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Measuring Continuity of Care for Diabetes: Which Visits to Include?This study examined how inclusion of different provider specialties affected Continuity of Care Index values, year-to-year stability, and association with emergency department visits.
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Characteristics of Self-Triaged Emergency Department Visits by Adults With CancerAdults with cancer may have difficulty self-assessing the clinical severity of their acute care needs, yet they rarely use a telephone triage line available to them.
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CMS Practice Assessment Tool Validity for Alternative Payment ModelsUsing data from 632 primary care practices, the authors show that the CMS Practice Assessment Tool has adequate predictive validity for participation in alternative payment models.
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Cost Will Be Massive Barrier in Access to Lenacapavir After Approval in the US: Gordon Crofoot, MD, PAThe recent FDA approval of lenacapavir is encouraging in its promise of long-term HIV prevention but might not be available for the vast majority of people in the US.
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Contributor: Value-Based Care Will Provide the Freedom to Fix What's Broken in Rural HealthThe tools we need to achieve long-term stability for community providers and ensure better outcomes for rural Americans are available, and CMS can help us utilize them.
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Out-of-Pocket Costs for Diabetes Medications in Employer-Sponsored Health Insurance PlansOut-of-pocket costs of diabetes medications other than insulin can be quite high for individuals with employer-sponsored health insurance.
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A Case-Control Study of Length of Stay OutliersLength of stay outliers are associated with hospital-acquired infections, complications, and discharge to facility, as opposed to nonmodifiable risk factors like age and comorbidities.
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Prospective or Retrospective ACO Attribution Matters for Seriously Ill PatientsThis study compared beneficiary characteristics and Medicare per capita expenditures among seriously ill Medicare accountable care organization (ACO) populations defined using prospective and retrospective claims-based attribution methods.
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Contributor: Sustaining the “New Normal”—The Future Is Still Bright for Telehealth in the Wake of COVID-19Consumers want telehealth and telehealth can help achieve organizational goals of avoiding unplanned care, closing care gaps, and achieving care targets.
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Effective Prevention and Management of COVID-19 in Outpatient Hemodialysis PatientsThe authors introduce a mobile phone app that may effectively prevent and manage coronavirus disease 2019 (COVID-19) in outpatient hemodialysis patients in Sichuan Province, China.
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Comparison of Mortality Between Medicare Advantage and Traditional Medicare Beneficiaries With Kidney FailureThe risk-adjusted 1-year mortality rate was not different between Medicare Advantage and traditional Medicare beneficiaries with kidney failure who initiated dialysis.
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Combined Effect of Continuous Glucose Monitoring and Semaglutide: Analysis of Administrative ClaimsClaims data reveal larger hemoglobin A1c decreases in people with type 2 diabetes who use continuous glucose monitoring and semaglutide compared with semaglutide alone.
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Health Care Resource Utilization, Quality Metrics, and Costs of Bladder Cancer Within the Oncology Care ModelSpending on novel therapies in high-risk bladder cancer had minimal impact on Oncology Care Model payments to practices, according to this cohort study and an average performance estimation.
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Incidence and Cost of Potentially Avoidable Emergency Department Visits for UrolithiasisThis study characterizes the incidence and associated factors of urolithiasis-related emergency department visits that are potentially preventable with appropriate ambulatory care and calculates their cumulative costs.
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Looking Toward the Future: Management of C. Diff InfectionClosing out their discussion on recurrent clostridium difficile infection management, experts share closing thoughts and hopes for the future.
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Breaking Barriers: Partnerships to Improve Diabetic Eye Health in AlabamaThis article reviews barriers to diabetic eye health across Alabama and highlights a partnership with Genentech and the American Diabetes Association to address this issue.
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High-Intensity Home-Based Rehabilitation in a Medicare Accountable Care OrganizationHigh-intensity home-based rehabilitation (HIHR) may substitute for facility-based postacute rehabilitation. Patients in HIHR had better functional outcomes at lower costs than patients in facility-based care.
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Behavior-Based Diabetes Management: Impact on Care, Hospitalizations, and CostsThe Diabetes Care Rewards program offers a business case for health plans to promote engagement through use of contingent incentives, thus improving health outcomes and lowering costs.
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Privately Negotiated Facility Fees at Ambulatory Surgery Centers and HospitalsPrivate negotiated facility fees at hospitals are on average double the ambulatory surgery center facility fees for common outpatient procedures.
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Clinical and Economic Burden of Uncontrolled Severe Noneosinophilic AsthmaAmong patients with severe asthma with low eosinophils untreated with biologics, there is a high burden of disease among those who have suboptimal disease control.
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Treatment Modification After Initiating Second-Line Medication for Type 2 DiabetesAmong adults with type 2 diabetes who started noninsulin second-line therapy, most modified treatment within 1 year. Discontinuation was by far the most common modification.
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Building Better Collaboration: Reducing Care Delays in Managing mCRCExperts discuss proactive steps health care teams, including pharmacists, can take to minimize delays and overcome payer-related barriers when prescribing third-line therapies for metastatic colorectal cancer (mCRC) and how collaboration between health care teams, payers, and manufacturers can be improved to reduce care delays.
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A Health Plan Showing Up in New Ways Amid COVID-19Amid the current devastation wrought by the global pandemic, a health insurer in California has demonstrated leadership in fighting through systemic deficiencies by empowering people, process, and technology to address coronavirus disease 2019 (COVID-19).
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Why Health Care Must Bridge Social ServicesExplore how integrated social services enhance health equity, as demonstrated by The Camden Coalition's innovative approaches to patient care and support.
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Contributor: How Pediatric Mental Health May Influence the Risk of Heart Disease in AdulthoodIn this contributor piece, the connection between the complexities of mental health and heart disease in at-risk communities is explored, with the authors stressing the importance of risk factor evaluation and multidisciplinary patient education from both mental and physical health providers.
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Physical Activity Improves Performance, Frailty Scores, PROs in Multiple MyelomaExercises such as resistance training and walking were safe and effective interventions that were associated with improved frailty scores and patient-reported outcomes (PROs) in patients with multiple myeloma receiving systemic treatment.
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Cost-effectiveness of a 3-Year Tele-Messaging Intervention for Positive Airway Pressure UseLong-term tele-messaging was more effective than no messaging and short-term messaging for positive airway pressure use, and it was highly likely to be cost-effective with an acceptable willingness-to-pay threshold.
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Contributor: Beyond the Sloganeering—A Data-Driven Analysis of Recent 340B GrowthThis contributor column discusses a recent study that shows the 340B Program’s explosive growth is overwhelmingly due to utilization increases, not price.
