Authors

CMS Needs to Rethink How Medicare Assesses Quality

Late 2020 changes make accountable care organizations a canary in the coal mine.

Association of Guideline-Concordant Care With Survival, Health Care Utilization, and Costs Among Older Women With Advanced Epithelial Ovarian Cancer

Non–guideline-concordant care for ovarian cancer was associated with higher all-cause and cancer-specific mortality, increased health care utilization, and increased Medicare expenditures, highlighting opportunities for improving cancer care in this vulnerable group.

Reduced Medical Spending Associated With Integrated Pharmacy Benefits

Members covered by an integrated pharmacy benefit (as opposed to a pharmacy carve-out) experienced slower growth in medical spending.

Managing Total Knee Replacement Under Value-Based Payments

This article describes the approach that a large primary care group at risk for value-based payments chose to deploy in managing clinical and financial outcomes of knee osteoarthritis jointly with orthopedic surgeons.

Bridging Education Gaps in Treatment for Scarring Alopecia With Innovative Approaches

Crystal Aguh, MD, FAAD, Johns Hopkins School of Medicine faculty, highlights the critical need for comprehensive education on hair loss across diverse hair types, stressing the importance of understanding inflammatory pathways for developing targeted therapies.

Dr Jeff Stark: New Bimzelx Dose Offers Simplicity and Choice

On October 14, 2024, the FDA approved a 320-mg single dose of bimekizumab-bkzx (Bimzelx; UCB) in a 2-mL prefilled syringe and autoinjector; both forms are now commercially available in the US.

Provider Capacity During Medicaid Expansion and a Public Health Emergency

This survey study finds that most Missouri Medicaid providers had capacity for new patients, even during a period of unprecedented Medicaid enrollment growth.

A Standardized Care Pathway Increases Optimal Dialysis Starts

The authors observed a significant increase in optimal starts for dialysis and in peritoneal dialysis rates after implementing a standardized end-stage renal disease transition pathway.

Association of Social Risks With Avoiding or Delaying Health Care and With Emergency Department Visits: Evidence From 2017 Ohio Medicaid Assessment Survey

Social risks (food insecurity, housing instability, financial strain, health insurance type) are associated with patients’ decisions to avoid/delay health care and increased utilization of the emergency department.

Implementing Team-Based Telemedicine Workflows in Safety-Net Primary Care

Telemedicine in safety-net primary care faces particular challenges. Consistent, team-based workflows can support video visit implementation and health care maintenance in telemedicine visits.

Remote Clinical Pharmacists Saved Nearly $9M, Helped Practices Meet EOM Targets

Clinical and Economic Outcomes of a Collaborative Cardiology Care Program

Patients with chronic cardiac conditions benefited from a health care program that strengthened collaboration between general practitioners and cardiology specialists in Baden-Wuerttemberg, Germany.

Revisiting Conclusions on the Empiric Segmentation of High-risk Patients

The authors provide feedback on generalizations made regarding interventions for high-risk populations in previous research.

The Association of Social Determinants of Health With Health Outcomes

This study explored the statistical association of key social determinants of health with specific health outcomes to validate impact and then created weighted categorical matrices.

Glomerular Filtration Rate Change and Outcomes in Type 2 Diabetes

Contributor: Association Between Social Deprivation, Race/Ethnicity, and Unplanned 30-Day Hospital Readmissions for Medicare Beneficiaries

Effects of Individualized Nurse-Led Care Plans on Olaparib Treatment Duration

A nurse-led personalized care program conducted through a specialty pharmacy prolonged medication persistence among patients with cancer receiving olaparib.

Trust Between Patients and Clinicians: An Overlooked and Affordable Approach to Improving US Health Care

Raising the visibility of the importance of trust in patient-clinician relationships can help ensure it is acknowledged and incorporated into policy and tactical considerations.

Novel Multicancer Early Detection Technology––Potential Value to Employers and the Workforce

Multicancer early detection technology could help reduce cancer mortality compared to the current strategy of single-cancer screening tests.

Avoiding Surgical Resection of Recurrent BRAF V600E–Mutated Iodine-Refractory Papillary Thyroid Cancer Involving Trachea/Thyroid Cartilage via Resensitization With Dabrafenib and Trametinib: Report of 3 Cases

Should Payers Incentivize Pharmacies to Blister-Package Chronic Medications?

Payers should consider providing higher reimbursement rates and/or preferred pharmacy networking status for pharmacies that provide chronic medications in blister packs for patients.

Covishield India: Demystifying Myths Through an Early Multicenter Safety Study

This was a multicenter study carried out in India to study the adverse and systemic effects of the indigenously developed Covishield vaccine.

Reimagining the Inpatient Palliative Care Consult: Lessons From COVID-19

Digital 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.

Pricing and Insurance Networks in Outpatient Surgery Markets

This article examines how prices, insurer payments, and patient payments for outpatient surgeries differ by site of care and network status.

Mental Health Service Utilization Review Patterns in a Medicaid Managed Care Program

Medicaid managed care utilization review data for mental health services were analyzed for the calendar years 2017 and 2018. These data indicate low rates of utilization review denials for both inpatient and outpatient mental health services.

Community Health Workers’ Critical Role in Trust Building Between the Medical System and Communities of Color

The authors interrogate elements of routine medical practice in New York City to argue for reforms of hospital culture through relational trust-building capabilities of community health workers.

Spending Patterns Among Commercially Insured Individuals During the COVID-19 Pandemic

In this analysis of more than 97 million commercially insured individuals, investigators found that the COVID-19 pandemic induced a spending shock in 2020 and that health care spending did not recover to baseline until mid-2021.

Chronic Overlapping Pain Conditions and Long-term Opioid Treatment

Little is known about opioid prescribing patterns in patients with chronic overlapping pain conditions. This study suggests target populations for interventions to manage chronic pain.

Clinic Price Reductions in a Tiered Total Cost Benefit Design

Findings of this evaluation of primary care clinic responses in a tiered total cost of care benefit design suggest that clinics respond by reducing prices.