The American Journal of Managed Care | March 2017

CLINICAL

Patients receiving postdischarge care from pharmacists had a 28% lower risk of readmission at 30 days and a 31.9% lower risk at 180 days compared with usual care.

COMMENTARY

Primary care physician recruitment and retention must rely on not only increased financial remuneration, but also on a redesign of workflow and processes.

MANAGERIAL

Private sector accountable care organization development has been motivated by perceived opportunities to improve quality, efficiency, and population health, and the belief that payment reform is inevitable.
Lean redesigns in primary care improved workflow efficiencies, physician productivity, and overall satisfaction among patients, physicians, and staff, with no adverse effects on clinical quality.

POLICY

Practice transformation toward comprehensive primary care slightly improved patient experience in 3 of 6 domains of care: access, provider support, and shared decision making.

WEB EXCLUSIVE

In this reply to the commentary, “A Call for a Statewide Medication Reconciliation Program,” published in the October 2016 issue of The American Journal of Managed Care®, authors discuss a proven and scalable solution to improve medication reconciliation that is already available to, and used by, clinicians.
An insurance company–sponsored enhanced primary care program had little effect on selected outcomes for low-income patients with diabetes.
Although clinical knowledge positions physicians and nurses well as consumer-directed health plan enrollees, they appeared less likely to choose these plans than nonmedical faculty and staff.
Affordable Care Act exchange enrollees in California and Colorado reported significant improvements in access to care and fewer barriers to receiving care due to costs.
Home health beneficiaries with diabetes using paid supplementary caregivers had 68% higher hazards of readmission due to urinary tract infection than those with unpaid supplementary caregivers.

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