Authors

Trends in Retail Clinic Use Among the Commercially Insured

Retail clinic use increased dramatically over 3 years, especially among young, healthy, higher income enrollees living close to retail clinics.

Health Plan's Use of Asthma Quality Improvement Projects to Meet NCQA Accreditation Standards

Atypical Presentation and Complications of GERD

Validity of the HEDIS Criteria to Identify Children With Persistent Asthma and Sustained High Utilization

Improving Care for Nursing Home-Acquired Pneumonia in a Managed Care Environment

Racial/Ethnic Disparities in Cost-Related Barriers to Care Among Near-Poor Beneficiaries in Medicare Advantage vs Traditional Medicare

Among 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.

Measuring Migraine-Related Quality of Care Across 10 Health Plans

Standardized measurement of migraine, an underdiagnosed and perhaps underrecognized condition, is necessary for health plans to understand utilization of costly diagnostic and treatment services.

The Cost of the Opioid Epidemic, In Context

Cost-Effectiveness of a Statewide Falls Prevention Program in Pennsylvania: Healthy Steps for Older Adults

“Healthy Steps for Older Adults,” the Pennsylvania Department of Aging’s falls prevention program, resulted in savings of $718 to $840 per person.

Insurance Switching and Mismatch Between the Costs and Benefits of New Technologies

Transformative therapies with high up-front costs will exacerbate the need to address gaps between payers when costs and benefits occur at different times.

Noninvasive Vagus Nerve Stimulation in a Primary Care Setting: Effects on Quality of Life and Utilization Measures in Multimorbidity Patients With or Without Primary Headache

Benzodiazepine and Unhealthy Alcohol Use Among Adult Outpatients

Among outpatients who were screened for alcohol use, those with unhealthy alcohol use, women, and those who were older, white, and of lower socioeconomic status were more likely to use benzodiazepines.

Cost Burden of Treatment Resistance in Patients With Depression

When a clinical staging algorithm for treatment-resistant depression was applied to administrative claims data, higher scores predicted higher future medical costs.

Chronic Disease Outcomes From Primary Care Population Health Program Implementation

Patients in practices with central population health coordinators had greater improvement in short-term chronic disease outcome measures compared with patients in practices without central support.

Care of Children With Epilepsy

Provider Organization Performance Assessment Utilizing Diabetes Physician Recognition Program

Retrospective chart review to assess the impact of the Diabetes Physician Recognition Program showed that most patients achieved control levels recommended by national treatment guidelines.

Case Study A

Revolutionizing Treatment Outcomes in Hepatitis C: Managed Care Implications and Considerations-A Clinical Overview

Managed Programs of Healthcare: Evaluating Effectiveness

Attributes Common to Programs That Successfully Treat High-Need, High-Cost Individuals

Many programs attempting to effectively treat high-need, high-cost individuals have not been able to lower spending, improve outcomes, or increase satisfaction. This paper suggests 8 attributes that many successful programs share.

Medicare Shared Savings Program ACO Network Comprehensiveness and Patient Panel Stability

Medicare Shared Savings Program accountable care organization (ACO) network comprehensiveness is associated with stable patient assignment year to year. Panel stability was significantly associated with improved diabetes and hypertension control in the short term.

Outcomes and Costs of Care for Acute Low Back Pain Among Specialties: Implications for Managed Care

Real-World Outcomes Among Patients With Early Rapidly Progressive Rheumatoid Arthritis

This study suggests that lower healthcare resource use and achieving low disease activity are associated with first-line abatacept compared with a first-line tumor necrosis factor-α inhibitor for patients with early rapidly progressive rheumatoid arthritis.

Cost-effectiveness of Brentuximab Vedotin With Chemotherapy in Treatment of CD30-Expressing PTCL

An economic model based on the ECHELON-2 trial demonstrated cost-effectiveness of brentuximab vedotin with chemotherapy in frontline treatment of CD30-expressing peripheral T-cell lymphoma (PTCL).

Optimizing Use and Addressing Challenges to Uptake of Biosimilars

Impact of Persistence With Infliximab on Hospitalizations in Ulcerative Colitis

Therapeutic persistence with infliximab was associated with signifi cantly fewer ulcerative colitis patients requiring hospitalization; once hospitalized, patients with therapeutic persistence had significantly decreased inpatient costs.

The Health Information Technology Special Issue: Continuing the Progress Toward Digital Transformation

A letter from the guest editor highlights the significant work that remains for provider organizations to integrate digital advancement as a key strategy in addressing some of the most pressing challenges that are transforming the health care landscape.