Authors
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Plan Designs That Encourage the Use of Generic Drugs Over Brand-Name Drugs: An Analysis of a Free Generic BenefitSmall increases and decreases in pharmacy copayments have little influence on patients’ switching to generic drugs or on improving adherence to medication regimens.
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Limited Distribution Networks Stifle Competition in the Generic and Biosimilar Drug IndustriesA limited distribution network is a pharmaceutical distribution strategy that some drug companies have capitalized upon to obstruct generic and biosimilar competition.
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The National Oncology Working Group (NOW) Initiative: Payer and Provider Collaborations in Oncology Benefits ManagementThis article highlights the work of the National Oncology Working Group (NOW) Initiative.
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The Impact of Evolving Treatment Options in Multiple Myeloma, Part 10Bruce A. Feinberg, DO; Ryan Haumschild, PharmD, MS, MBA; Thomas Ollis, MS, RPh; and Joseph Mikhael, MD, discuss the future treatment landscape for the management of multiple myeloma.
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The Oncology Medical Home - Beyond Clinical PathwaysClinical pathways have been emphasized as a means to deliver efficient, quality care and to ensure better outcomes at lower costs. The Oncology Medical Home takes this to the next, more comprehensive, step of quantifying and improving quality and value in cancer care while lowering overall costs.
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Building Partnerships Between a College of Pharmacy and ACOs: Development of the ACORN SEEDTo promote future partnerships among colleges of pharmacy and accountable care organizations, this article describes several initial challenges to partnership formation, including those related to agenda setting and resource utilization.
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Health Insurance Design and Conservative Therapy for Low Back PainThis study examined the association between health insurance design features and choice of physical therapy or chiropractic care by patients with new-onset low back pain.
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Pragmatic Clinical Trials: US Payers' Views on Their ValuePayers like key traits of pragmatic clinical trials, but are wary of pharmaceutical companies and plan to carefully scrutinize this new, appealing type of evidence.
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CHAPTER 3. Guideline for Detection and Management of Diabetes in PregnancyFrom the Adult Diabetes and Clinical Research sections, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts
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Insurers’ Perspectives on MA Value-Based Insurance Design ModelThis article describes perspectives of Medicare Advantage (MA) insurers about participating in the CMS value-based insurance design model test launched in 2017.
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Medical Homes and Cost and Utilization Among High-Risk PatientsA longitudinal case-control design was used to evaluate the effects of the patient-centered medical home model on medical costs and utilization among high-risk patients.
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Medicare Advantage Control of Postacute Costs: Perspectives From StakeholdersThis qualitative study examines the methods that Medicare Advantage plans use to control or reduce postacute spending and their associated unintended consequences.
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Managing Inappropriate Requests of Laboratory Tests: From Detection to MonitoringThis study shows automatic, practical, simple, and effective strategies designed in the laboratory, in consensus with requesting clinicians, to improve laboratory test appropriateness.
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Retail Clinic Utilization Associated With Lower Total Cost of CareRetail clinic use is associated with lower overall total cost of care based on a matched-pair analysis.
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Out-of-Pocket Spending for Health Care After COVID-19 HospitalizationFor most patients who survive COVID-19 hospitalization, out-of-pocket spending within 180 days of discharge is modest. However, 1 in 10 have out-of-pocket spending exceeding $2000.
