G. Caleb Alexander, MD, MS

Four large Medicare Advantage insurers manage access to expensive physician-administered drugs with a combination of prior authorization, step therapy, and Part D formulary design.

Opioid utilization management in Medicare was associated with mixed effects on opioid prescribing, and prior authorization was associated with a decreased likelihood of subsequent overdose.

Financial incentives alter the quality and quantity of care that physicians provide. Understanding physicians' recent experience with incentives may help shape current payment reform efforts.

High rates of health information technology use by physicians were only modestly associated with better knowledge of drug costs.