This study assesses the clinical and economic implications from a payer perspective of human papillomavirus genotyping for cervical cancer screening in comparison with existing practices.
The Medicaid population has significantly higher hepatitis C virus (HCV) prevalence and mortality rates than patients with private insurance. These data must be considered when policy makers assess providing additional support to Medicaid programs for HCV elimination.
Among a diabetes group visit population, this study found substantial savings in outpatient charges due to reduction in the use of more expensive specialty visits.
Rural patients receive less postacute care after hospital discharge than urban patients, especially after elective joint replacement-a condition selected for bundled payments.
Use of online shared records was higher among HIV patients who had indicators of recent increases in healthcare needs and lower among several vulnerable populations.
The existence of chronic conditions did not adversely impact the ability of children in Medicaid managed care to access and utilize recommended preventive care services.
By covering vaccinations under both the medical and pharmacy benefit, rather than the medical benefit alone, health insurers can help improve adult vaccination rates.
The authors compare methods of retrospectively attributing patients to provider systems by the fraction of patients attributed and the stability of attribution over time.
Focusing on quality and quality measurements has the potential to reduce costs, increase quality, and deliver more value to patients, consumers, and customers.
In this qualitative investigation, leaders of Medicaid managed care plans were interviewed to identify facilitators of and barriers to electronic consultation for specialty care delivery.
Some hospitals were able to outperform others in a commercial insurer episode-based incentive program, but there was little evidence of global reductions in episode spending.
Patients with rheumatoid arthritis self-report a moderate rate of any previous pneumococcal vaccination (54%) and a very low rate of herpes zoster vaccination (8%).
The frequency with which 7 of the largest Medicare Advantage plans impose step therapy protocols in their Part B drug coverage decisions varies substantially.
A networked system designed to promote patient self-management appears to be safe and effective in capturing, integrating, and presenting medication adherence and physiologic information.
Physician-led patient care teams have the potential to impact care transitions to prevent fragmentation of care, and ensure seamless care delivery.