Authors
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Predicting Opioid Use Disorder and Associated Risk Factors in a Medicaid Managed Care PopulationA Medicaid managed care organization developed a machine learning model to identify opioid use disorder (OUD) risk factors and predict OUD incidence in its multistate population.
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The Pharmacist’s Role in Value-Based Oncology Models: David Awad, PharmD, BCOPPharmacists are being asked to not only manage medications and side effects but also be fiscally responsible for the whole institution and its trickle-down effect on costs, said David Awad, PharmD, BCOP, of Robert Wood Johnson University Hospital.
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Oncology Alternative Payment Models: Lessons From Commercial InsuranceDeveloping alternative payment models for commercial populations in specialties such as oncology is rife with practical challenges. Leading payers and practices share lessons to date.
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COVID-19’s Hidden Toll: Noah Greenspan, DPT, on Inflammation, Flares, and RecoveryNoah Greenspan, DPT, PT, CCS, EMT-B, cardiopulmonary physical therapist and director of the Pulmonary Wellness and Rehabilitation Center in New York City, reflects on how the reality of COVID-19 infection proved far more complex than initially thought.
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Impact of Advance Care Planning Consults on Advance Directives CompletionImplementing advance care planning consults can increase advance directive completion rates. The authors demonstrate the impact of consults on completed advance directives in the medical record.
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ASCO 2024 Review and Needed Future Research in CDK4/6 inhibitors Early Breast CancerA panel of experts review ASCO 2024 and the need for future research in CDK4/6 inhibitors.
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Machine Intelligence for Early Targeted Precision Management and Response to Outbreaks of Respiratory InfectionsThis paper evaluates novel machine intelligence to predict patients at risk of severe respiratory infections and recommend postacute care providers likely to reduce infection risk.
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Managed Care COVID-19 Outcomes in a Population Health ProgramData from 38,193 patients showed that managed care patients have COVID-19 risk factors similar to those of the general population and that a population health program decreased mortality.
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Antihyperglycemic Treatment Patterns for Chronic Kidney Disease and Type 2 DiabetesThis study characterized antihyperglycemic medication use after chronic kidney disease onset among patients with type 2 diabetes to uncover potential unmet needs in clinical practice.
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Privately Negotiated Facility Fees at Ambulatory Surgery Centers and HospitalsPrivate negotiated facility fees at hospitals are on average double the ambulatory surgery center facility fees for common outpatient procedures.
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Service Line Care Delivery Model for COVID-19 Patient-Centric CareThe authors provide steps hospitals can take to align their care delivery model to effectively meet the demands of a public health crisis such as the current pandemic.
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Corticosteroid Premedication for Infliximab Remains Unnecessarily CommonAlthough use of corticosteroid premedication prior to infliximab infusions is declining, it remains unnecessarily high despite limited benefit and the risk of serious adverse events from corticosteroids.
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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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Transitional Care Management Visits to Improve Coordination of CareInspira Care Connect, LLC, an accountable care organization, incorporated transitional care management services into its postdischarge follow-up process to prevent avoidable utilization of health care services and costs.
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A Pharmacist’s Perspective on Optimizing Therapy Selection and Deprescribing in Oncology: Jason Bergsbaken, PharmD, MBA, BCOPJason Bergsbaken, PharmD, MBA, BCOP, explains the value of pharmacist involvement in precision molecular tumor boards and end-of-life care discussions, highlighting their role in ensuring evidence-based therapy selection, patient-specific recommendations, and shared decision-making that aligns treatment with individual goals.
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Contributor: It’s Time to Talk About Paying Clinical Trial Participants MoreThere is wide variation in the governance over research participant pay, and with rapid advances in technology enabling trial access, industry should step up and pay patients what they are worth, says Gunnar Esiason, a patient advocate living with cystic fibrosis.
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Patients’ Needs Following Emergency Care for Ambulatory Care–Sensitive ConditionsTo inform intervention development, we assessed for medication changes and patient care needs following treat-and-release Veterans Affairs emergency department visits for chronic ambulatory care–sensitive conditions.
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Choosing Wisely Interventions to Reduce Antibiotic Overuse in the Safety NetThis study evaluates the impact of Choosing Wisely–based interventions on antibiotic prescribing for viral respiratory tract infections in a real-world safety-net setting.
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Advanced Care at Home at Scale in an Integrated Health Care SystemAdvanced care at home (otherwise known as hospital at home) can be scaled and provide care for a sizable portion of a hospital’s inpatient census, creating hospital capacity in an integrated delivery system.
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Comparison of Primary Payer in Cancer Registry and Discharge DataEnrollment in managed care among Medicaid enrollees presents challenges to classifying Medicaid coverage in cancer registries.
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Exploring The Future of NF1-PN ManagementPanelists discuss the future of NF1-associated plexiform neurofibromas management, highlighting the potential for advances in targeted therapies, gene therapies, and personalized medicine to offer more effective, tailored treatments, while emphasizing early detection, improved imaging, and a greater focus on quality of life through psychosocial support, pain management, and functional rehabilitation.
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Impact of COVID-19 on Specialty Televisits in a Large Integrated Health Care SystemSpecialty televisits remain common in the Veterans Health Administration following the COVID-19 pandemic, suggesting they will remain an important ongoing care modality for many patients.
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Telemetry: Appropriateness of Initial Assignment and Duration in Nonintensive SettingThe authors report overutilization of telemetry monitoring in a community setting, increasing the cost of health care and potential harm to patients with unnecessary interventions.
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Contributor: How to Become a Star Ratings “Triple Threat” With CAHPS, Medication Adherence, and an SDOH-First Approach to Member EngagementMedicare Advantage plans can implement 3 simple steps to make sure that they are competitive in the modern Stars environment.
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Impact of Medical Care Coordination Intervention on Patient ActivationThis observational evaluation compared an adult medical care coordination intervention with usual care and found that the intervention was associated with significant improvements in patient activation.
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Service Line Care Delivery Model for COVID-19 Patient-Centric CareThe authors provide steps hospitals can take to align their care delivery model to effectively meet the demands of a public health crisis such as the current pandemic.
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Systemic Treatments for Advanced Prostate Cancer: Relationship Between Health Insurance Plan and Treatment CostsThe authors examine how insurer and patient out-of-pocket payments for advanced prostate cancer differ by drug and health plan type and describe the relationship between these payments and utilization.
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Generalized Cost-Effectiveness Analysis to Assess Treatment Value in Hepatitis CThis article estimates the comprehensive value of direct-acting antivirals for the treatment of hepatitis C virus using a generalized cost-effectiveness analysis.
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Modeling of an Alternative Reimbursement Method for Palliative CareThe authors modeled a version of the Patient and Caregiver Support for Serious Illness alternative reimbursement structure for palliative care using data from the Statin Trial.
