Authors

Hospital Participation in Medicare ACOs: No Change in Admission Practices and Spending

Hospital accountable care organization (ACO) participation did not impact emergency department admission rates, length of stay, or costs, suggesting limited effectiveness in reducing spending for unplanned admissions and challenging hospital-led ACO cost-saving strategies.

Consumer-Centric Approach to Enhance Access to Pediatric Specialty Care

The authors’ organization optimized scheduling techniques that improved patient access to pediatric specialists to within 7 calendar days for new patients.

An Assessment of Nurse Practitioner Low-Value Care Use in Primary Care

Primary care nurse practitioners were found to use low-value care at lower or relatively similar rates compared with the general clinician population.

Factors Associated With Lung Cancer Risk Factor Documentation

This cross-sectional observational study found several factors associated with whether a patient had sufficient lung cancer risk factor documentation in the electronic health record.

Primary Care Nurse Practitioner Management of Adolescent Behavioral Health

Personnel costs ($90,514) of a primary care–embedded adolescent behavioral health nurse practitioner over 2 years were 63% of the potential revenue generated ($144,449).

How Value-Based Care With Provider Enablement Improves Maternal and Infant Outcomes in Medicaid

Supported value-based care improves prenatal care while reducing neonatal intensive care unit stays, preterm birth rates, low birth weight rates, and costs for mothers and infants.

Addressing Cancer Care Barriers Through Community Outreach and Support

February 4 is World Cancer Day, and in these interviews with our Strategic Alliance Partner, NYU Langone Health, we learn about the importance of forming strong relationships with the communities you are located in and with whom you work to optimize cancer-related outcomes.

FDA Approves bluebird bio's Lovo-Cel Gene Therapy for Sickle Cell Disease

The decision was supported by efficacy data from 36 patients from the ongoing phase 1/2 HGB-206 trial (NCT02140554) and 2 patients in the phase 3 HGB-210 trial (NCT04293185). It was the second approval from FDA for a gene therapy for sickle cell disease.

Estimating the Economic Burden of Migraine on US Employers

The Migraine Impact Model is an interactive calculator that estimates migraine prevalence within a workforce and the associated economic burden of migraine on the employer.

Adolescent Anterior Cruciate Ligament Reconstruction: A Decade of Rising Surgical Cost

Adolescent anterior cruciate ligament reconstruction surgery can preserve health and restore function of the knee joint, but the surgical cost has outpaced inflation.

Addressing Cost Barriers to Medication Adherence: Sam Peasah, PhD

Sam Peasah, PhD, MBA, RPh, director of High-Value Health Care Value-Based Pharmacy Initiatives at UPMC Health Plan, discusses ways that health plans can help reduce the cost burden of medications to improve adherence.

Accountable Care Organizations: Looking for Answers to an Overspending, Underachieving System

Effects of an Out-of-Pocket Maximum in Medicare Part D

This study compares the impact of the 3 different out-of-pocket maximums proposed in Congress and by the Medicare Payment Advisory Commission.

The Impact of Immune Checkpoint Inhibitors on Cost and Quality of Life in the Initial Treatment of Patients With Advanced or Metastatic NSCLC

Immune checkpoint inhibitors (ICIs) represent a significant benefit for the initial treatment of patients with advanced or metastatic non−small cell lung cancer (NSCLC). Beyond clinical benefit of increased overall survival, it represents a class of medications with a favorable adverse effect profile compared with chemotherapy. Drugs that target programmed cell death protein 1 (PD-1) receptor and its ligand PD-L1 are ICIs that work by taking the brakes off the immune system and promote T-cell−mediated cancer cell destruction. Current NCCN guidelines recommend that all patients with advanced or metastatic NSCLC have their PD-L1 status (amount of PD-L1 on cancer cells) assessed to guide treatment section. However, this recommendation is not always followed and may lead to inappropriate treatment selection and potential increased cost. Through appropriate biomarker testing, subsequent appropriate utilization of ICIs may help to drive down other costs and improve health-related quality of life. Managed care pharmacists should continue to focus on promotion of guideline concordant care that includes appropriate biomarker testing and selection of an evidence-based preferred treatment option.

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.

Evaluating Smoking Cessation Service at an Emergency Department Clinical Observation Unit

This study aimed to evaluate the impact of a smoking cessation service in a group of patients admitted to a short-stay unit in the emergency department.

Health Outcomes Under Full-Risk Medicare Advantage vs Traditional Medicare

Physician groups under 2-sided risk–based Medicare Advantage provide care associated with higher quality and efficiency compared with care by these same groups under fee-for-service Medicare.

Updated Clinical Guidelines Outline Optimal Treatment of Helicobacter pylori Infection

For pharmacists wondering whether bismuth quadruple therapy still reigns as the gold standard, the wait is over—the latest recommendations are here.

Limited English Proficiency, Cardiovascular Risk Factors, Cardiovascular Disease, and In-Hospital COVID-19 Outcomes

This study evaluated whether limited English proficiency modifies the association between cardiovascular risk factors or cardiovascular disease and outcomes in patients hospitalized with COVID-19.

The Biosimilar Shift: Trending Infliximab Biosimilar Utilization and Associated Cost Savings for Commercial Insurance

Infliximab biosimilars created price competition causing insurance claims costs for infliximab originator and infliximab biosimilars to decrease, generating significant savings to the health care system.

Care Fragmentation Predicts 90-Day Durable Ventricular Assist Device Outcomes

This analysis evaluates the relationship between hospital care delivery network fragmentation and in-hospital and 90-day outcomes. These networks may be novel targets for improving outcomes.

Impact of COVID-19 Pandemic on Accessibility of Taiwanese Medical Care

The COVID-19 pandemic disrupted access to routine medical care in community populations in Taiwan. The unmet needs should be emphasized as normal life resumes.

Psoriasis Treatment Center of New Jersey Reports Positive Results for Tapinarof in Psoriasis Trial

In this study, 52% of adult patients achieved the treat-to-target goal of 1% BSA or less within 3 months of incorporating tapinarof cream into their biologic regimen.

Participating Faculty: Metastatic Colorectal Cancer: Considerations for Treatment in the Third Line and Beyond

Care Coordination Engagement Patterns in Long-Term Patients

Care coordination engagement increases over time in long-term high-cost, high-need patients, with no identifiable data-driven times for when to initiate patient care de-escalation.

Screening for Health Literacy, Social Determinants, and Discrimination in Health Plans

This study provides insight on the experiences of patients of a national health plan with 2 structural determinants of health—health care discrimination and health literacy—and how those interact with social determinants of health and patient demographics.

US Cost-effectiveness and Budget Impact of Point-of-Care NAAT for Streptococcus

This study evaluates the cost-effectiveness and budget impact to US payers of point-of-care nucleic acid amplification tests (NAAT) for group A streptococcus.

Researchers Propose Model to Replicate Patient Experience in Artificial Pancreas System

A methodology to monitor patient-in-the-loop modes and faults was examined using a hybrid automata model that was able to replicate patient’s real-life operation modes.

Real-world HIV Diagnostic Testing Patterns in the United States

This retrospective study evaluated real-world implementation of the updated CDC HIV algorithm in a large US laboratory.