The American Journal of Managed Care | April 2017

CLINICAL

Patients receiving care for advanced non–small cell lung cancer in small, independent oncology practices are more likely to receive chemotherapy in the last 30 days of life.

COMMENTARY

The complex interplay of behavioral economics may result in reimbursement methodology alternatives to the prevailing fee-for-service payment system having less impact on prescribing behavior than has been conjectured.

MANAGERIAL

In primary care, nurse practitioners and physician assistants do not necessarily order more ancillary services, or more costly services among alternatives, than physicians.

POLICY

High-cost patients are only modestly concentrated in specific hospitals and healthcare markets.

TRENDS FROM THE FIELD

This study describes a widespread variation in medication adherence, pharmacy cost sharing, and medical spending. Increased cost sharing may decrease adherence and increase total diabetes spending.

WEB EXCLUSIVE

This study demonstrates that the predictive accuracy of primary care physicians’ assessment of future hospitalization risk is comparable to commonly used quantitative risk stratification instruments.
An examination of the asthma medication ratio (≥0.50) as an informative metric in program evaluation and for healthcare organizations to measure quality of care provided to patients with asthma.
The main reason given for receiving results online was time savings, reported by 77% of participants, followed by lowering the chance of missing the results (31%).
Patients endure heavy medication complexity following hospital discharge for acute coronary syndrome.
The authors propose a simple legal mechanism to combat chargemaster abuses and encourage provider price competition. This solution is superior to prevailing legislative and regulatory responses to surprise out-of-network bills.

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