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Prospective or Retrospective ACO Attribution Matters for Seriously Ill Patients

This study compared beneficiary characteristics and Medicare per capita expenditures among seriously ill Medicare accountable care organization (ACO) populations defined using prospective and retrospective claims-based attribution methods.

Contributor: Sustaining the “New Normal”—The Future Is Still Bright for Telehealth in the Wake of COVID-19

Consumers want telehealth and telehealth can help achieve organizational goals of avoiding unplanned care, closing care gaps, and achieving care targets.

Effective Prevention and Management of COVID-19 in Outpatient Hemodialysis Patients

The authors introduce a mobile phone app that may effectively prevent and manage coronavirus disease 2019 (COVID-19) in outpatient hemodialysis patients in Sichuan Province, China.

Biosimilar Interchangeability and Substitution in the US: What Comes Next?

Changing the FDA biosimilar interchangeability standards is a necessary but likely insufficient step to improve biosimilar competition in the US.

Patient and Physician Perceptions of a Hypercholesterolemia Safety-Net Program

Patients’ misperceptions of statins and physicians’ limited knowledge of a hypercholesterolemia safety-net program warrant additional interventions to reduce barriers and improve care.

Comparison of Mortality Between Medicare Advantage and Traditional Medicare Beneficiaries With Kidney Failure

The risk-adjusted 1-year mortality rate was not different between Medicare Advantage and traditional Medicare beneficiaries with kidney failure who initiated dialysis.

Combined Effect of Continuous Glucose Monitoring and Semaglutide: Analysis of Administrative Claims

Claims data reveal larger hemoglobin A1c decreases in people with type 2 diabetes who use continuous glucose monitoring and semaglutide compared with semaglutide alone.

Health Care Resource Utilization, Quality Metrics, and Costs of Bladder Cancer Within the Oncology Care Model

Spending on novel therapies in high-risk bladder cancer had minimal impact on Oncology Care Model payments to practices, according to this cohort study and an average performance estimation.

Incidence and Cost of Potentially Avoidable Emergency Department Visits for Urolithiasis

This study characterizes the incidence and associated factors of urolithiasis-related emergency department visits that are potentially preventable with appropriate ambulatory care and calculates their cumulative costs.

Pharmacogenomics for Improved Outcomes and Decreased Costs in Health Care

Bridging Boundaries: A Research Consortium to Advance Hospital-at-Home Care Delivery

As the hospital-at-home model grows, a consortium is needed to advance scalability, equity, caregiver well-being, and cost efficiency through research and collaboration.

Behavior-Based Diabetes Management: Impact on Care, Hospitalizations, and Costs

The Diabetes Care Rewards program offers a business case for health plans to promote engagement through use of contingent incentives, thus improving health outcomes and lowering costs.

Privately Negotiated Facility Fees at Ambulatory Surgery Centers and Hospitals

Private negotiated facility fees at hospitals are on average double the ambulatory surgery center facility fees for common outpatient procedures.

Clinical and Economic Burden of Uncontrolled Severe Noneosinophilic Asthma

Among patients with severe asthma with low eosinophils untreated with biologics, there is a high burden of disease among those who have suboptimal disease control.

Treatment Modification After Initiating Second-Line Medication for Type 2 Diabetes

Among adults with type 2 diabetes who started noninsulin second-line therapy, most modified treatment within 1 year. Discontinuation was by far the most common modification.

A Health Plan Showing Up in New Ways Amid COVID-19

Amid the current devastation wrought by the global pandemic, a health insurer in California has demonstrated leadership in fighting through systemic deficiencies by empowering people, process, and technology to address coronavirus disease 2019 (COVID-19).

Contributor: How Pediatric Mental Health May Influence the Risk of Heart Disease in Adulthood

In this contributor piece, the connection between the complexities of mental health and heart disease in at-risk communities is explored, with the authors stressing the importance of risk factor evaluation and multidisciplinary patient education from both mental and physical health providers.

Physical Activity Improves Performance, Frailty Scores, PROs in Multiple Myeloma

Exercises such as resistance training and walking were safe and effective interventions that were associated with improved frailty scores and patient-reported outcomes (PROs) in patients with multiple myeloma receiving systemic treatment.

Cost-effectiveness of a 3-Year Tele-Messaging Intervention for Positive Airway Pressure Use

Long-term tele-messaging was more effective than no messaging and short-term messaging for positive airway pressure use, and it was highly likely to be cost-effective with an acceptable willingness-to-pay threshold.

Contributor: How to Fight the Cold and the Flu This Season

With cold and flu season approaching, tips for avoiding the worst of the respiratory viruses are important for facing the coming months, when health experts expect an uptick in flu cases compared with the past 2 years.

Unmet Health Care and Health-Related Social Needs of Laundromat Users

Laundromats offer a promising outreach setting for Medicaid payers because Medicaid enrollees represent a majority of laundromat users and have disproportionately high levels of unmet needs.

High-Need Beneficiary Enrollment Patterns in Medicare Advantage and Traditional Medicare

Accounting for 32% of all Medicare enrollees in 2019, high-need beneficiaries were more likely to be in traditional Medicare than Medicare Advantage.

Diagnosis Patterns and Stress Testing Trends After Implementing High-Sensitivity Troponin Assay

This study found that switching from a conventional troponin assay to a high-sensitivity troponin assay resulted in changes to diagnosis patterns and stress testing trends.

Congress Ends Surprise Billing: Implications for Payers, Providers, and Patients

The No Surprises Act represents a rare bipartisan moment for Congress and a long-needed safeguard for patients that will reorient relationships among payers and providers.

At-Home Hemoglobin A1c Testing During COVID-19 Improved Glycemic Control

Providing at-home hemoglobin A1c test kits increases testing rates and facilitates hemoglobin A1c reduction over time among members of a large commercial health plan with diabetes.

Final Panel Thoughts on the Management of SMA

Panelists discuss how spinal muscular atrophy (SMA) treatment will evolve over the next 5 years, likely incorporating improved gene therapy delivery systems, combination therapies, and rehabilitation models, while maintaining individualized approaches for each patient.

How Do Primary Community Hospitals Enact Early Response to COVID-19? The Experience From Chengdu, China

Our 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.

Association of the MedWise Risk Score With Health Care Outcomes

Primary Care Practice Structural Capabilities in Health Professional Shortage Areas

Nurse practitioners are increasingly meeting primary care demands in underserved areas and are more likely to deliver structural capabilities related to chronic disease management.

Cancellations in Primary Care in the Veterans Affairs Health Care System

This article examines the prevalence of unused primary care appointments in the Veterans Affairs Health Care System.