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Impact of Payment Models on Medical Specialist Physician Practice PatternsThis article explores the impact of payment models (fee for service vs salary based) on practice patterns, including wait times and care for patients with chronic diseases.
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Collaboration to Transition Members to Preferred Formulary Dipeptidyl-Peptidase-4 InhibitorA collaboration between a drug plan and clinical pharmacists led to nearly 50% of members successfully switching to a preferred dipeptidyl-peptidase-4 inhibitor.
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Effects of Adjunctive Cariprazine Formulary Restrictions in Major Depressive DisorderPatients who experienced a formulary-related rejection of cariprazine for adjunctive treatment of major depressive disorder had significantly higher hospitalization rates than those with approved claims.
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Care Fragmentation Predicts 90-Day Durable Ventricular Assist Device OutcomesThis analysis evaluates the relationship between hospital care delivery network fragmentation and in-hospital and 90-day outcomes. These networks may be novel targets for improving outcomes.
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Regulation of Provider Networks in Response to COVID-19The authors describe federal and state provider network adequacy standards and discuss how regulators should adapt these standards and accompanying monitoring processes in response to coronavirus disease 2019 (COVID-19).
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Activation, Physical Activity, and Outcomes Among Individuals With T2DThis study presents an integrated, exploratory assessment of physical activity, patient activation, health-related quality of life, and clinical outcomes among older adults with type 2 diabetes (T2D) using survey, wellness, and claims data.
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Improving Lupus Care Requires Addressing Social Determinants, Expanding Access: Margrit Wiesendanger, MD, PhDIn the final part of her interview, Margrit Wiesendanger, MD, PhD, discusses the need to improve lupus care by addressing social determinants of health and expanding access to treatment.
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Contributor: Data, Education, and Community: The Winning Formula for Addressing SDOH for Kidney Care PatientsAddressing patients with chronic kidney disease requires a commitment to data, education, and community, specifically in those affected by social determinants of health (SDOH).
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Operating Room Efficiency of Orthopedic Surgery During the COVID-19 EraThe authors analyzed the impacts of COVID-19 on orthopedic operating room efficiency via comparison of 14,856 surgeries performed before, during, and after the pandemic.
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Factors Associated With Unplanned Admissions Among Patients With Chronic ConditionsThis study identified risk factors for unplanned admissions among patients with multiple chronic conditions to inform focused interventions.
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Outcomes of Antiviral Treatment for Influenza in Type 2 DiabetesAntiviral treatment was associated with lower health care resource utilization and costs in patients with type 2 diabetes and a diagnosis of influenza.
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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.
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Medical Home Visit Programs During COVID-19 State of EmergencyThis report highlights the unique challenges faced by home health programs in addition to discussing how technology and policy changes have helped the elderly homebound during the coronavirus disease 2019 (COVID-19) pandemic.
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Senate Introduces Bill to Extend 5% Incentives for APMsThe bipartisan bill would help lower Medicare costs and improve quality of care, according to the National Association of ACOs.
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Medicare Advantage–Pharmacy Partnership Improves Influenza and Pneumococcal Vaccination RatesPatients whose pharmacy receives notification of their immunization gap have twice the odds of receiving immunizations compared with those whose pharmacy does not receive the notification.
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Post-SNF Outcomes and Cost Comparison: Medicare Advantage vs Traditional MedicarePatients enrolled in Medicare Advantage had better outcomes and lower cost following skilled nursing facility (SNF) discharge than patients enrolled in traditional fee-for-service Medicare.
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Improving Glycemic Control in Diabetes Through Virtual Interdisciplinary RoundsPatients with diabetes whose providers received advice from remote, virtual interdisciplinary rounds had a greater 1-year reduction in hemoglobin A1c than comparable patients.
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Trends in Market Share Among Hospitals Participating in ACOs and NonparticipantsAccountable care organization (ACO) participation was associated with an increase in hospitals’ mean market share and with additional market share gains in more concentrated markets.
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Main Conference Takeaways Regarding cGVHD ManagementSergio A. Giralt, MD, discusses the key results from recent chronic graft-vs-host disease (cGVHD) research presented at ASH 2024 and how these findings will influence his clinical practice. He also shares his main takeaways on evolving strategies for cGVHD management.
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Perspectives on Nonmedical Switching and the COVID-19 Pandemic: A Narrative ReviewThis review describes the impact of nonmedical switching of biologic therapies on US patients and providers, with a focus on switching to in-class alternatives.
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Contributor: CMS Can Seize Opportunities to Fix the Rural Glitch, Risk Adjustment Caps in MSSPThe Medicare Shared Savings Program (MSSP) has seen its growth slow, but CMS has an opportunity to act on proposals that would address benchmarking and more fairly allocate savings to accountable care organizations in the program.
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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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Factors That Increase Utilization Management Risk: A Proof of ConceptA score was developed to measure patient risk from payer utilization management policies and its relationship to real-world US commercial payer utilization management policies.
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Pharmacist Hypertension Management Using an Electronic Health Record–Based ApproachThe authors studied the impact of a pharmacist intervention on blood pressure control compared with usual care.
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Implementation and Cost Validation of a Real-time Benefit ToolThis study evaluates impact of a real-time benefit tool on medication access and physician and pharmacy workflows at a large academic medical center.
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Ensuring Access to Pegcetacoplan Requires Updated Guidelines, Education, and Distribution Solutions: Carla Nester, MD, MSA, FASNThere are key steps to take that can ensure equitable access to pegcetacoplan, explained Carla Nester, MD, MSA, FASN, who also highlighted remaining questions on long-term outcomes, safety, and pediatric use.
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A Machine Learning Technology for Addressing Medication-Related Risk in Older, Multimorbid PatientsA novel machine learning system effectively stratifies emergency department use and hospitalization risk of older patients with multimorbidity who take multiple medications and provides appropriate medication recommendations.
