John Hsu, MD, MBA, MSCE

In Massachusetts’ largest Medicaid accountable care organization (ACO), high-risk care management significantly reduced spending, emergency department visits, and hospitalizations, demonstrating that targeted strategies can manage health care costs amid budget constraints.

Although commercial accountable care organization populations are healthy on average, some individuals might benefit from programs for high-risk patients to mitigate high levels of health care utilization.

Payment models that align financial incentives of payers, providers, and patients can mitigate spending growth in thoughtful ways, but the details of the models matter.

Using a seamlessly shared inpatient-outpatient electronic health record was associated with greater rates of postdischarge follow-up delivered through telemedicine or laboratory monitoring and without an in-person office visit.

Racial/ethnic minorities and patients living in poorer neighborhoods were more likely to access their personal health record exclusively with a mobile device.

This study examines the plan characteristics associated with generic risperidone use and spending and adherence outcomes associated with use among Medicare Advantage Part D beneficiaries.

Patients with diabetes that are cared for by primary care teams with higher cohesion experienced greater EHR-related outcome improvements, compared with patients cared for by lower cohesion teams.

A systematic review of insurance benefit designs with differential cost sharing for substitute prescription drugs.

This review article explores the Medicare data available for researchers and approaches that could be used to enhance the data%u2019s value for comparative effectiveness research.

Health plan accounting data are used to test how well the CMSHCC risk adjustment system tracks relative costs of treating various diagnoses: not very well.