Reference-based pricing combined with employer education and an online shopping tool significantly improved members’ utilization of lab services at or below the reference price
The authors find 51% of accountable care organizations have private payer contracts, which are more likely than public contracts to include downside risk and upfront payments.
With effective methods of promoting telemedicine yet to be established, new risk-based payment models offer the greatest potential for telemedicine’s effective and efficient use.
Palliative principles were applied to the care of more HH patients than non-HH patients, but no differences were found in their utilization of healthcare services.
Prescription cost and pharmacy convenience were identified as the most significant drivers of out-of-plan pharmacy use.
This study analyzes the factors associated with insurer participation in the initial year of individual market exchanges created under the Affordable Care Act.
Even in a fully integrated healthcare system, only 28% of cancer quality measures could be validated by using electronically available data.
Greater geographic variation was found among private than public payers in the inpatient price per discharge for most hospital services.

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