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Assessment of Drug Consumption Patterns for Medicare Part D PatientsThis retrospective cohort study found that a sizable proportion of standard Medicare Part D drug program beneficiaries reached the “doughnut hole.”
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The AADE DEAP — A Diabetes Self-Management Training Success StoryFor several years, the American Association of Diabetes Educators has been collecting evidence that shows that diabetes self-management training programs meeting its accreditation standards warrant coverage by public and private insurers.
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Project ECHO: An Effective Means of Increasing Palliative Care CapacityThis article provides insight on the work of 7 of Project ECHO’s replicating partners from around the world who are implementing the ECHO model to address the knowledge gap that underlies integrated palliative care crisis.
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Physician Response to Patient Request for Unnecessary CareMany primary care physicians in the United States reported providing unnecessary medical care in response to patient requests; several factors predicted this behavior.
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Thinking Clearly About Payment ReformA strategic framework for payment reform needs to be developed to guide the growing momentum in order to mitigate unintended consequences and maximize coordination.
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How Similar Are States' Medicaid Preferred Drug Lists?Comparison of the generosity and consistency of 10 states' Medicaid preferred drug lists for the top therapeutic classes revealed a large degree of inconsistency.
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Improving HCV Cure Rates in HIV-Coinfected Patients - A Real-World PerspectiveThe authors examine real-world hepatitis C virus cure rates with direct-acting antivirals among patients coinfected with HIV.
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Targeting High-Risk Employees May Reduce Cardiovascular Racial DisparitiesTargeting cardiovascular risk reduction interventions to high-risk patients has the potential to reduce cardiovascular racial disparities, improve health, and reduce costs.
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High-Risk Care Management Impact on Medicaid ACO Utilization and SpendingIn 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.
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Healthcare Professionals’ Perceptions of Challenges to Chronic Pain ManagementHealthcare professionals report pain management barriers across system, provider, and patient levels, highlighting the need to consider chronic pain as a chronic condition that warrants coordinated approaches.
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Empirical Analysis of Domestic Medical Travel for Elective Cardiovascular ProceduresPromoting domestic medical travel to high-quality providers could improve clinical outcomes and reduce long-term healthcare costs.
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Relationship Between Short-Acting β-Adrenergic Agonist Use and Healthcare CostsOveruse of rescue medication among asthma patients is associated with increased exacerbations and higher total and asthma-related healthcare costs.
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Does Care Consultation Affect Use of VHA Versus Non-VHA Care?Uncoordinated multisystem use is problematic for Veterans Health Administration (VHA) patients with dementia. The Partners in Dementia Care intervention is successful in changing the pattern of VHA versus non-VHA use.
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Lessons From the Front: Designing and Implementing Clinical Pathways by and for CliniciansAs cancer care becomes more complex and more expensive, decision-support algorithms offer a mechanism to define best practice, reduce unwarranted variation, and control costs across growing networks.
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Initiation of Triple Therapy Maintenance Treatment Among Patients With COPDClaims data analysis showed that 60% of patients with chronic obstructive pulmonary disease (COPD) receiving triple therapy had no evidence of exacerbation or only 1 exacerbation not resulting in hospitalization.
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Are Chronically Ill Patients High Users of Homecare Services in Canada?Assessments of self-care capacity and other measures were the most precise ways to identify individuals who could be classified as chronically ill, in their status as the highest users, both individually and collectively, of homecare services.
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The Cost of Learning: Participating in APMs Despite Projected Financial LossesThis article explores Northwestern Medicine’s decision to participate in a Medicare alternative payment model (APM) despite projected losses.
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Does Medicare Managed Care Reduce Racial/Ethnic Disparities in Diabetes Preventive Care and Healthcare Expenditures?The authors aimed to examine whether participation in Medicare managed care, compared with fee-for-service, has any effects on racial/ethnic disparities in diabetes care and healthcare expenditures among older adults.
