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New Insights Into Meth-Associated PAH Care Gaps: Anjali Vaidya, MD, on Closing the DivideResearch from Anjali Vaidya, MD, FACC, FASE, FACP, Temple University Hospital, reveals critical care gaps for patients with methamphetamine-associated pulmonary arterial hypertension (PAH), emphasizing the need for early diagnosis and integrated support.
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Addressing STIs Through Managed Care: Opportunities in Medicaid and BeyondMedicaid and other managed care organizations could take several key steps to respond to the sexually transmitted infection (STI) epidemic in the US, including congenital syphilis.
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Racial and Ethnic Disparities in Prior Authorizations for Patients With CancerThe prior authorization process for patients with cancer demonstrates fewer days until submission and lower denial rates for Asian patients relative to White patients.
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New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient MixOn this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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Using Data Exchange to Improve Quality Reporting, Target Outreach, and Reduce CostCovered California and Health Net’s novel data exchange initiative significantly improved quality measurement and potentially reduced costs by more than $640,000.
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Investigating Real-world Consequences of Biases in Commonly Used Clinical CalculatorsClinical calculators that do not include demographic variables may be biased, and their equity should be understood in the context of clinical guidelines.
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Assessing Surveillance Utilization and Value in Commercially Insured Patients With Colorectal CancerTrends in surveillance testing after treatment for colorectal cancer remained relatively stable recently, and patients who overutilized surveillance measures had quicker recurrence detection but higher costs.
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Key Takeaways for the Management of HIV PrEPA panel of experts share closing thoughts and advice for the management and uptake of HIV PrEP therapy.
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Continuously Updated Forecasting of SARS-CoV-2 in a Regional Health SystemThis study presents a methodology for forecasting demand of COVID-19 on health resources in an integrated health system.
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The Persistent Pandemic of Violence Against Health Care WorkersThe problem of violence against health care workers has escalated across the world, and tackling this issue requires the support of administrators.
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A Scoping Review of US Insurers’ Use of Patient-Reported OutcomesThis scoping review found 350 articles that discuss US health insurance providers’ use of patient-reported outcomes about health-related quality of life.
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Characteristics of Accountable Care Organizations’ Preferred Skilled Nursing Facility NetworksMedicare accountable care organizations use preferred skilled nursing facility networks for postacute care management, although the size, structure, and resource allocation of networks vary widely.
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Final Thoughts on Bronchiectasis ManagementPanelists discuss how bronchiectasis is more common than previously thought, with growing awareness, research, and specialized centers improving diagnosis and treatment options, though challenges remain in standardizing care and securing insurance coverage for therapies.
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A Kidney Diagnostic’s Impact on Physician Decision-making in Diabetic Kidney DiseaseThe 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.
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CMS Practice Assessment Tool Validity for Alternative Payment ModelsUsing 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.
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Contributor: The Price of Mental WellnessConsidering 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.
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Contributor: ACO Success—Driving Better Outcomes and Liberating CliniciansPhysicians 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.
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Provider Barriers in Uptake of Biosimilars: Case Study on FilgrastimPrevious 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.
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Income Differences Between Locations of 340B Entities and Contract PharmaciesThe authors find that 340B-covered hospitals and grantees are contracting mainly with pharmacies in significantly more affluent neighborhoods than their own.
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Association Between Screening for Suspected COVID-19 Cases and Outcomes of Patients Revisiting the Emergency DepartmentPatients 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.
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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."
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How the Name Change to Myeloproliferative Neoplasms Affected People With the DiseaseA decision to rename myeloproliferative neoplasms led to a plethora of developments in a space where there was once little interest.
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Evaluating Access to Care for Medicare Beneficiaries Younger Than 65 YearsEnrollment in Medicare coverage without out-of-pocket protections was associated with a higher likelihood of reporting cost and access barriers to care.
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Using Natural Language Processing to Classify Social Work InterventionsNatural 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.
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Impact of Telemedicine Use on Outpatient-Related CO2 Emissions: Estimate From a National CohortTelemedicine was associated with a monthly avoidance of greenhouse gas emissions equivalent to the emissions of 61,255 to 130,076 passenger vehicles.
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Primary Care Case Conferences to Mitigate Social Determinants of Health: A Case Study From One FQHC SystemThis article describes perceived benefits, facilitators, and challenges of conducting interprofessional team case conferences in primary care settings to address patients’ complex social needs.
