Authors
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Medical Policy Determinations for Pharmacogenetic Tests Among US Health PlansThis analysis demonstrated significant variability in medical policy determinations and evidence cited for clinically relevant pharmacogenetic tests among major US health insurers and laboratory benefit managers.
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Are Work Relative Value Units Correlated With Operative Duration of Common Surgical Procedures?Work relative value units (wRVUs) correlate with operative duration of common surgical procedures. Reimbursement for physicians depending on wRVUs is fair for commonly performed surgeries.
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Newly Approved Triplet Regimen Boosts Survival in R/R LBCL: Craig Portell, MDECHELON-3 (NCT04404283) principal investigator Craig A. Portell, MD, speaks to the significance of this triplet approval from February as an alternative to more complex and time-consuming regimens in the setting of relapsed/refractory large B-cell lymphoma (R/R LBCL).
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The Essential Role of Population Health During and Beyond COVID-19The authors detail how population health management enables health systems to promote public health, strengthen health system resiliency, and support financial recovery during and beyond coronavirus disease 2019 (COVID-19).
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Impact of Electronic Information Exchange on Repeat Imaging During 30-Day Readmissions Among Medicare BeneficiariesThis analysis of Medicare data examines the relationships between fragmented readmission, health information exchange, and repeat imaging in older adults with and without Alzheimer disease.
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Doctors Can Work With Patients to Be More Proactive in Glaucoma Care: Christine Funke, MDChristine Funke, MD, spoke about the role of doctors in making sure their patients are receiving proper care after being diagnosed with glaucoma.
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Development and Validation of the COVID-19 Hospitalized Patient Deterioration IndexThe authors developed and validated an accurate, well-calibrated, easy-to-implement COVID-19 hospitalized patient deterioration index to identify patients at high or low risk of clinical deterioration.
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Tacking Upwind: Reducing Spending Among High-risk Commercially Insured PatientsAlthough commercial accountable care organization populations are healthy on average, some individuals might benefit from programs for high-risk patients to mitigate high levels of health care utilization.
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Racial/Ethnic Disparities in Cost-Related Barriers to Care Among Near-Poor Beneficiaries in Medicare Advantage vs Traditional MedicareAmong near-poor Black and Hispanic individuals, Medicare Advantage was associated with increased vision care and some, although not uniform, reductions in access disparities vs traditional Medicare.
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Comparison of Mortality Between Medicare Advantage and Traditional Medicare Beneficiaries With Kidney FailureThe risk-adjusted 1-year mortality rate was not different between Medicare Advantage and traditional Medicare beneficiaries with kidney failure who initiated dialysis.
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Integrating Primary Care and Public Health for Advance Care PlanningThis article proposes a new model, Public-Primary ACP, that leverages coordination between primary care and public health workforces to improve delivery of advance care planning.
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Addressing STIs Through Managed Care: Opportunities in Medicaid and BeyondMedicaid and other managed care organizations could take several key steps to respond to the sexually transmitted infection (STI) epidemic in the US, including congenital syphilis.
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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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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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Dosage and Outcomes in a Complex Care InterventionAssociations between intervention dosage and hospital use outcomes were observed among patients enrolled in a care management program serving individuals with complex needs.
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Strategies for Improving Patient Access to Dermatology CareElizabeth Jones, MD, FAAD, highlights the persistent issue of insurance companies favoring expensive, newer medications over equally effective generics in dermatology, emphasizing the time-consuming prior authorization process and advocating for patient partnerships and systemic improvements.
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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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AI in Health Care: Closing the Revenue Cycle GapThis commentary explores the current state, challenges, and potential of artificial intelligence (AI) in health care revenue cycle management, emphasizing collaboration, data standardization, and targeted implementation to enhance adoption.
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How Do Primary Community Hospitals Enact Early Response to COVID-19? The Experience From Chengdu, ChinaOur hospital is a primary hospital in Chengdu, China. Since February 5, our hospital has been listed as the primary designated medical unit for treating new patients with coronavirus disease 2019 (COVID-19) in Jinniu District. In this letter, we share our COVID-19 experience with readers.
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Health Systems and Telemedicine Adoption for Diabetes and Hypertension CareSmall practices reduced their use of telemedicine during early stages of the COVID-19 pandemic. Technical support may help expand and maintain telemedicine in small practices.
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Patient Experience After Modifying Visit Delivery During the COVID-19 PandemicCoronavirus disease 2019 (COVID-19) was associated with immediate weekly visit trend decreases for overall, primary care, and specialty care with long-term recovery trends; transformation to virtual visits; and increasing long-term trends for meeting patient scheduling and visit needs.
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Determinants of ICS Therapy Adherence in Patients With AsthmaThis study describes determinants affecting disease control and inhaled glucocorticosteroid therapy adherence for patients with asthma in western China.
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Diabetes Care Quality: Do Large Medical Groups Perform Better?Large medical groups perform better than medium- or small-sized groups on diabetes quality measures, perhaps because they have more care management processes in place.
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Physicians in ACOs Report Greater Documentation BurdenAn analysis of nationally representative survey data from 2019 and 2021 shows that office-based physicians participating in accountable care organizations (ACOs) reported greater documentation burden across several measures.
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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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Impact of Travel Distance on Quality Outcomes in Colorectal CancerThis study identified characteristics of patients with colorectal cancer who traveled farther for surgery and found that those who traveled tended to stay longer at the hospital.
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Addressing Evolving Patient Concerns Around Telehealth in the COVID-19 EraWith a rapid shift to telehealth during the coronavirus disease 2019 (COVID-19) pandemic, clinicians, health care organizations, and policy makers must consider and address patients’ evolving needs, concerns, and expectations.
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Variation in Network Adequacy Standards in Medicaid Managed CareMedicaid managed care network adequacy standards exhibit significant heterogeneity across regions and specialties, potentially creating large variations in health care access and quality.
