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Rethinking the Use of Real-World Evidence to Improve Policy Decisions

Population Health Starts With Access to Care

Access and quality are inseparable, so providers prioritizing population health goals can find success by starting from a solid foundation of patient access. So how can providers streamline access to care and directly influence population health? The answer lies with sophisticated patient engagement technology.

Improving Costs and Outcomes Across Complex and Vulnerable Populations

Will Your State Have a Shortage of Nurses in the Next Decade?

Overall, the United States is predicted to see a shortage of 193,000 nursing professionals by 2020, according to a 2015 report.

Pharmacoeconomics Refresher: The CVS $100k/QALY Announcement (Part 3)

In this series, we have used the recent announcement by CVS Health regarding a strategy to lower drug prices as an example to review basic pharmacoeconomic principles. For Part 3, we are going to discuss various stakeholders and how each might view the results of decisions based off of pharmacoeconomic analyses.

Understanding Diabetes Risks Can Save Your Limbs

Racial and Ethnic Disparities in Telemental Health Use Among Publicly Insured Children

Among publicly insured children with mental health–related encounters, racial and ethnic disparities in telemental health use widened following the onset of the COVID-19 pandemic.

Facilitators of and Barriers to Medicaid Investment in Electronic Consultation Services

In this qualitative investigation, leaders of Medicaid managed care plans were interviewed to identify facilitators of and barriers to electronic consultation for specialty care delivery.

Discharge Timing and Associations With Outcomes Following Heart Failure Hospitalization

A retrospective multicenter study found that patients with heart failure discharged by noon had higher short- and long-term mortality and increased early readmission rates compared with afternoon discharges.

Lp(a) and Getting a Head Start Against Heart Disease: Jeremy Wigginton, MD

Lipoprotein a (Lp[a]) is a valuable tool for assessing a patient's risk of cardiovascular disease, which can facilitate earlier intervention efforts and reduce health care costs, argued Jeremy Wigginton, MD.

Assertive Community Treatment for Complex and Costly Patients

Assertive community treatment, a strongly evidence-based practice for delivering care to individuals with schizophrenia and low health care engagement, is applicable to disengaged, medically complex patients.

Once-Monthly Maridebart Cafraglutide Shows Up to 16% Weight Loss

A phase 2 trial demonstrated substantial weight loss with the long-acting peptide–antibody conjugate, as well as other cardiometabolic improvements.

Trends in Glucagon-Like Peptide 1 Receptor Agonist Prescribing Patterns

Glucagon-like peptide 1 receptor agonists, including semaglutide, have increased in use and will continue to increase due to their effectiveness in weight loss.

Value-Based Care Interventions and Management of CKD Progression

Patients with chronic kidney disease (CKD) stages 3b or 4 experienced slower decline in estimated glomerular filtration rate 20 months after enrollment in a value-based kidney care program.

Early SYRUS Data Highlight Safety, Efficacy of AZD0486 in Relapsed/Refractory B-Cell ALL: Ibrahim Aldoss, MD

AZD0486 demonstrated encouraging safety and dose-dependent efficacy in heavily pretreated adolescent and adult patients with relapsed/refractory B-cell acute lymphoblastic leukemia (ALL), according to early findings from the phase 1/2 SYRUS trial and Ibrahim Aldoss, MD, of City of Hope.

Do Localized Disasters Impact Clinical Measures of Health Care Quality?

This study examines the impact of geographically limited disasters on health care quality performance scores of Medicare Advantage contracts, finding limited impact on performance scores.

Preventing Tomorrow’s High-Cost Claims: The Rising-Risk Patient Opportunity in Medicaid

For Medicaid care management, focusing on rising-risk patients is more effective than targeting high-cost claimants, whose spending tends to decrease over time due to regression to the mean.

Effects of Individualized Nurse-Led Care Plans on Olaparib Treatment Duration

A nurse-led personalized care program conducted through a specialty pharmacy prolonged medication persistence among patients with cancer receiving olaparib.

Frequent Primary Care Visits May Lower Costs for Higher-Risk Commercially Insured Adults

Tory M. Wolff, MBA, discusses his study showing that frequent routine primary care visits may lower costs for higher-risk commercially insured adults.

To Expand Access to Cancer Expertise, Collaboration Is Key

Effects of Maryland’s All-Payer Model on Elective Joint Replacement Surgery

The Maryland All-Payer Model was associated with an increase in population-based rates of elective major joint replacements, with a more pronounced effect observed in Maryland-only hospitals.

Varied Access: The Pharmacogenetic Testing Coverage Divide

On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.

Prevalence and Inclusiveness of Pay-for-Performance Incentives for HPV Vaccination

This article examines the prevalence of pay-for-performance incentives to promote human papillomavirus vaccination and other quality metrics as reported by frontline clinical staff.

Outcomes in Patients With IBD Stratified by Risk of Disease Progression

This study validates criteria to identify patients with inflammatory bowel disease (IBD) at risk of worsening disease who may benefit from early treatment with advanced therapies.

Participating Factulty: Real-World Impact of Infliximab Precision-Guided Dosing on Management of Patients With IBD

Managed Care COVID-19 Outcomes in a Population Health Program

Data from 38,193 patients showed that managed care patients have COVID-19 risk factors similar to those of the general population and that a population health program decreased mortality.

Gaps in the Coordination of Care for Older Adults With or at Risk for Cardiovascular Disease

Older adults with cardiovascular disease (CVD) or CVD risk factors report that gaps in communication among their providers are common and hazardous.

Cost-Effectiveness of a Multicancer Early Detection Test in the US

Multicancer early detection testing results in extended life-years and reduced cancer treatment costs through earlier diagnosis, leading to a cost-effective option in cancer screening.

Clinical Outcomes in Heart Failure Monitoring: A Pooled Rates Analysis

This systematic literature review and pooled rates analysis investigated the standard of care for patients with heart failure in the US post hospital discharge.

The Role of Advanced Technologies in Improving Diabetes Outcomes

This article reviews underlying barriers to health care access and discusses how a value-based diabetes care model could improve patient outcomes and reduce long-term costs.