Authors
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Association of Physician Specialty With Psoriatic Arthritis Treatment and CostsIn this retrospective cohort study of patients with newly diagnosed psoriatic arthritis, the authors examine the association of treatment selection and costs with physician specialty.
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Social Determinants of Health and Emergency Department Utilization in Alabama Children’s Health Insurance ProgramCommunity social determinants of health such as rurality and low socioeconomic status moderate the association between an individual’s race and emergency care use.
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Patterns of Opioid Use in Commercially Insured Patients With CancerAmong the fewer than half of patients with cancer who received opioid fills, a relatively small proportion (2.5%) had potentially problematic opioid use.
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Scenario Analysis When Conducting Budget Impact Analyses for Rare DiseasesThe authors propose conducting a scenario analysis for interventions to treat rare diseases by varying health plan size to demonstrate the variability of potential budget impact.
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Future of PrEPExperts in HIV provide closing thoughts on the future of PrEP, including improvement of uptake and addressing access disparities.
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Using Electronic Health Records and Claims Data to Identify High-risk Patients Likely to Benefit From Palliative CareDeep learning algorithms could improve palliative care by predicting mortality from electronic health records and claims data.
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Cost-Benefit Analysis of Sacubitril/Valsartan in a Medicaid PopulationThe cost avoidance of heart failure–related hospitalizations and emergency department visits may outweigh the additional drug cost in Medicaid members adherent to sacubitril/valsartan.
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Evaluation of Biosimilar Trastuzumab MYL-1401O in HER2-Positive Breast CancerThe authors evaluate the effect and safety of biosimilar trastuzumab MYL-1401O in human epidermal growth factor receptor 2 (HER2)–positive early-stage (neoadjuvant and adjuvant therapy) and metastatic (palliative therapy) breast cancer using real-world data.
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Reimagining the Inpatient Palliative Care Consult: Lessons From COVID-19Digital innovations in palliative care during COVID-19 have changed how hospitalized patients receive palliative care. We propose an approach to implement new models at scale.
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Identifying Complex Patients Using Adjusted Clinical Groups Risk Stratification ToolIn this study, the authors developed a method for use in primary care to identify a group of patients with complex care needs using Aggregated Diagnosis Groups.
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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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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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Risk Adjusting for Medicaid Participation in Medicare AdvantageWhen comparing risk-adjustment approaches based on Medicaid status of Medicare beneficiaries, this analysis found that predicted spending levels varied depending on states’ Medicaid eligibility criteria.
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Variation in Spending Associated With Primary Care PracticesPhysician practices account for a significant amount of variation in spending.
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Leveraging Longitudinal Clinical Laboratory Results to Improve Prenatal CareCollaboration between a clinical laboratory and a managed care organization improved prenatal care and outcomes through real-time, actionable, laboratory-derived insights and care coordination.
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Contributor: The Case for Education and Clinical Decision Support With PharmacogeneticsPrescribing is a complex process with multiple factors to consider on top of the 3 primary questions about effectiveness, harm, and cost. Pharmacogenetics has put this complexity under the spotlight and prompted educational programs and the development of new clinical decision support systems.
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Trends in Medicare Part D Coverage of Generics With Equivalent Brand-Name DrugsHigh-tier generic drug placement in Medicare Part D has increased over time, but it may be related to a drug’s clinical profile and availability of substitutes rather than preferred brand-name drug coverage.
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Investigating Real-world Consequences of Biases in Commonly Used Clinical CalculatorsClinical calculators that do not include demographic variables may be biased, and their equity should be understood in the context of clinical guidelines.
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Assessing Surveillance Utilization and Value in Commercially Insured Patients With Colorectal CancerTrends in surveillance testing after treatment for colorectal cancer remained relatively stable recently, and patients who overutilized surveillance measures had quicker recurrence detection but higher costs.
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Key Takeaways for the Management of HIV PrEPA panel of experts share closing thoughts and advice for the management and uptake of HIV PrEP therapy.
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Continuously Updated Forecasting of SARS-CoV-2 in a Regional Health SystemThis study presents a methodology for forecasting demand of COVID-19 on health resources in an integrated health system.
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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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A Scoping Review of US Insurers’ Use of Patient-Reported OutcomesThis scoping review found 350 articles that discuss US health insurance providers’ use of patient-reported outcomes about health-related quality of life.
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A Kidney Diagnostic’s Impact on Physician Decision-making in Diabetic Kidney DiseaseThe KidneyIntelX test would affect primary care physician (PCP) decision-making, and PCPs would use the results of KidneyIntelX more than albuminuria and estimated glomerular filtration rate when making decisions about diabetic kidney disease management.
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CMS Practice Assessment Tool Validity for Alternative Payment ModelsUsing data from 632 primary care practices, the authors show that the CMS Practice Assessment Tool has adequate predictive validity for participation in alternative payment models.
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Contributor: The Price of Mental WellnessConsidering the personal, societal, and economic toll of treatment-resistant depression, we must make it easier to access medicines and care that provide value, both for the patient and for the health care system.
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Site of Care Potentially Limits Cost Savings From BiosimilarsAlthough previous work has found lower costs for biosimilar filgrastim compared with reference filgrastim, this study found that site of care can change this calculus, reducing savings.
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How the Name Change to Myeloproliferative Neoplasms Affected People With the DiseaseA decision to rename myeloproliferative neoplasms led to a plethora of developments in a space where there was once little interest.
