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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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Medicare Advantage Plan Representatives’ Perspectives on Pay for SuccessThis study examined how Medicare Advantage plan representatives perceive the alternative financing model Pay for Success and its potential to address members’ social risk factors.
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Guideline Concordance of New Statin Prescriptions: Who Got a Statin?New statin prescriptions at the Veterans Health Administration were reviewed using a cross-sectional study design. Statins were frequently prescribed outside of guideline recommendations.
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Trends in Out-of-Pocket Healthcare Costs Among Older Community-Dwelling Medicare BeneficiariesOut-of-pocket healthcare costs rose significantly between 2000 and 2004; these data provide a baseline for evaluating Medicare reform proposals that affect beneficiary spending.
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Integrated Care Organizations: Medicare Financing for Care at HomeThis paper presents a policy proposal to integrate care for Medicare beneficiaries through creation of integrated care organizations and a Medicare home care benefit.
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Are Medical Offices Ready for Value-Based Reimbursement? Staff Perceptions of a Workplace Climate for Value and EfficiencyThis study surveyed 840 clinical and nonclinical staff in 96 medical offices regarding workplace policies and procedures that facilitate a climate for value.
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Costs for a Health Coaching Intervention for Chronic Care ManagementOn average, the health coach intervention cost $483 per participant per year. There was no evidence that the coaching intervention saved money at 1 year.
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ACO Coalition Members Present Success Stories in Diabetes ManagementAs part of its mission to bring together stakeholders engaged in implementing the Affordable Care Act, The American Journal of Managed Care created the ACO and Emerging Healthcare Delivery Coalition, which gives participants opportunities to share best practices in using new reimbursement models. The final panel of "Patient-Centered Diabetes Care: Putting Theory Into Practice" invited ACO Coalition members to present insights on diabetes care.
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Does a Personalized Approach Improve Patient Satisfaction in Thoracic Oncology?Evaluation of cancer patients’ quality of life at admission enabled improvement of their satisfaction with received care at discharge.
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Reducing Low-Value Care in VirginiaVirginia is currently focused on creating a collaborative, data-informed process to reduce the use of low-value services and care and better serve patients.
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Using "Roll-up" Measures in Healthcare Quality Reports: Perspectives of Report Sponsors and National AlliancesThis study identifies practices and perceptions around public reporting of “roll-upâ€
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Self-Reported Health and Functional Status Information Improves Prediction of Inpatient Admissions and CostsAmong a Medicare population, use of 3 self-reported health items improves predicted inpatient admissions and healthcare costs when used with risk-prediction model.
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Identifying Groups of Nonparticipants in Type 2 Diabetes Mellitus EducationThis study describes reasons for nonparticipation in type 2 diabetes mellitus education and identifies typical subgroups of nonparticipants in order to improve recruitment strategies.
