Although health plan accountable care models have evolved provider readiness, data, analytics, and the use of performance measurement are important components of plan-provider partnerships.
Implementing patient decision aids was associated with lower rates of elective surgery for benign prostatic hyperplasia and of active treatment for localized prostate cancer.
Data from a national survey of Veterans Health Administration specialists indicate that referral templates may improve the appropriateness, clarity, and completeness of primary care–specialty care referrals.
Weekend cardiac catheterization availability for inpatients reduced length of stay and maintained quality of care (no excess hazard for weekend cases), but costs were similar.
Primary care teams reduced their prescribing of potentially inappropriate medications to older veterans after participation in the Veterans Affairs (VA) Geriatric Scholars Program.
Results, lessons, and challenges of a local lung cancer screening program within a national demonstration project.
Accountable care is forcing providers to develop new capacities and strategies for managing cost and quality trends. Prospectively managing the health of populations requires shifting the focus of care delivery from episodic interventions to continuous population management. As a result, accountable care organizations (ACOs) are dedicating considerable focus to developing the infrastructure and tools needed to help patients manage their chronic conditions. This is a significant departure from traditional care-delivery models and will require provider organizations to develop new partnerships and embrace new methods.
Referral patterns by family physicians affect numerous aspects of medical care. This study compares the outpatient referral rates of residents, residency faculty, and clinical faculty.
Marketplace consumers desire more health plan measures on how well plans support long-term patient—physician relationships. Consumers are skeptical of measures about rewarding providers for high quality.
This qualitative study assesses patient, PCP, and oncologist views on primary care roles in shared cancer care, as well as patterns of communication between physicians.
Among Medicare enrollees with metastatic colorectal cancer, the use of newer chemotherapy agents was lower for African American patients and for older patients.
Home health beneficiaries with diabetes using paid supplementary caregivers had 68% higher hazards of readmission due to urinary tract infection than those with unpaid supplementary caregivers.
This article presents challenges and solutions regarding health care–focused large language models (LLMs) and summarizes key recommendations from major regulatory and governance bodies for LLM development, implementation, and maintenance.
Placing formulary restrictions on brand name drugs shifts use toward generics, lowers the cost per prescription fill, and has minimal impact on overall adherence for antidiabetes, antihyperlipidemia, and antihypertension medications among low-income subsidy recipients in Medicare Part D plans.
This study demonstrates a method for understanding the effects of drug spending in the design of alternative payment models.
An intensive tobacco dependence intervention based on selfdetermination theory that targeted all smokers was cost-effective and facilitated patient autonomy, perceived competence, and long-term tobacco abstinence.
Physician utilization during the year before the first indication of type 2 diabetes did not differ between Medicaid-covered and privately insured youth.
This study examined the effect of physician-specific pay-for-performance incentives on well-established ambulatory quality measures in a large group practice setting.
Racial/ethnic minorities and patients living in poorer neighborhoods were more likely to access their personal health record exclusively with a mobile device.