Authors

Characteristics of Accountable Care Organizations’ Preferred Skilled Nursing Facility Networks

Medicare accountable care organizations use preferred skilled nursing facility networks for postacute care management, although the size, structure, and resource allocation of networks vary widely.

A Kidney Diagnostic’s Impact on Physician Decision-making in Diabetic Kidney Disease

The KidneyIntelX test would affect primary care physician (PCP) decision-making, and PCPs would use the results of KidneyIntelX more than albuminuria and estimated glomerular filtration rate when making decisions about diabetic kidney disease management.

Exploratory Study of Selected Stakeholder Insights Into Continuous Glucose Monitoring in T2D With Risk-Sharing Agreements

A small expert panel was selected to share professional experiences with risk-sharing agreements and advance the cost-effective utilization of continuous glucose monitoring–centered care in type 2 diabetes (T2D).

CMS Practice Assessment Tool Validity for Alternative Payment Models

Using data from 632 primary care practices, the authors show that the CMS Practice Assessment Tool has adequate predictive validity for participation in alternative payment models.

Contributor: The Price of Mental Wellness

Considering the personal, societal, and economic toll of treatment-resistant depression, we must make it easier to access medicines and care that provide value, both for the patient and for the health care system.

Contributor: ACO Success—Driving Better Outcomes and Liberating Clinicians

Physicians have been facing increasing workloads making it difficult to practice medicine as they were trained, but an accountable care organization might provide an opportunity for real change to deliver high-value, compassionate care.

Provider Barriers in Uptake of Biosimilars: Case Study on Filgrastim

Previous studies have found modest uptake of biosimilars in both commercial and Medicare populations. This study finds that the uptake varies between the rural and urban provider settings.

The Current and Emerging Treatment Landscape for Chronic Cough

Income Differences Between Locations of 340B Entities and Contract Pharmacies

The authors find that 340B-covered hospitals and grantees are contracting mainly with pharmacies in significantly more affluent neighborhoods than their own.

Association Between Screening for Suspected COVID-19 Cases and Outcomes of Patients Revisiting the Emergency Department

Patients who revisit the emergency department shortly after discharge are at high risk for complications and death, exacerbated by COVID-19 screening workload. Detection efforts impact outcomes.

OneOncology and Its Practice Partners Celebrate 5 Years of Cancer Care Excellence

“OneOncology was started by physicians and for physicians,” said Jeff Patton, MD, OneOncology CEO. “As we’ve grown and enhanced world-class cancer care in communities across the country, strengthening practice independence and empowering their decision-making has always been our north star."

How the Name Change to Myeloproliferative Neoplasms Affected People With the Disease

A decision to rename myeloproliferative neoplasms led to a plethora of developments in a space where there was once little interest.

Validation of the FINE-CKD Model for Future Health Technology Assessments for Finerenone in Patients With Chronic Kidney Disease And Type 2 Diabetes

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.

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.

Using Natural Language Processing to Classify Social Work Interventions

Natural language processing can be used for automated extraction of social work interventions from electronic health records, thereby supporting social work staffing and resource allocation decisions.

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.

Primary Care Case Conferences to Mitigate Social Determinants of Health: A Case Study From One FQHC System

This article describes perceived benefits, facilitators, and challenges of conducting interprofessional team case conferences in primary care settings to address patients’ complex social needs.

Contributor: COVID-19’s Impact on ACO REACH Deserves CMS' Attention

CMS must account for inclusion of COVID years in 2023 ACO REACH benchmarks to avoid unfairly penalizing REACH ACOs.

US Cost-effectiveness and Budget Impact of Point-of-Care NAAT for Streptococcus

This study evaluates the cost-effectiveness and budget impact to US payers of point-of-care nucleic acid amplification tests (NAAT) for group A streptococcus.

Physician Groups Mostly Unhappy With Proposed Medicare Fee Schedule

The proposed fee schedule for 2024 would reduce payments by 3.4%. Most responses were swift and negative.

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.

Dual-Eligible Beneficiaries’ Grocery Supplemental Benefit Use and Health Care Utilization

Medicare Advantage grocery supplemental benefit use is associated with increased outpatient care, suggesting that policy changes allowing for nonmedical supplemental benefits could improve beneficiaries’ health, especially for dual-eligible beneficiaries.

Opioid Safety Initiative Associated With Decreased Emergency Department Opioid Prescribing

A scalable health system–wide emergency physician education and feedback initiative was associated with decreased opioid prescribing, in excess of background temporal decline.

Trends in Medicare Part D Coverage of Generics With Equivalent Brand-Name Drugs

High-tier generic drug placement in Medicare Part D has increased over time, but it may be related to a drug’s clinical profile and availability of substitutes rather than preferred brand-name drug coverage.

Workforce Innovation Reduces Medicaid Costs in Chronic Care

This study of community health workers as clinical extenders demonstrates significant cost savings in managing chronic conditions among Medicaid beneficiaries.

Outcomes of Antiviral Treatment for Influenza in Type 2 Diabetes

Antiviral treatment was associated with lower health care resource utilization and costs in patients with type 2 diabetes and a diagnosis of influenza.

Choosing Wisely Interventions to Reduce Antibiotic Overuse in the Safety Net

This study evaluates the impact of Choosing Wisely–based interventions on antibiotic prescribing for viral respiratory tract infections in a real-world safety-net setting.

Using Data Exchange to Improve Quality Reporting, Target Outreach, and Reduce Cost

Covered California and Health Net’s novel data exchange initiative significantly improved quality measurement and potentially reduced costs by more than $640,000.

Pharmacist-Driven SMART Formulary Improves Pharmacoequity

A large academic medical center implemented a charitable care formulary with clinical pharmacist oversight, which resulted in more efficient usage of funds and fewer readmissions.