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Evaluation of Agreements Between Managed Care Organizations and Providers of Community-Based Mental Illness and Addiction Disorder Treatments

Positive Predictive Values of ICD-9 Codes to Identify Patients With Stroke or TIA

This study determined that ICD-9 codes 433.X1, 434.XX, and V12.54 had positive predictive values >90%, and may be used to focus care on stroke patients.

Tips for Caring for Patients Who Have Been Treated for Childhood Cancer

Suggestions on how to approach a childhood cancer survivor in your practice, several useful resources, and information on what referrals and tests may be indicated.

Abdominal Aortic Aneurysm

Validation of a Claims-Based Algorithm to Characterize Episodes of Care

The Michigan Value Collaborative has created a claims-based algorithm that categorizes claims into episode components. This manuscript describes the validation of this algorithm.

Primary Care Physicians' Experiences With Case Finding for Practice-Based Care Management

Criteria used by primary care physicians to select patients for practice-based care management programs were explored in a qualitative study.

Periodic Health Examinations and Missed Opportunities Among Patients Likely Needing Mental Health Care

Among patients likely needing mental health care, two-thirds had no discussion or perfunctory discussion of mental health during periodic health exams.

Cost of Illness of Chronic Angina

Response to “e-Consult Implementation Success: Lessons From 5 County-Based Delivery Systems”

Partnering teams for delivery of continuity of care between primary care and community behavioral health systems can learn from e-consult implementation.

National Trends in the Provision of Smoking Cessation Aids Within the Veterans Health Administration

Cost-Effectiveness of Intensive Tobacco Dependence Intervention Based on Self-Determination Theory

An intensive tobacco dependence intervention based on selfdetermination theory that targeted all smokers was cost-effective and facilitated patient autonomy, perceived competence, and long-term tobacco abstinence.

The Economic Rationale for Adherence in the Treatment of Type 2 Diabetes Mellitus

Shifting Cardiovascular Care to Nurses Results in Structured Chronic Care

This study sought to explore if shifting care to nurses in cardiovascular risk management in primary care is a key to more structured chronic care.

Economic Considerations for the Treatment of Opioid and Alcohol Dependence: A Managed Care Perspective

Pediatric Integrated Delivery System's Experience With Pandemic Influenza A (H1N1)

Experience of a pediatric integrated delivery system with the surge from the 2009 H1N1 pandemic is described, emphasizing scale, scope, and flexibility at multiple locations.

Intensive Care Management of a Complex Medicaid Population: A Randomized Evaluation

The authors present findings of a randomized evaluation of Medicaid patients at an academic medical center, which found that intensive care management was associated with reduced total medical expense.

Strategies for Identifying and Channeling Patients for Depression Care Management

This article examines screening strategies for possible depression in the context of a care management program for chronically ill Medicare recipients.

Medical Utilization Surrounding Initial Opioid-Related Diagnoses by Coding Method

Medical utilization profiles of commercially insured members with opioid-related disorders differ depending on the code used to document the initial diagnosis in administrative claims.

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.

The Need to Level the Playing Field Between Accountable Care Organizations and Medicare Advantage

For several reasons, including meeting the HHS Secretary’s Medicare quality and value payment goals, the ACO program needs to reformed to equate with Medicare Advantage.

The Importance of Appropriate Treatment of Chronic Bronchitis

Reporting Provider Performance: What Can Be Learned From the Experience of Multi-Stakeholder Community Coalitions?

Pragmatic Clinical Trials: US Payers' Views on Their Value

Payers like key traits of pragmatic clinical trials, but are wary of pharmaceutical companies and plan to carefully scrutinize this new, appealing type of evidence.

Contributor: Prioritizing Patient-Centered Value Over International Reference Pricing in US Drug Policy

The authors argue that sustainable drug pricing reform should focus on patient-centered value, not price alone.

Cost of Post-Traumatic Stress Disorder vs Major Depressive Disorder Among Patients Covered by Medicaid or Private Insurance

Post-traumatic stress disorder was associated with 4.2% to 9.3% higher annual per-patient healthcare costs compared with MDD among patients covered by Medicaid or private insurance.

Edaravone in the Treatment of Amyotrophic Lateral Sclerosis: Efficacy and Access to Therapy - A Roundtable Discussion

Follow-Up Among Women with an Abnormal Mammogram in an HMO: Is It Timely, Complete, and Efficient?

Severity of Hereditary Angioedema, Prevalence, and Diagnostic Considerations

Preventive/Office Visit Patient Knowledge and Their Insurance Information Gathering Perceptions

Patients have an incomplete understanding of what constitutes no-cost preventive care services. Ease of obtaining information from insurance companies can significantly affect whether patients are charged correctly.

Patient Safety-Focused Medication Therapy Management: Challenges Affecting Future Implementation

Lessons learned from implementation of a pharmacist-delivered medication therapy management intervention in primary care can inform future studies and be adopted into real-world clinical settings.