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How Do Providers Prioritize Prevention? A Qualitative StudyPrimary care providers utilize many strategies for prioritizing preventive care during time-constrained clinical encounters, in addition to being prompted by clinical reminders.
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Formulary Restrictions and Stroke Risk in Patients With Atrial FibrillationLimiting access to non–vitamin K antagonist oral anticoagulants through step therapy and prior authorization may exacerbate current underuse of anticoagulants and increase the risk of stroke in patients with newly diagnosed atrial fibrillation.
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Systematic Review of Benefit Designs With Differential Cost Sharing for Prescription DrugsA systematic review of insurance benefit designs with differential cost sharing for substitute prescription drugs.
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Helping Cancer Patients and Caregivers Navigate Immunotherapy TreatmentPatients, caregivers, and providers need education on immunotherapy treatment, support in patient-provider communications as well as support in mitigating the financial impact of immunotherapy treatment.
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Is Occupational Type Related to Obesity Risk?Sociodemographic characteristics of blue-collar workers may be attributed to the higher rates of obesity and chronic disease seen among them compared with white-collar workers.
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Emergency Department Visits for Nonurgent Conditions: Systematic Literature ReviewThis article presents a systematic review of the US literature on factors influencing the decision to visit the emergency department for nonurgent conditions.
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Primary Care Physician Resource Use Changes Associated With Feedback ReportsImplementing systemwide dissemination of feedback reports to primary care physicians in an integrated delivery system may be associated with changes in medical resource use.
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Cost-Effectiveness of Medicare Drug Plans in Schizophrenia and Bipolar DisorderIn Medicare Part D, generic drug coverage was cost saving compared with no coverage in bipolar disorder and schizophrenia while improving health outcomes.
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Effects of a Community-Based Care Management Model for Super-UtilizersA community-based care management program for high-risk patients reduced hospital readmissions and also likely reduced admissions and Medicare parts A and B spending.
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Self-Efficacy in Insurance Decision Making Among Older AdultsOlder adults who prefer to delegate insurance decisions tend to be female and married, to have less Medicare knowledge, and to have someone in their lives they trust to make decisions for them.
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Positive Predictive Values of ICD-9 Codes to Identify Patients With Stroke or TIAThis study determined that ICD-9 codes 433.X1, 434.XX, and V12.54 had positive predictive values >90%, and may be used to focus care on stroke patients.
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Multi-Payer Advanced Primary Care Practice Demonstration on Quality of CareAn evaluation of the Multi-Payer Advanced Primary Care Practice Demonstration found mixed results in terms of quality of care provided to Medicare and Medicaid beneficiaries.
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Connecting Statewide Health Information Technology Strategy to Payment ReformWhen aggregated data regarding health outcomes are shared, a clearer picture emerges of provider performance baselines and improvements with which payment models can be developed.
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The Oncology Medical Home - Beyond Clinical PathwaysClinical pathways have been emphasized as a means to deliver efficient, quality care and to ensure better outcomes at lower costs. The Oncology Medical Home takes this to the next, more comprehensive, step of quantifying and improving quality and value in cancer care while lowering overall costs.
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Healthcare Utilization and Costs in Persons With Insomnia in a Managed Care PopulationPatients with an insomnia diagnosis have higher healthcare utilization and costs than a matched control group, both before and after the diagnosis.
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Patients' Preferences for Receiving Laboratory Test ResultsThe main reason given for receiving results online was time savings, reported by 77% of participants, followed by lowering the chance of missing the results (31%).
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Medicare Part D After 2 YearsCoverage under Part D is comparable to that under non–Part D plans with respect to key features likely to be important to Medicare beneficiaries.
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Building Trust Can Improve American HealthcareThe promise of high-quality, affordable care aligning with the individual needs of patients remains elusive. Increasingly, the missing ingredient seems obvious: trust.
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Costs of Heart Failure-Related Hospitalizations in Patients Aged 18 to 64 YearsHospitalization costs associated with heart failure averaged $23,077 and were higher when heart failure was a secondary rather than the primary diagnosis.
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Implementing a Hybrid Approach to Select Patients for Care Management: Variations Across PracticesHybrid approaches allow for clinician input into case finding for care management, but training and monitoring is required to protect against unintentional biases.
