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Two-Sided Risk in the Oncology Care ModelThe US healthcare system remains one of the most inefficient healthcare systems in the world. The Bloomberg Health-Care Efficiency Index ranked the United States 54th among 56 countries in 2018, tied with Azerbaijan and only ahead of Bulgaria. This occurs even though the United States spends $10,244 per capita annually on healthcare, a figure representing 17% of the gross domestic product.
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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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Closing the Personalized Medicine Information Gap: HER2 Test Documentation PracticeDespite universal access to HER2 testing in Ontario, variability in reporting by region and disease severity presents challenges for program evaluation and quality improvement initiatives.
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Association of Care Management Intensity With Healthcare Utilization in an All-Condition Care Management ProgramHigher intensity of care management in an all-condition program addressing care coordination and care barriers was associated with increased healthcare utilization among Medicaid and Medicare patients.
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Racial and Ethnic Disparity in Palliative Care and Hospice UseRace/ethnicity was not a predictor of inpatient palliative care consultation or discharge to hospice in 4 hospitals with an inpatient palliative care service.
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Amazing Grace: A Free Clinic's Transformation to the Patient-Centered Medical Home ModelDespite many barriers, Grace Medical Home, a free clinic, achieved patient-centered medical home recognition in October 2014 through a focused team-based approach.
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Aligning Payment Reform and Delivery Innovation in Emergency CareThe authors apply HHS’s payment taxonomy framework to acute unscheduled care and describe how payment reform supports delivery innovation.
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Consumer Attitudes Toward Personal Health Records in a Beacon CommunityEven in communities with health information technology initiatives, consumer use of personal health records may be limited by the
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Health Information Technology and Physicians' Knowledge of Drug CostsHigh rates of health information technology use by physicians were only modestly associated with better knowledge of drug costs.
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Cost-Effectiveness of 21-Gene Assay in Node-Positive, Early-Stage Breast CancerA decision-analytic model was used to estimate cost-effectiveness of adopting a 21-gene assay in treatment decisions for women with early-stage N (1-3)/ER HER2-negative breast cancer.
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Rising Use of Surveillance Colonoscopy and Potential ImpactsThe proportion of colonoscopies performed for postpolypectomy surveillance has increased significantly, particularly among older patients with limited life expectancy, raising concern for possible overuse.
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Understanding Factors Associated With Readmission Disparities Among Delta Region, Delta State, and Other HospitalsRevisions of the Hospital Readmissions Reduction Program should consider including community characteristics in risk adjustment models and adding mechanisms that recognize improvement given the uniqueness of the Mississippi Delta region.
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Identifying Children at Risk of Asthma Exacerbations: Beyond HEDISAnalysis of insurance claims reveals that criteria other than the Healthcare Effectiveness Data and Information Set (HEDIS) persistent asthma definition can identify more at-risk patients with reasonable loss of specificity.
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Psoriatic Arthritis Treatment Patterns and Costs Among Pharmacologic Treatment–Naïve PatientsWe present results of an analysis of IBM MarketScan databases that evaluates treatment patterns and health care costs for treatment-naïve patients with psoriatic arthritis.
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Can Managed Care Organizations Partner With Manufacturers for Comparative Effectiveness Research?Two case studies examine the benefits of manufacturers and managed care organizations partnering in pragmatic or practical clinical trials to generate real-world evidence.
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Guideline-Based Peer-to-Peer Consultation Optimizes Pegfilgrastim Use With No Adverse Clinical ConsequencesActive expert peer-to-peer consultation with prescribing oncologists can promote adherence to guidelines and lead to cost reductions without risk of neutropenic fever, with or without hospitalization, for patients with cancer.
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The Role of Retail Pharmacies in CVD Prevention After the Release of the ATP IV GuidelinesThe release of the ATP-4 guidelines meaningfully changes the way the authors manage cholesterol and prevent cardiovascular disease. The broad footprint of retail pharmacies, with their ability to assess risk, prescribe, and manage adherence, allow them to be unique partners in cholesterol management and cardiovascular disease prevention.
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State of Emergency Preparedness for US Health Insurance PlansHealth insurance plans serve a critical role in public health emergencies. The authors queried plans about issues related to emergency preparedness: infrastructure, adaptability, connectedness, and best practices.
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Impact of Electronic Prescribing on Medication Use in Ambulatory CareBoth potential benefits and unexpected consequences were found as a result of the rollout of electronic prescribing.
