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A Case-Control Study of Length of Stay OutliersLength of stay outliers are associated with hospital-acquired infections, complications, and discharge to facility, as opposed to nonmodifiable risk factors like age and comorbidities.
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Prospective or Retrospective ACO Attribution Matters for Seriously Ill PatientsThis 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.
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Contributor: Sustaining the “New Normal”—The Future Is Still Bright for Telehealth in the Wake of COVID-19Consumers want telehealth and telehealth can help achieve organizational goals of avoiding unplanned care, closing care gaps, and achieving care targets.
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Effective Prevention and Management of COVID-19 in Outpatient Hemodialysis PatientsThe 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.
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Comparison of Mortality Between Medicare Advantage and Traditional Medicare Beneficiaries With Kidney FailureThe risk-adjusted 1-year mortality rate was not different between Medicare Advantage and traditional Medicare beneficiaries with kidney failure who initiated dialysis.
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Combined Effect of Continuous Glucose Monitoring and Semaglutide: Analysis of Administrative ClaimsClaims data reveal larger hemoglobin A1c decreases in people with type 2 diabetes who use continuous glucose monitoring and semaglutide compared with semaglutide alone.
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Health Care Resource Utilization, Quality Metrics, and Costs of Bladder Cancer Within the Oncology Care ModelSpending 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.
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Incidence and Cost of Potentially Avoidable Emergency Department Visits for UrolithiasisThis 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.
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Looking Toward the Future: Management of C. Diff InfectionClosing out their discussion on recurrent clostridium difficile infection management, experts share closing thoughts and hopes for the future.
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Breaking Barriers: Partnerships to Improve Diabetic Eye Health in AlabamaThis article reviews barriers to diabetic eye health across Alabama and highlights a partnership with Genentech and the American Diabetes Association to address this issue.
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High-Intensity Home-Based Rehabilitation in a Medicare Accountable Care OrganizationHigh-intensity home-based rehabilitation (HIHR) may substitute for facility-based postacute rehabilitation. Patients in HIHR had better functional outcomes at lower costs than patients in facility-based care.
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Behavior-Based Diabetes Management: Impact on Care, Hospitalizations, and CostsThe 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.
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Privately Negotiated Facility Fees at Ambulatory Surgery Centers and HospitalsPrivate negotiated facility fees at hospitals are on average double the ambulatory surgery center facility fees for common outpatient procedures.
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Clinical and Economic Burden of Uncontrolled Severe Noneosinophilic AsthmaAmong patients with severe asthma with low eosinophils untreated with biologics, there is a high burden of disease among those who have suboptimal disease control.
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Treatment Modification After Initiating Second-Line Medication for Type 2 DiabetesAmong 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.
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Building Better Collaboration: Reducing Care Delays in Managing mCRCExperts discuss proactive steps health care teams, including pharmacists, can take to minimize delays and overcome payer-related barriers when prescribing third-line therapies for metastatic colorectal cancer (mCRC) and how collaboration between health care teams, payers, and manufacturers can be improved to reduce care delays.
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A Health Plan Showing Up in New Ways Amid COVID-19Amid 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).
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Contributor: How Pediatric Mental Health May Influence the Risk of Heart Disease in AdulthoodIn 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.
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Physical Activity Improves Performance, Frailty Scores, PROs in Multiple MyelomaExercises 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.
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Cost-effectiveness of a 3-Year Tele-Messaging Intervention for Positive Airway Pressure UseLong-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.
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Contributor: Beyond the Sloganeering—A Data-Driven Analysis of Recent 340B GrowthThis contributor column discusses a recent study that shows the 340B Program’s explosive growth is overwhelmingly due to utilization increases, not price.
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Contributor: How to Fight the Cold and the Flu This SeasonWith 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.
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Unmet Health Care and Health-Related Social Needs of Laundromat UsersLaundromats 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.
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High-Need Beneficiary Enrollment Patterns in Medicare Advantage and Traditional MedicareAccounting for 32% of all Medicare enrollees in 2019, high-need beneficiaries were more likely to be in traditional Medicare than Medicare Advantage.
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Diagnosis Patterns and Stress Testing Trends After Implementing High-Sensitivity Troponin AssayThis 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.
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Congress Ends Surprise Billing: Implications for Payers, Providers, and PatientsThe 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.
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At-Home Hemoglobin A1c Testing During COVID-19 Improved Glycemic ControlProviding 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.
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Final Panel Thoughts on the Management of SMAPanelists 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.
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How Do Primary Community Hospitals Enact Early Response to COVID-19? The Experience From Chengdu, ChinaOur 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.
