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Contributor: COVID-19’s Impact on ACO REACH Deserves CMS' AttentionCMS must account for inclusion of COVID years in 2023 ACO REACH benchmarks to avoid unfairly penalizing REACH ACOs.
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mCRC Treatment Access: IRA Cost Cap Impact and Final InsightsMedical experts discuss how the Inflation Reduction Act’s out-of-pocket prescription drug cost cap, effective in 2025, may impact access to oral chemotherapy options for metastatic colorectal cancer.
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US Cost-effectiveness and Budget Impact of Point-of-Care NAAT for StreptococcusThis study evaluates the cost-effectiveness and budget impact to US payers of point-of-care nucleic acid amplification tests (NAAT) for group A streptococcus.
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Physician Groups Mostly Unhappy With Proposed Medicare Fee ScheduleThe proposed fee schedule for 2024 would reduce payments by 3.4%. Most responses were swift and negative.
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Health Care Resource Utilization, Quality Metrics, and Costs of Bladder Cancer Within the Oncology Care ModelSpending 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.
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Opioid Safety Initiative Associated With Decreased Emergency Department Opioid PrescribingA scalable health system–wide emergency physician education and feedback initiative was associated with decreased opioid prescribing, in excess of background temporal decline.
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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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Outcomes of Antiviral Treatment for Influenza in Type 2 DiabetesAntiviral treatment was associated with lower health care resource utilization and costs in patients with type 2 diabetes and a diagnosis of influenza.
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Choosing Wisely Interventions to Reduce Antibiotic Overuse in the Safety NetThis study evaluates the impact of Choosing Wisely–based interventions on antibiotic prescribing for viral respiratory tract infections in a real-world safety-net setting.
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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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Pharmacist-Driven SMART Formulary Improves PharmacoequityA large academic medical center implemented a charitable care formulary with clinical pharmacist oversight, which resulted in more efficient usage of funds and fewer readmissions.
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Contributor: Why Key Leadership Experiences Are Vital for Developing Future Physician LeadersAs chief quality officer for Allegheny Health Network, Brian M. Parker, MD, is responsible for ensuring that the highest standards of patient care quality, safety, and service excellence are achieved.
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Contributor: Equity, Not Equality, Is Needed to Close Racial Gap in Chronic Kidney Disease OutcomesImproving clinical care is only one element of the 360-degree, holistic treatment that is necessary to achieve patient equity, not equality, in patients with chronic kidney disease. Biology, lifestyle, and socioeconomic status are 3 areas in which inequities often have a particularly negative impact on a carefully constructed care plan.
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Telehealth Transitional Care and 30-Day Readmission During the COVID-19 PandemicThis study found that the dramatic shift from face-to-face posthospital transitional care to telehealth did not affect 30-day readmission or mortality during the COVID-19 pandemic.
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Implementation of Early Follow-up Care After Heart Failure HospitalizationAn early heart failure follow-up intervention succeeded in increasing referral to and completion of cardiology appointments within 7 days of discharge. The intervention was associated with lower risk of 30-day all-cause emergency department visits, all-cause hospitalizations, or death.
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Availability of Off-Marketplace Plans With Lower Premiums for Higher-Income FamiliesOff-marketplace plans are widely available, and individuals with higher incomes can obtain silver plans with low premiums off-marketplace.
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AI-Driven Clinical Support Tools Show Promise in Alleviating Provider Burnout and Workflow ChallengesStephen Speicher, MD, and Kate Estep, from Flatiron Health, discuss the future of oncology care with artificial intelligence (AI).
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Artificial Intelligence in Medicare: Utilization, Spending, and Access to AI-Enabled Clinical SoftwareThis study quantified the trends over time in utilization of, spending on, and access to CT fractional flow reserve, the first artificial intelligence (AI)–enabled clinical software reimbursed by Medicare.
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Association of Social Risks With Avoiding or Delaying Health Care and With Emergency Department Visits: Evidence From 2017 Ohio Medicaid Assessment SurveySocial risks (food insecurity, housing instability, financial strain, health insurance type) are associated with patients’ decisions to avoid/delay health care and increased utilization of the emergency department.
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Contributor: The Era of Disease-Modifying Alzheimer Disease TreatmentsNew treatments for Alzheimer disease don’t reverse cognitive symptoms, but they do significantly slow progression. Evidence suggests that earlier treatment is most effective.
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Assessing Opportunities to Advance Quality Measures in Adult ObesityObesity is a serious chronic disease and risk factor for a broad range of outcomes. This study identifies opportunities for improving quality in obesity care.
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Impact of Delayed Adoption of Novel Atrial Fibrillation TreatmentsUsing direct oral anticoagulants as a case study, the authors examined how delayed adoption of novel treatments could impact patient health outcomes and cost.
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A 10-Step Program to Successfully Reduce Low-Value CareThe frequency of low-value care can be reduced by a respectful, data-driven process anchored in nonjudgmental communication and explicit core values.
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Effect of a Patient Activation Intervention on Hypertension Medication Optimization: Results From a Randomized Clinical TrialIn patients with hypertension, a patient activation intervention increased rates of switching to a thiazide, suggesting that such interventions may address medication optimization challenges.
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Operating Room Efficiency of Orthopedic Surgery During the COVID-19 EraThe authors analyzed the impacts of COVID-19 on orthopedic operating room efficiency via comparison of 14,856 surgeries performed before, during, and after the pandemic.
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Automated Detection of Retinal DiseaseWith diabetes rates projected to rise sharply, automated retinal screening may represent an attractive low-cost option to meet the growing demand for routine screening services.
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Telehealth User Experiences During COVID-19: A Case Study of Outpatient Cardiovascular Clinics Affiliated With a Large Academic PracticeIn cardiovascular clinics during COVID-19, notable barriers to successful telehealth use included obtaining diagnostic information needed to deliver high-quality care and technology-related challenges for patients.
