journal of Managed Care > December 2017
The American Journal of Managed Care - December 2017
December 12, 2017 – Jeffrey M. Ashburner, PhD, MPH; Daniel M. Horn, MD; Sandra M. O’Keefe, MPH; Adrian H. Zai, MD, PhD; Yuchiao Chang, PhD; Neil W. Wagle, MD, MBA; and Steven J. Atlas, MD, MPH
Patients in practices with central population health coordinators had greater improvement in short-term chronic disease outcome measures compared with patients in practices without central support.
Expanding the "Safe Harbor" in High-Deductible Health Plans: Better Coverage and Lower Healthcare Costs
December 12, 2017 – A. Mark Fendrick, MD, and Rashna Soonavala
Amending regulations to expand the “safe harbor” by allowing predeductible coverage of high-value services and medications for chronic diseases would provide Americans a plan option that better meets their clinical and financial needs.
December 07, 2017 – Rachel O. Reid, MD, MS; Brendan Rabideau, BA; and Neeraj Sood, PhD
Switching to a consumer-directed health plan is associated with reduced overall outpatient spending, but not with reduced spending on low-value healthcare services.
December 13, 2017 – David Cutler, PhD; Michael Ciarametaro, MBA; Genia Long, MPP; Noam Kirson, PhD; and Robert Dubois, MD, PhD
Transformative therapies with high up-front costs will exacerbate the need to address gaps between payers when costs and benefits occur at different times.
TRENDS FROM THE FIELD
December 14, 2017 – Michelle P. Lin, MD, MPH; Bonnie B. Blanchfield, ScD, CPA; Rose M. Kakoza, MD, MPH; Vineeta Vaidya, MS; Christin Price, MD; Joshua S. Goldner, MD; Michelle Higgins, PA-C; Elisabeth Lessenich, MD, MPH; Karl Laskowski, MD, MBA; & Jeremiah D. Schuur, MD, MHS
Results of our pilot randomized controlled intervention involving emergency department (ED)-based care coordination and community health workers demonstrated a trend toward fewer ED visits, fewer hospitalizations, and lower costs among intervention patients.
December 15, 2017 – Qian Shi, PhD, MPH; Thomas J. Yan, MS; Peter Lee, BS; Paul Murphree, MD, MHA; Xiaojing Yuan, MPH; Hui Shao, PhD, MHA; William H. Bestermann, MD; Selina Loupe, BS; Dawn Cantrell, BA; David Carmouche, MD; John Strapp, BA; and Lizheng Shi, PhD, MSPharm
Implementation of the Quality Blue Primary Care program in Louisiana was associated with a shift in primary care delivery and reductions in overall cost.
December 19, 2017 – Alexis Coulourides Kogan, PhD; Eileen Koons, MSW, ACSW; and Susan Enguidanos, PhD
Findings suggest that some at-risk patients may not be receptive to in-home transition interventions and that opting out may be associated with higher odds of hospital readmission.
December 20, 2017 – Stanley E. Waintraub, MD; Donna McNamara, MD; Deena Mary Atieh Graham, MD; Andrew L. Pecora, MD; John Min, BS; Tommy Wu, BA; Hyun Gi Noh, MSC; Jacqueline Connors, RN, OCN; Ruth Pe Benito, MPH, BS; Kelly Choi, MD; Eric Schultz, BS; & Stuart L. Goldberg, MD
Universal gene expression profiling of patients with stage II breast cancer resulted in outpatient savings of $11,000 (inclusive of testing costs) within 6 months of initiation of medical therapy.
December 20, 2017 – Rami J. Hosein, MD, MPH; Joan C. Lo, MD; Bruce Ettinger, MD; Bonnie H. Li, MS; Fang Niu, MS; Rita L. Hui, PharmD, MS; and Annette L. Adams, PhD, MPH
The authors observed a marked shift toward treatment of higher-risk subsets of younger postmenopausal women (with prior fracture and/or with osteoporosis), and away from women at lower risk.
December 18, 2017 – Lihao Chu, PhD; Neeraj Sood, PhD; Michael Tu, MS; Katrina Miller, MD; Lhasa Ray, MD; and Jennifer N. Sayles, MD
This study examined emergency department use by Medicaid beneficiaries with disabilities in safety-net clinics that have adopted the patient-centered medical home model compared with matched comparison beneficiaries.
Impact of Statin Guidelines on Statin Utilization and Costs in an Employer-Based Primary Care Clinic
December 18, 2017 – Holly E. Gurgle, PharmD, BCACP, CDE; Marisa B. Schauerhamer, PharmD; Simón A. Rodriguez, PharmD; and Carrie McAdam-Marx, MSCI, PhD, RPh
Adherence to clinical guidelines in practice is often suboptimal and controversial. This study compares actual statin utilization and cost with full adoption of major clinical guidelines in a real-world population.