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Costs and Spillover Effects of Private Insurers' Coverage of Hepatitis C TreatmentExpanding private-payer coverage of hepatitis C treatment may yield significant long-term cost savings for private payers, reduced costs to Medicare, and increased social value.
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Ambulatory Care–Sensitive Emergency Visits Among Patients With Medical Home AccessPatients often self-refer to the emergency department (ED) for management of an ambulatory care–sensitive condition, and the ED may be the most appropriate care location.
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Toyota Production System Quality Improvement Initiative Improves Perioperative Antibiotic TherapyUse of Toyota production system methods as part of a nosocomial MRSA prevention initiative on a surgical unit improved quality of care in other areas.
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Impact of Primary and Specialty Care Integration via Asynchronous CommunicationGeisinger’s Ask-a-Doc program, which enables direct asynchronous communication between primary and specialty care, was associated with lower healthcare utilization and cost, implying more efficient care.
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Economic Implications of Weight Change in Patients With Type 2 Diabetes MellitusModest weight loss (>3%) among metformin-treated patients with type 2 diabetes mellitus was associated with decreased costs, lower resource utilization, and lower rates of treatment discontinuation.
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Methodological Effects on the Measurement of Repeat HospitalizationsThe rates of potentially preventable readmissions vary across measurement methodologies which explains inconsistencies in previous studies. Results suggest measurement of readmissions incentivizes inefficient behavior.
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Relationship Between Quality Improvement Processes and Clinical PerformanceThis study examines the clinical effects of care management and quality improvement interventions implemented by physician groups on pay-for-performance success.
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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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Health Information Technology for Ambulatory Care in Health SystemsHealth systems are important in driving electronic health record adoption in ambulatory clinics, although the uptake of key functionalities varies across systems.
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Electronic Health Records: Potential to Transform Medical EducationWith the transition to "meaningful use" of electronic health records, medical educators should consider ways to meaningfully improve how physicians are trained for practice.
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Quality of Care at Retail Clinics for 3 Common ConditionsQuality of care for 3 conditions, based on widely accepted objective measures, was superior in MinuteClinics compared with ambulatory care facilities or emergency departments.
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Spending Variation Among ACOs in the Medicare Shared Savings ProgramAnalysis of spending differences among accountable care organizations (ACOs) may help identify cost savings opportunities. We examined the magnitude and sources of spending variation among ACOs over 4 years.
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Case Study: How Does an ACO Generate Savings Three Years in a Row?Increasing accountable care organization savings is dependent on maximizing quality scores and increasing the number of beneficiaries while maintaining a low per-capita spend through efficiencies of care.
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Ambulatory Care–Sensitive Emergency Visits Among Patients With Medical Home AccessPatients often self-refer to the emergency department (ED) for management of an ambulatory care–sensitive condition, and the ED may be the most appropriate care location.
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Impact of an Online Prescription Management Account on Medication AdherenceOnline prescription management accounts may help promote medication adherence, as utilizing patients had a higher proportion of days covered than nonusers.
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Diabetes Care Improvement in Pharmacist- Versus Nurse-Supported Patient-Centered Medical HomesIn this longitudinal comparative effectiveness study of different chronic disease self-management support approaches within 1 system, both pharmacist- and nurse-led patient-centered medical home approaches improved diabetes care.
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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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Building Partnerships Between a College of Pharmacy and ACOs: Development of the ACORN SEEDTo promote future partnerships among colleges of pharmacy and accountable care organizations, this article describes several initial challenges to partnership formation, including those related to agenda setting and resource utilization.
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Vedolizumab First Shows Clinical and Economic Advantage in Ulcerative ColitisUsing vedolizumab first, before tumor necrosis factor-α inhibitors, improved quality-adjusted life-years in both ulcerative colitis and Crohn disease, and was less costly in ulcerative colitis, according to a real-world economic analysis from the EVOLVE study.
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The Role of Nurse Practitioners in Primary HealthcareThe potential of nurse practitioners is not being fully realized in primary care medical practices. Consequently, cost and quality gains are not being achieved.
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Patient Assistance: Implementing Preventative Steps to Ensure Financial WellnessAn overview of patient assistance programs at Smilow Cancer Hospital at Yale-New Haven, including their innovative hospital-based explanation of benefits form, which can eliminate patient responsibilities and help expedite the turnaround times for payment processing with copay assistance.
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Developing a Composite Weighted Quality Metric to Reflect the Total Benefit Conferred by a Health PlanThe authors developed a weighted quality measure to reflect the total health benefit conferred by a health plan annually to its members.
