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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.

Justified Billing Practices Can Improve Revenue for Weight-Focused Visits

Analysis of billing codes before and after implementation of a care process for weight-focused visits revealed increased primary care revenue for these encounters.

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.

Primary Care Video and Telephone Telemedicine During the COVID-19 Pandemic: Treatment and Follow-up Health Care Utilization

Telephone visits may offer a simple and convenient option to address patient primary care needs without raising safety concerns.

Cost Sharing for Oral Lenvatinib Among Commercially Insured Patients

Among a cohort of insured patients with cancer, the median total monthly cost of oral lenvatinib was $17,253, and 75% of patients paid $100 or less out of pocket per month for the drug.

Initiation of the Interchangeable Biosimilar Insulin Glargine-yfgn Among Older Adults

Initiators of biosimilar insulin glargine-yfgn were more likely to reside in rural areas, live in long-term care facilities, or have multiple prescribers and were less likely to have previously used an originator insulin glargine product.

Association of Physician Specialty With Psoriatic Arthritis Treatment and Costs

In this retrospective cohort study of patients with newly diagnosed psoriatic arthritis, the authors examine the association of treatment selection and costs with physician specialty.

Medicare Advantage in the US Mainland and Puerto Rico

Medicare Advantage enrollment has increased in the US and Puerto Rico, with a dramatic growth among Puerto Rico beneficiaries with end-stage renal disease.

Social Determinants of Health and Emergency Department Utilization in Alabama Children’s Health Insurance Program

Community social determinants of health such as rurality and low socioeconomic status moderate the association between an individual’s race and emergency care use.

Patterns of Opioid Use in Commercially Insured Patients With Cancer

Among the fewer than half of patients with cancer who received opioid fills, a relatively small proportion (2.5%) had potentially problematic opioid use.

Reducing Racial Disparities in CLL Treatment by Addressing Key Social Barriers: Joanna Rhodes, MD, MSCE

Joanna Rhodes, MD, MSCE, highlights significant racial and ethnic disparities that persist in access to preferred CLL treatments.

Implementing Team-Based Telemedicine Workflows in Safety-Net Primary Care

Telemedicine in safety-net primary care faces particular challenges. Consistent, team-based workflows can support video visit implementation and health care maintenance in telemedicine visits.

Contributor: Patient-Centered Approaches to Supporting Medication Adherence Among Persons With Schizophrenia

There are effective strategies that can be employed concurrently to promote adherence to medications for schizophrenia, including but not limited to pharmacological, technological, and psychosocial interventions.

Medicare Expenditures in the First Year of Amyotrophic Lateral Sclerosis Diagnosis

Medicare expenditures for patients with amyotrophic lateral sclerosis are more than 3 times those of the average Medicare beneficiary, and drug therapies are an important cost driver.

How Understanding Risk Factors Can Help Patients With Chronic Diseases Quit Smoking

How much does education about the specific risks of smoking assist in smoking cessation?

Factors Associated With Unplanned Admissions Among Patients With Chronic Conditions

This study identified risk factors for unplanned admissions among patients with multiple chronic conditions to inform focused interventions.

Scenario Analysis When Conducting Budget Impact Analyses for Rare Diseases

The authors propose conducting a scenario analysis for interventions to treat rare diseases by varying health plan size to demonstrate the variability of potential budget impact.

Impact of Medical Care Coordination Intervention on Patient Activation

This observational evaluation compared an adult medical care coordination intervention with usual care and found that the intervention was associated with significant improvements in patient activation.

Economics of a Health System’s Direct-to-Consumer Telemedicine for Its Employees

A direct-to-consumer telemedicine service resulted in lower per-episode unit costs for care within 7 days and only marginally increased the use of services overall.

Using Electronic Health Records and Claims Data to Identify High-risk Patients Likely to Benefit From Palliative Care

Deep learning algorithms could improve palliative care by predicting mortality from electronic health records and claims data.

Cost-Benefit Analysis of Sacubitril/Valsartan in a Medicaid Population

The cost avoidance of heart failure–related hospitalizations and emergency department visits may outweigh the additional drug cost in Medicaid members adherent to sacubitril/valsartan.

Subjective and Objective Impacts of Ambulatory AI Scribes

Although the vast majority of physicians using an artificial intelligence (AI) scribe perceived a reduction in documentation time, those with the most actual time savings had higher relative baseline levels of documentation time.

Effects of Individualized Nurse-Led Care Plans on Olaparib Treatment Duration

A nurse-led personalized care program conducted through a specialty pharmacy prolonged medication persistence among patients with cancer receiving olaparib.