A. Mark Fendrick, MD

Given the severe unmet needs of the most vulnerable members of our communities, geographic expansion and rigorous evaluations of comparable, highly personalized care management interventions are warranted.

As we reset post pandemic, providers and payers are in an excellent position to prioritize a reallocation of health care expenditures driven primarily by individual and population health gains.

Use of low-value care services during COVID-19 exhibits substantial heterogeneity but, on average, shows declines similar to the use of high-value services; low-value care use lags behind high-value care use in the rebound phase.

As promising advances in providing care at home evolve, further research—with special attention to underserved populations—is needed to assess the clinical, equity, and economic impacts and to accelerate implementation where appropriate.

The authors of this editorial highlight some of the myths surrounding complex care management, identify areas where research could be most informative, and recommend best next steps in developing effective and efficient complex care management programs.

As awareness of nonalcoholic fatty liver disease (NAFLD) rises, it is essential to develop and implement a rigorously determined approach to identify patients who will, or will not, benefit from diagnostic evaluation.

Reducing cascades while maintaining our commitment to high-quality care requires equipping patients and clinicians with the information, tools, and support to embrace uncertainty.

Multicancer early detection technology could help reduce cancer mortality compared to the current strategy of single-cancer screening tests.

Multicancer early detection technology could help reduce cancer mortality compared to the current strategy of single-cancer screening tests.

To mark the 25th anniversary of the journal, each issue in 2020 includes an interview with a health care thought leader. The December issue features a conversation with the journal’s co-editors-in-chief, Michael E. Chernew, PhD, and A. Mark Fendrick, MD.

Although shortfalls in continuity were well described prior to coronavirus disease 2019 (COVID-19), the pandemic has created an opportunity to augment this critical component of care delivery, with the potential to improve patient-centered outcomes and enhance spending efficiency.

With a “new normal” level of care going forward post coronavirus disease 2019 (COVID-19), the key will be to invest in high-value services while deterring a resurgence of low-value care.

The coronavirus disease 2019 (COVID-19) pandemic will exacerbate the financial situations of the millions of Americans who struggle to afford their medical care, but policy solutions are available to quickly mitigate this problem.

Innovative, cost-neutral plan designs that cover more essential services on a predeductible basis, while decreasing exposure to and spending on harmful care, would better meet the clinical and financial needs of millions of Americans.

This study evaluates the ease of ordering high- and low-value clinical services in a national sample of electronic health records.

The competing strategies of patient assistance programs and co-pay accumulator adjustment programs create confusion and administrative burden for clinicians and patients, potentially reducing adherence to clinically indicated services and worsening patient outcomes.

For primary care to fulfill its promise of promoting a healthier population and more efficient spending, deliberate efforts to curtail the use of low-value services are warranted.

When it comes to the political iceberg of drug prices, there is more than meets the eye. Policies that reduce prices but do not lower consumers’ out-of-pocket costs will not address the main challenge facing most Americans.

New value frameworks should incorporate real-world evidence that reflects patient treatment behavior, adherence to medication, and equity concerns arising from disparities in care.

Health system leaders, policy makers, payers, and consumer advocates should use multiple synergistic levers to reduce the use of care that does not provide clinical benefit.

The implementation of alternative payment models that successfully capture clinical heterogeneity—without adding unacceptable levels of administrative complexity—may be equally (if not more) important than site-neutral payment policies.

More consideration should be focused on consumer decision making and the quality and costs of acute care, and less attention should be paid to where care is delivered.

Higher cost sharing is associated with reduced branded antidepressant initiation among patients trying generic therapy. Dynamic benefit designs could enhance access to branded medications when appropriate.

Amending regulations to expand the “safe harbor” by allowing predeductible coverage of high-value services and medications for chronic diseases would provide Americans a plan option that better meets their clinical and financial needs.

Retail prices for commonly prescribed drugs are often absent from state prescription drug price websites, but when reported, can vary substantially.

Following the results of the recent presidential election, AJMC® Co-Editors-in-Chief weigh in on the implications of this new chapter in health reform.

Arkansas has implemented multi-payer payment reform incorporating both episodic and Patient-Centered Medical Home models. Early perceptions of a sample of stakeholders were largely positive to date.