Authors

Contributor: The Connection Between Gout and CVD Requires Cross-Specialty Collaboration

The Panicos are on a mission to change how we think about gout. Why? As a husband-and-wife DO duo, the Panicos each have a unique perspective on gout and how physicians in their respective fields can better collaborate to help patients who live with this systemic disease.

Differences in Telehealth During COVID-19 Between Commercial and Medicaid Enrollees

Differences in use of telehealth between commercial and Medicaid populations during the COVID-19 pandemic are associated with managed care enrollment.

Key Federal Legislation Impacting Managed Care Pharmacy: Geni Tunstall, JD

Geni Tunstall, JD, discusses how pharmacy benefit manager reforms, Medicaid changes, and the MAHA initiative may impact managed care pharmacy operations.

How DNA Medicines Could Transform Treatment of Glioblastoma Multiforme

Better technology is rekindling the promise of DNA medicines in oncology, including the treatment of glioblastoma.

Medicare Advantage Reimbursement Structures Impact Home Health Delivery and Outcomes

Medicare Advantage plans that place greater restrictions on home health agency care delivery may have more adverse patient outcomes than plans that provide episodic payments.

Insurance-Provided Grocery Assistance and Health Care Outcomes Among Patients With Diabetes

Receipt of an insurer-provided grocery benefit was associated with decreased rates of diabetes with complications and increased medication adherence among a population with diabetes.

Health Care Resource Utilization, Quality Metrics, and Costs of Bladder Cancer Within the Oncology Care Model

Spending on novel therapies in high-risk bladder cancer had minimal impact on Oncology Care Model payments to practices, according to this cohort study and an average performance estimation.

Demographic Disparities in Video Visit Telemetry: Understanding Telemedicine Utilization

A stratified demographics analysis of video visit telemetry data reveals that age older than 65 years and African American/Black race are associated with higher video visit failure rates, whereas language, sex, and ethnicity are not.

Whither CAR T? Will the FDA Being Under the Hood and the Availability of Bispecifics Make These Therapies Less Attractive?

Association of Dermatology Wait Times With Insurance Coverage in Michigan

Disparities in dermatologic care for patients with Medicaid exist, and delays in medical dermatologic care among Medicaid patients must be addressed.

Proactive Care Management of AI-Identified At-Risk Patients Decreases Preventable Admissions

Proactive care management for artificial intelligence (AI)–identified at-risk patients reduced potentially preventable hospital admissions.

Coverage With Evidence Development: Where Are We Now?

Review of CMS’ coverage with evidence development program exposes a need to improve program transparency and clarify requirements and timetables for reporting to improve access to novel therapies.

Improving Care Coordination and Reducing ED Utilization Through Patient Navigation

A navigation program demonstrated decreased odds of repeat emergency department (ED) visits in patients with low baseline ED utilization and increased odds of follow-up primary care appointments.

Striving for Health Equity: Antoine Keller, MD

Antoine Keller, MD, argued the value of grounding health care policy in equity as clinicians prepare for a changing health care landscape in the coming years.

Outcomes in Patients With IBD Stratified by Risk of Disease Progression

This study validates criteria to identify patients with inflammatory bowel disease (IBD) at risk of worsening disease who may benefit from early treatment with advanced therapies.

Variation in Fracture Risk Estimation Among East Asian Women

Fracture prediction tools for East Asian individuals vary by country. In the United States, the US-Asian Fracture Risk Assessment Tool provides hip fracture probabilities that correspond to observed estimates.

Racial and Ethnic Disparities in Telemental Health Use Among Publicly Insured Children

Among publicly insured children with mental health–related encounters, racial and ethnic disparities in telemental health use widened following the onset of the COVID-19 pandemic.

Activation, Physical Activity, and Outcomes Among Individuals With T2D

This 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.

Impact of COVID-19 Pandemic on Accessibility of Taiwanese Medical Care

The COVID-19 pandemic disrupted access to routine medical care in community populations in Taiwan. The unmet needs should be emphasized as normal life resumes.

Provider and Patient Insights Into the Cancer Care Journey

A survey was conducted to determine opportunities to aid primary care providers and patients in the difficult journey of an oncology patient.

Choosing Wisely Interventions to Reduce Antibiotic Overuse in the Safety Net

This study evaluates the impact of Choosing Wisely–based interventions on antibiotic prescribing for viral respiratory tract infections in a real-world safety-net setting.

Implementation of Early Follow-up Care After Heart Failure Hospitalization

An early heart failure follow-up intervention succeeded in increasing referral to and completion of cardiology appointments within 7 days of discharge. The intervention was associated with lower risk of 30-day all-cause emergency department visits, all-cause hospitalizations, or death.

Trends in Medicare Part D Coverage of Generics With Equivalent Brand-Name Drugs

High-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.

Projected US Savings From Biosimilars, 2021-2025

Projected savings from biosimilars from 2021 to 2025 were $38.4 billion vs conditions as of quarter 4 of 2020 and were driven by new biosimilar entry. Savings were $124.5 billion under an upper-bound scenario.

A Value Proposition for Pragmatic Clinical Trials

The authors examine the origin, benefits, and challenges of pragmatic clinical trials to assess the ultimate value of this research design.

Cost-Effectiveness of Implementing a Home Blood Pressure Telemonitoring Program

A home blood pressure telemonitoring program effectively reduced blood pressure in real-world clinical settings, but program enrollment expenses increased overall costs.

Predicting Hospital Readmission in Medicaid Patients With Diabetes Using Administrative and Claims Data

A statistical model based entirely on claims data can accurately predict 30-day hospital readmission in Medicaid patients with diabetes.

US Cost-effectiveness and Budget Impact of Point-of-Care NAAT for Streptococcus

This study evaluates the cost-effectiveness and budget impact to US payers of point-of-care nucleic acid amplification tests (NAAT) for group A streptococcus.

Predicting Opioid Use Disorder and Associated Risk Factors in a Medicaid Managed Care Population

A 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.

Digital Health Implementation Among Older Adults: Health Technology Navigators’ Perspectives

Health technology navigators share perspectives on barriers to and facilitators of digital health access for older, linguistically diverse patients in a Los Angeles safety-net system.