Authors
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Real-World Users of Triple Therapy for Asthma in the USThis retrospective cohort study evaluated baseline demographics, clinical characteristics, and treatment patterns of US patients with asthma who newly initiated single- or multiple-inhaler triple therapy.
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Adverse Drug Effects Across Patients With Heart Failure: A Systematic ReviewThis systematic literature review reports incidence of adverse drug effects associated with guideline-directed medical therapy for patients with heart failure with reduced ejection fraction.
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Association of Co-pay Elimination With Medication Adherence and Total CostThis study evaluated cost and utilization attributed to members enrolled in a health care program with no pharmacy co-pay. Health care savings were identified in addition to medication adherence improvements.
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An Outpatient Critical Care Transition Clinic Model Reduces Admissions/Readmissions in Medically Complex PatientsCritical care transition clinic patients with chronic conditions had a 31% reduction in relative risk for inpatient admissions, and the clinic reduced cost by more than $1 million.
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Politics vs Science: The Future of US Public HealthOn this episode of Managed Care Cast, we speak with Perry N. Halkitis, PhD, MS, MPH, dean of the Rutgers School of Public Health, on the public health implications of the US withdrawal from the World Health Organization and the role of public health leaders in advocating for science and health.
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Facilitators of and Barriers to Medicaid Investment in Electronic Consultation ServicesIn this qualitative investigation, leaders of Medicaid managed care plans were interviewed to identify facilitators of and barriers to electronic consultation for specialty care delivery.
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Minimally Invasive Glaucoma Surgery Offers Quality of Life Improvements in Patients With Glaucoma: Christine Funke, MDMinimally invasive glaucoma surgery offers alternatives for patients looking for methods of treating glaucoma without affecting quality of life.
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Bridging the Gap Between Medical and Pharmacy BenefitsAs health care costs rise, especially for patients with complex conditions, a major barrier to access is the disconnect between medical benefits and pharmacy benefits.
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Medication Adherence Star Ratings Measures, Health Care Resource Utilization, and CostFor patients prescribed diabetes, hypertension, and hyperlipidemia medications, nonadherence to CMS Star Ratings quality measures of medication adherence was associated with increased health care resource utilization and costs.
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Primary Care Redesign and Care Fragmentation Among Medicare BeneficiariesThis article examines the association between a large-scale primary care redesign—the Comprehensive Primary Care Plus Initiative—and ambulatory care patterns of Medicare beneficiaries with highly fragmented care.
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Increased Likelihood of Psychiatric Readmission With Medicaid Expansion vs Legacy CoverageIndividuals who became eligible for Medicaid through Medicaid expansion have an increased likelihood of psychiatric readmission compared with their legacy-enrolled counterparts.
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Dr Ibrahim Aldoss on the Need for Targeted Therapy for KMT2Ar Acute LeukemiasIbrahim T. Aldoss, MD, of City of Hope Comprehensive Cancer Center, discusses the potential of revumenib in KMT2A-rearranged (KMT2Ar) acute leukemias, with pivotal results presented at the 65th Annual American Society of Hematology Annual Meeting and Exposition this week.
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Hidradenitis Suppurativa Onset and Treatment: Challenges and Hope for PatientsChristopher Sayed, MD, discusses how hidradenitis suppurativa typically presents and looks forward, following the November approval of bimekizumab.
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New Era of CLL Treatments Brings Changes to Use of HSCTWith a 42% reduction seen in the use of hematopoietic stem cell transplantation (HSCT) throughout the decade, researchers suggest that transplantation may be reserved for more fit patients.
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Primary Care for New vs Established Medicaid EnrolleesUnder Affordable Care Act Medicaid expansion in New Jersey, new and distinct patterns of primary care utilization emerged for new vs established enrollees.
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Medication Adherence Star Ratings Measures, Health Care Resource Utilization, and CostFor patients prescribed diabetes, hypertension, and hyperlipidemia medications, nonadherence to CMS Star Ratings quality measures of medication adherence was associated with increased health care resource utilization and costs.
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Pervasiveness and Clinical Staff Perceptions of HPV Vaccination FeedbackThis article used regression analyses to quantify how clinical staff perceive provider feedback to improve human papillomavirus (HPV) vaccination rates and determine the prevalence of such feedback.
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Antihyperglycemic Treatment Patterns for Chronic Kidney Disease and Type 2 DiabetesThis study characterized antihyperglycemic medication use after chronic kidney disease onset among patients with type 2 diabetes to uncover potential unmet needs in clinical practice.
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Telehealth Insights From an Integrated Care SystemExperiences from a large, integrated, value-based health system suggest that telehealth can be an effective care delivery approach. Public policies can improve telehealth access and care.
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Implementing Multistate Behavioral Health Pay-for-Performance Initiatives in Medicaid Managed CareThe authors describe a pay-for-performance initiative targeting behavioral health providers, which was introduced by a large Medicaid managed care organization across multiple states.
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Humira: The First $20 Billion DrugThe authors review a House Oversight Committee investigation report on AbbVie’s practices pertaining to adalimumab (Humira) to shed light on broader pharmaceutical market dynamics hindering a competitive market.
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In Evaluating Rheumatoid Arthritis Treatments, Involving Patients Is KeyStacy Courtnay is the community network chair for the Arthritis Foundation in Atlanta highlights a report that discusses how understanding patient experiences in RA can shift questions researchers ask.
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Patient Perspectives on Technology-Based Approaches to Social Needs ScreeningPatients are essential stakeholders in designing systems to capture social needs. The authors present key findings from patient interviews regarding social needs screening through technology-based modalities.
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Budget Impact Analysis of Biosimilar Natalizumab in the USProjected savings from biosimilar natalizumab were $452,611 over 3 years, driven by decreased drug acquisition costs and a utilization shift from reference to biosimilar natalizumab.
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Primary Care Visit Cadence and Hospital Admissions in High-Risk PatientsPatients with congestive heart failure and/or chronic obstructive pulmonary disease who had more quarterly primary care visits had lower rates of hospitalizations during the COVID-19 pandemic.
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Clinicians Should Be Able to Rely on Coverage for Category 2B Treatments: Eric Lander, MDEric Lander, MD, discussed the difficulty that clinicians and pharmacists face in getting insurance coverage for category 2B treatments in the National Comprehensive Cancer Network guidelines, which could affect how patients are treated for cancer.
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How Medicare Advantage Plans Use Data for Supplemental Benefits Decision-MakingThis article presents findings from interviews conducted with executives from 29 Medicare Advantage plans regarding plan decision-making processes related to new social risk factor–related benefits.
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Shifts in Standard of Care for Adults and Children With KMT2A AMLPanelists emphasize that the approval of menin inhibitors has transformed the treatment landscape for KMT2A-rearranged acute myeloid leukemia (AML) by replacing historically limited and toxic chemotherapy-based strategies with a targeted, guideline-endorsed option that aligns with disease biology—offering renewed hope for both adult and pediatric patients, especially in the relapsed/refractory setting.
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Medicare Payment Rule Threatens Access to Life-Sustaining Kidney CareThe authors call on Congress to reform Medicare reimbursement for dialysis, saying the recent rule puts clinics at risk of closure.
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Social Determinants of Health: Are Colonoscopies Always Fit for Duty?Social determinants of health are associated with colonoscopy noncompletion in a Medicaid patient population at the Providence Community Health Centers.
