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Potential Impact of Hospital at Home on Postoperative ReadmissionsMany postoperative readmissions are amenable to diversion to a hospital at home program for surgical patients, representing an opportunity to generate revenue and improve patient experience.
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Mental Health Service Utilization Review Patterns in a Medicaid Managed Care ProgramMedicaid managed care utilization review data for mental health services were analyzed for the calendar years 2017 and 2018. These data indicate low rates of utilization review denials for both inpatient and outpatient mental health services.
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Assessment of Structured Data Elements for Social Risk FactorsAn expert panel identified and assessed electronic health record and health information exchange structured data elements to support future development of social risk factor computable phenotyping.
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Diabetes Associated With Higher Health Care Utilization and Poor Outcomes After COPD-Related HospitalizationsPatients with diabetes and chronic obstructive pulmonary disease (COPD) have worse outcomes when hospitalized and appear to be more vulnerable to respiratory and nonrespiratory complications after a COPD exacerbation, which highlights the need for targeted interventions in this population.
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Characterizing Telehealth Use in the US: Analysis of the 2022 Health Information National Trends SurveyPatients’ motivations for telehealth use require further investigation to develop appropriate policies.
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Challenges Faced by Medicaid Managed Care Coordinators Working With Members With Substance Use DisorderAccessing medical and social resources for patients, heavy administrative burden, and lack of data integration are barriers to Medicaid managed care organization care coordinators’ job performance.
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Patient-Centered Oncology Care: Impact on Utilization, Patient Experiences, and QualityPractices implementing a patient-centered oncology care pilot had improved quality, but utilization and patient experiences did not differ from comparison practices.
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Navigating Privacy and Security in Telemedicine for Primary CareThis qualitative study of patients and providers in primary care evaluated privacy and safety considerations in telemedicine following the COVID-19 pandemic.
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Evaluating Smoking Cessation Service at an Emergency Department Clinical Observation UnitThis study aimed to evaluate the impact of a smoking cessation service in a group of patients admitted to a short-stay unit in the emergency department.
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Key Takeaways on Enhancing Outcomes for mNSCLC Without Targetable Driver MutationsThe panel provides insights on enhancing outcomes for patients with metastatic non-small cell lung cancer without targetable driver mutations.
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Discussing the Pathophysiology of Alopecia AreataPanelists discuss how alopecia areata (AA) is a chronic autoimmune disease characterized by inflammation that attacks hair follicles, leading to hair loss and varying disease progression.
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“Can You Hear Me Now?”: Postoperative Patient-Initiated Communication With ProvidersPatient-provider communication after surgery is critical for patient safety. The growth of patient-provider communication technologies has created opportunities to study postoperative patient-initiated communication.
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Association Between Use of Clinician Performance Information and Patient ExperienceHigh patient experience scores were associated with the collection and use of any clinician performance information, especially with whether the practice shared this information internally to compare.
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Integrating Predictive Models Into Care: Facilitating Informed Decision-Making and Communicating Equity IssuesAs predictive models proliferate, providers and decision makers require accessible information to guide their use. Preventing and combating bias must also be priorities in model development and in communication with providers and decision makers.
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An Outpatient Critical Care Transition Clinic Model Reduces Admissions/Readmissions in Medically Complex PatientsCritical care transition clinic patients with chronic conditions had a 31% reduction in relative risk for inpatient admissions, and the clinic reduced cost by more than $1 million.
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Managing Total Knee Replacement Under Value-Based PaymentsThis article describes the approach that a large primary care group at risk for value-based payments chose to deploy in managing clinical and financial outcomes of knee osteoarthritis jointly with orthopedic surgeons.
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Medication Persistence and Its Impact on Type 2 DiabetesMost newly treated patients with type 2 diabetes exhibit suboptimal medication persistence, which is associated with higher risk of hospitalization and increased medical costs.
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Long-Term Health Care Costs Following COVID-19: Implications for Pandemic PreparednessA difference-in-differences analysis of health care claims data evaluated excess health care costs in the 12 months following COVID-19 diagnosis among the general and older adult populations.
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Reducing Delays in Breast Cancer Care Using an Innovative Digital Health PlatformThe use of a novel digital health platform achieved a 55% reduction in time to treatment among women with a new diagnosis of breast cancer.
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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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Insurer Costs of COVID-19 by Disease Severity and DurationPayer costs for COVID-19 ranged from a mean of $505 for asymptomatic cases to $126,094 for severe cases with post–COVID-19 condition.
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Modeling Financial Outcomes and Quantifying Risk in Episode-Based Payment ModelsThis article provides a description of prospective financial simulation methodology and use cases with empirical data for episode-based bundled payments, including implications for contract negotiations and value-based care redesign.
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COVID-19 Vaccine Hesitancy and Health Literacy in US Southern StatesCOVID-19 vaccine hesitancy is not associated with health literacy. Personal perception of threat was associated with reduced vaccine hesitancy.
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Kansas City’s TB Outbreak Can Be Contained With the Lessons From COVID-19In this final interview clip, Michael A. Bernstein, MD, stresses the need for effective communication and proactive screening to contain the ongoing tuberculosis (TB) outbreak in Kansas City.
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Provider Capacity During Medicaid Expansion and a Public Health EmergencyThis survey study finds that most Missouri Medicaid providers had capacity for new patients, even during a period of unprecedented Medicaid enrollment growth.
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Contributor: Roadmap to the Quadruple Aim—A Framework for Minimizing Physician Burnout During the Transition to Value-Based CareAs provider and payer organizations pursue the Quadruple Aim, it is important that they take into account not just the contracting but also the transformation in staffing, clinical workflows, and culture as these organizations evolve.
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Affordable Care Act Enrollment in Texas After Rating Area AdjustmentsRural marketplace rating area change in Texas did not increase enrollment but increased share of enrollment in gold plans.
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ASCO 2024 and Beyond: Addressing NSCLC Unmet Needs and Future Research DirectionsJason Porter, MD, provides concluding insights on the LAURA phase 3 trial, CHRYSALIS-2 study, TROPION-Lung05 trial, and CheckMate 9LA study, along with other notable findings from the ASCO 2024 conference.
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Understanding the Complexities of Equity Within the Emergence and Utilization of AI in Academic Medical CentersThis editorial discusses positions for academic medical centers to consider when designing and implementing artificial intelligence (AI) tools.
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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.
