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Appropriate ED Utilization Leading to Better Care CoordinationAddressing avoidable emergency department (ED) utilization takes interventions in partnership with providers.
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The Persistent Pandemic of Violence Against Health Care WorkersThe problem of violence against health care workers has escalated across the world, and tackling this issue requires the support of administrators.
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Building Research Capacity in Primary Care Practices That Serve Predominantly Racial and Ethnic Minority PopulationsThe successful collaboration between a primary care–based network of practices and academic researchers demonstrates feasibility and the need for more funding for primary care research.
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Stakeholder Analysis: Medicare Diabetes Prevention Program Awareness and ImplementationThis article describes facilitators of and barriers to uptake of the underutilized Medicare Diabetes Prevention Program from the perspectives of health care providers and program suppliers in western Pennsylvania.
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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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Estimating the Economic Burden of Migraine on US EmployersThe Migraine Impact Model is an interactive calculator that estimates migraine prevalence within a workforce and the associated economic burden of migraine on the employer.
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Reimbursement for Genetic Variant Reinterpretation: Five Questions Payers Should AskPeriodic reinterpretation of genetic sequencing results presents a challenge for developing transparent and systematic coverage and reimbursement policies.
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Cost of Home vs Clinic Administration of Paclitaxel in Metastatic Breast CancerHome administration of oral paclitaxel and encequidar is associated with potential cost savings for payers compared with clinic administration of intravenous chemotherapy in metastatic breast cancer patients.
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Guideline-Informed Care Among Medicaid-Enrolled Children With Food AllergyThis article describes food allergy–related service utilization and identifies factors associated with guideline-informed care among Medicaid-enrolled US children with food allergy.
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Impact of Including Drug Spending in Oncology Alternative Payment ModelsThis study demonstrates a method for understanding the effects of drug spending in the design of alternative payment models.
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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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Accountable Care Organizations and HPV Vaccine Uptake: A Multilevel AnalysisThe authors evaluated whether adolescents receiving care at accountable care organizations (ACOs) vs non-ACOs were more likely to initiate and complete the human papillomavirus (HPV) vaccination series.
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Contributor: Medicare Policy Proposal Jeopardizes Care for Those on DialysisCEOs of 3 kidney care organizations explain flaws in CMS' recent reimbursement proposal.
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Lp(a) and Getting a Head Start Against Heart Disease: Jeremy Wigginton, MDLipoprotein a (Lp[a]) is a valuable tool for assessing a patient's risk of cardiovascular disease, which can facilitate earlier intervention efforts and reduce health care costs, argued Jeremy Wigginton, MD.
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Addressing the Opioid CrisisThe authors highlight the diversity of multiagency electronic data-sharing approaches and present a case study addressing the opioid crisis
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Building Community and Advancing Care at MDA 2025One of the major highlights of the Muscular Dystrophy Association (MDA) Clinical & Scientific Conference is that invaluable networking opportunities can help clinicians elevate their own best practices.
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Pediatric Alopecia Areata Treatment With Baricitinib, Combination Therapies, Patient AdherenceIn an interview with Brittany Craiglow, MD, FAAD, dermatologist at Dermatology Physicians of Connecticut in Fairfield, she advocates for combination therapies using baricitinib to treat pediatric alopecia areata and highlights the need for personalized treatment approaches based on Janus kinase inhibitor responses.
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“Flipping the Script” to Reshape Access, Redefine Value in Oncology: Andrew Chapman, DO"Value" in oncology should measure far more than clinical outcomes, stated Andrew Chapman, DO, as he argued how rethinking "value" could not only enhance patient care but also drive down costs.
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Increased Awareness, Novel Interventions Spell New Era for MASLD/MASH: Naim Alkhouri, MDThe future of treating metabolic dysfunction–associated steatohepatitis (MASH) looks brighter than ever, says Naim Alkhouri, MD, as data emerges on newly developed interventions.
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Determinants of ICS Therapy Adherence in Patients With AsthmaThis study describes determinants affecting disease control and inhaled glucocorticosteroid therapy adherence for patients with asthma in western China.
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AUA 2024: Disrupting the Field of UrologySpeakers at the 2024 American Urological Association (AUA) annual meeting highlighted the innovations and advancements that are pushing the field of urology forward.
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Legislative Updates Shaping Managed Care Pharmacy: Adam Colborn, JDAdam Colborn, JD, associate vice president for congressional affairs, Academy of Managed Care Pharmacy, highlights key policy updates that are impacting managed care pharmacy.
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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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Medicare Advantage in Rural Areas: Implications for Hospital SustainabilityThis retrospective cohort study of rural hospitals found that Medicare Advantage penetration increased substantially from 2008 to 2019 and was associated with greater hospital sustainability.
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Rituximab Reference vs Biosimilar Utilization for Oncology vs Nononcology IndicationsReporting on the real-world utilization of reference rituximab and its biosimilars can help show prescribing habits and reveal cost-saving opportunities.
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Patient-Centered Communication and Outcomes in Heart FailureAmong community patients living with heart failure, excellent and good patient-centered communication was associated with a reduced risk of death.
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Three New Studies Explore Treatment Strategies for Heart Failure and Comorbid ConditionsFindings from the SUMMIT, Altshock-2, and FAIR-HF2 trials were presented at the American College of Cardiology 2025 Annual Scientific Session.
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A Cue-to-Action Pilot Project to Increase Screening MammographyA targeted cue-to-action campaign of outreach, education, and incentive can improve uptake of screening mammography.
