Authors

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.

Upper Payment Limit Implementation Risks for Patients, Pharmacies, and Providers

As prescription drug affordability boards move toward upper payment limit implementation, uncertainties introduced across the health care system and risks to patient access warrant urgent attention.

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.

Evaluation of Biosimilar Trastuzumab MYL-1401O in HER2-Positive Breast Cancer

The authors evaluate the effect and safety of biosimilar trastuzumab MYL-1401O in human epidermal growth factor receptor 2 (HER2)–positive early-stage (neoadjuvant and adjuvant therapy) and metastatic (palliative therapy) breast cancer using real-world data.

The Impact of Health Benefit Design on Patients With Infertility

This retrospective analysis explored the impact of infertility health benefit design on the use of infertility medications and procedures and pregnancy outcomes.

Reimagining the Inpatient Palliative Care Consult: Lessons From COVID-19

Digital innovations in palliative care during COVID-19 have changed how hospitalized patients receive palliative care. We propose an approach to implement new models at scale.

Identifying Complex Patients Using Adjusted Clinical Groups Risk Stratification Tool

In this study, the authors developed a method for use in primary care to identify a group of patients with complex care needs using Aggregated Diagnosis Groups.

Evaluating Access to Care for Medicare Beneficiaries Younger Than 65 Years

Enrollment in Medicare coverage without out-of-pocket protections was associated with a higher likelihood of reporting cost and access barriers to care.

Patients’ Needs Following Emergency Care for Ambulatory Care–Sensitive Conditions

To inform intervention development, we assessed for medication changes and patient care needs following treat-and-release Veterans Affairs emergency department visits for chronic ambulatory care–sensitive conditions.

Real-World Analysis Reveals Favorable Outcomes With Liso-Cel in CLL

Real-world data show liso-cel drives high responses in relapsed/refractory CLL, with an 85% ORR, a 44% CR rate, and manageable safety.

Lp(a): Evidence of a Link to Major Adverse Cardiovascular Events

Impact of Telemedicine Use on Outpatient-Related CO2 Emissions: Estimate From a National Cohort

Telemedicine was associated with a monthly avoidance of greenhouse gas emissions equivalent to the emissions of 61,255 to 130,076 passenger vehicles.

Service Line Care Delivery Model for COVID-19 Patient-Centric Care

The authors provide steps hospitals can take to align their care delivery model to effectively meet the demands of a public health crisis such as the current pandemic.

Cost-Effectiveness of a Multicancer Early Detection Test in the US

Multicancer early detection testing results in extended life-years and reduced cancer treatment costs through earlier diagnosis, leading to a cost-effective option in cancer screening.

Participating Faculty: Payer and Provider Solutions to Utilization Management Challenges in the Management of Rare Hematologic Cancers