Authors
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Patient Experience in a COVID-19 Patient Home Monitoring ProgramPatients who participated in a COVID-19 patient home monitoring program were satisfied with their care and stated that their participation made them less likely to seek care in the emergency department.
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Implementation of Early Follow-up Care After Heart Failure HospitalizationAn 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.
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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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Projected US Savings From Biosimilars, 2021-2025Projected 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.
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A Value Proposition for Pragmatic Clinical TrialsThe authors examine the origin, benefits, and challenges of pragmatic clinical trials to assess the ultimate value of this research design.
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Predicting Hospital Readmission in Medicaid Patients With Diabetes Using Administrative and Claims DataA statistical model based entirely on claims data can accurately predict 30-day hospital readmission in Medicaid patients with diabetes.
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US Cost-effectiveness and Budget Impact of Point-of-Care NAAT for StreptococcusThis study evaluates the cost-effectiveness and budget impact to US payers of point-of-care nucleic acid amplification tests (NAAT) for group A streptococcus.
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Predicting Opioid Use Disorder and Associated Risk Factors in a Medicaid Managed Care PopulationA 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.
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Digital Health Implementation Among Older Adults: Health Technology Navigators’ PerspectivesHealth 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.
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Choosing Wisely Interventions to Reduce Antibiotic Overuse in the Safety NetThis study evaluates the impact of Choosing Wisely–based interventions on antibiotic prescribing for viral respiratory tract infections in a real-world safety-net setting.
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Optimizing the Management of TRDDrs Steven Levine, Patricia Ares-Romero, Samuel Nordberg, Martin Rosenzweig, and Carrie Jardine share insight on the future treatment landscape for TRD.
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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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Future Research Priorities for Non-Hodgkin Lymphomas: Craig A. Portell, MDFuture research into non-Hodgkin lymphoma treatments needs to explore long-term outcomes and a better understanding of the biologic rationale for various treatments, explained ECHELON-3 principal investigator Craig A. Portell, MD, of UVA Health.
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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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Cuts to HIV Vaccine Research Come Amid Challenges to Other Vaccines, TreatmentThe Trump administration has ended a program seeking a vaccine for HIV, the first in a series of decisions that is leaving vaccine research and expertise behind.
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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.
