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A Novel Pharmaceutical-ACO Collaboration: the Merck/Heritage Provider Network Open Innovation ChallengeAccountable 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.
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Outpatient Referral Rates in Family MedicineReferral patterns by family physicians affect numerous aspects of medical care. This study compares the outpatient referral rates of residents, residency faculty, and clinical faculty.
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What Performance Measures Do Consumers Find Useful When Selecting Marketplace Health Plans?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.
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Primary Care and Communication in Shared Cancer Care: A Qualitative StudyThis qualitative study assesses patient, PCP, and oncologist views on primary care roles in shared cancer care, as well as patterns of communication between physicians.
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Racial/Ethnic and Age Disparities in Chemotherapy Selection for Colorectal CancerAmong Medicare enrollees with metastatic colorectal cancer, the use of newer chemotherapy agents was lower for African American patients and for older patients.
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Does Paid Versus Unpaid Supplementary Caregiving Matter in Preventable Readmissions?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.
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Health Equity in the Era of Large Language ModelsThis 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.
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Impact of Formulary Restrictions on Medication Use and CostsPlacing 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.
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Impact of Including Drug Spending in Oncology Alternative Payment ModelsThis study demonstrates a method for understanding the effects of drug spending in the design of alternative payment models.
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Cost-Effectiveness of Intensive Tobacco Dependence Intervention Based on Self-Determination TheoryAn 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.
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Physician Utilization by Insurance Type Among Youth With Type 2 DiabetesPhysician utilization during the year before the first indication of type 2 diabetes did not differ between Medicaid-covered and privately insured youth.
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Effect of Physician-Specific Pay-for-Performance Incentives in a Large Group PracticeThis study examined the effect of physician-specific pay-for-performance incentives on well-established ambulatory quality measures in a large group practice setting.
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Bridging the Digital Divide: Mobile Access to Personal Health Records Among Patients With DiabetesRacial/ethnic minorities and patients living in poorer neighborhoods were more likely to access their personal health record exclusively with a mobile device.
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The Association of Health Literacy Domains With Hospitalizations and MortalityDespite previous research evidence, this study did not reveal an overall association of health literacy, numeracy, and graph literacy with all-cause hospitalizations or mortality.
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Patients' Success in Negotiating Out-of-Network BillsNineteen percent of bills for out-of-network visits were negotiated, and of these negotiated bills, individuals were successful in lowering their costs approximately half the time.
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Supporting the Patient's Role in Guideline Compliance: A Controlled StudyThis study measured compliance with evidence-based guidelines after clinical alerts sent to physicians, compared with compliance after alerts sent to both physicians and their patients.
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Positive Quality Interventions: An Innovative Platform for Oncology Practice CollaborationAn in-depth look into a nationwide collaborative initiative to standardize and improve oncology dispensing practices for the benefit of patient/provider education, adherence, and overall care.
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Call Center Performance Affects Patient Perceptions of Access and SatisfactionGreater telephone wait times, but not abandonment rates, were associated with lower patient perceptions of their ability to obtain urgent care in a timely manner.
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Insurance Switching and Mismatch Between the Costs and Benefits of New TechnologiesTransformative therapies with high up-front costs will exacerbate the need to address gaps between payers when costs and benefits occur at different times.
