Authors
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Service Line Care Delivery Model for COVID-19 Patient-Centric CareThe 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.
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Cost-Effectiveness of a Multicancer Early Detection Test in the USMulticancer 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.
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Private Label BiosimilarsThe expert panel discusses the greater potential for private label biosimilars.
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Risk Adjusting for Medicaid Participation in Medicare AdvantageWhen comparing risk-adjustment approaches based on Medicaid status of Medicare beneficiaries, this analysis found that predicted spending levels varied depending on states’ Medicaid eligibility criteria.
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Long-Term Health Care Costs Following COVID-19: Implications for Pandemic PreparednessA difference-in-differences analysis of health care claims data evaluated excess health care costs in the 12 months following COVID-19 diagnosis among the general and older adult populations.
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Variation in Spending Associated With Primary Care PracticesPhysician practices account for a significant amount of variation in spending.
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Leveraging Longitudinal Clinical Laboratory Results to Improve Prenatal CareCollaboration between a clinical laboratory and a managed care organization improved prenatal care and outcomes through real-time, actionable, laboratory-derived insights and care coordination.
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Clinical Decision-Making in ITP: Timing Treatment Initiation and Therapy GoalsAn expert discusses treatment strategies for immune thrombocytopenic purpura (ITP), emphasizing individualized decisions based on platelet count, bleeding symptoms, and comorbidities, with options ranging from observation to urgent therapies like steroids or IVIG, and longer-term approaches tailored to patient health, treatment goals, and lifestyle considerations.
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Long-Term Health Care Costs Following COVID-19: Implications for Pandemic PreparednessA difference-in-differences analysis of health care claims data evaluated excess health care costs in the 12 months following COVID-19 diagnosis among the general and older adult populations.
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Contributor: The Case for Education and Clinical Decision Support With PharmacogeneticsPrescribing is a complex process with multiple factors to consider on top of the 3 primary questions about effectiveness, harm, and cost. Pharmacogenetics has put this complexity under the spotlight and prompted educational programs and the development of new clinical decision support systems.
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Long-Term Health Care Costs Following COVID-19: Implications for Pandemic PreparednessA difference-in-differences analysis of health care claims data evaluated excess health care costs in the 12 months following COVID-19 diagnosis among the general and older adult populations.
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Trends in Medicare Part D Coverage of Generics With Equivalent Brand-Name DrugsHigh-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.
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Building Community and Advancing Care at MDA 2025One of the major highlights of the Muscular Dystrophy Association (MDA) Clinical & Scientific Conference is that invaluable networking opportunities can help clinicians elevate their own best practices.
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Cost Analysis of Self-Monitoring Blood Glucose in Nonintensively Managed Type 2 DiabetesAnalysis of claims data showed reduced utilization and costs among patients with nonintensively managed type 2 diabetes using self-monitoring of blood glucose compared with continuous glucose monitoring.
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5 Things Everyone Should Know for National Immunization Awareness MonthNational Immunization Awareness Month highlights the importance of lifelong vaccination to prevent diseases, a practice that has averted millions of deaths, proven to be a cost-effective public health strategy, and offers crucial protection even to individuals who are immunocompromised.
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The Effect of Medicare Eligibility on Diagnosis of Chronic ConditionsMedicare coverage did not necessarily lead to increased diagnosis of chronic conditions.
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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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Child and Adolescent Obesity Exacerbated During the COVID-19 PandemicThe aim of the study was to not only observe the disparities exacerbated by the COVID-19 pandemic but also to draw attention to the issue to drive real, lasting change.
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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.
