An analysis of administrative claims showed increasing rates of heroin overdose among an insured population and opportunities for interventions during healthcare encounters before overdose.
Retrospective evaluations of electronic health records and claims databases to assess clinical outcomes and costs associated with evidence-based pathways in colon cancer.
Parents with language barriers reported less timely illness care and routine care for children in managed care Medicaid.
Hospitalization costs associated with heart failure averaged $23,077 and were higher when heart failure was a secondary rather than the primary diagnosis.
The authors describe a quality improvement intervention that focuses on directly scheduling mammogram appointments for women who lack adherence despite written outreach letters.
We used aggregated pharmacy claims data available within the electronic health record to identify a high rate of primary nonadherence in a nonintegrated primary care network.
Routinely screening pregnant women for Staphylococcus aureus colonization and decolonizing carriers before cesarean delivery are unlikely to be cost-effective under current epidemiologic circumstances.
Patients utilizing Medisave for a diabetes management program in Singapore were more compliant with care processes, but reductions in hospitalization and costs were not sustained.
The health benefits for participants of the Complete Health Improvement Program ("CHIP"), a lifestyle medicine program, are present regardless of the program tuition payment source.
Mechanisms to better codify clinical outcomes and intermediate outcome milestones are necessary to make the fullest use of EHR data for comparative effectiveness research.
Criteria used by primary care physicians to select patients for practice-based care management programs were explored in a qualitative study.
We examined the impact of electronic reminders followed by performance reports and financial incentives. Physicians responded more to reports and incentives than to reminders alone.
At least 50 quality events per physician are needed to reach a minimum level of reliability for most quality measures calculated from administrative data.
Super-utilizers place a significant clinical and financial burden on the healthcare system. The authors investigated the effectiveness of community navigators in reducing hospital utilization and costs.
Determining the impact of health information technology adoption and hospital-physician integration on hospital efficiency.
How does the largest payer in a state with a large senior population respond to the rising need for diabetes care and prevention?
A qualitative study of patient and provider perspectives regarding the after-visit summary and the patient portal features of the electronic health record.
Health 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.
Revisions 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.