Authors

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.

Grocery Card Use Associated With Increased Care Among Dual-Eligible Beneficiaries: Jennifer L. Kowalski, MS

MA grocery card use was associated with modest increases in wellness, primary care, and specialist visits among dual-eligible beneficiaries, says Jennifer L. Kowalski, MS.

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.

Contributor: Why Key Leadership Experiences Are Vital for Developing Future Physician Leaders

As 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.

Contributor: Equity, Not Equality, Is Needed to Close Racial Gap in Chronic Kidney Disease Outcomes

Improving 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.

Telehealth Transitional Care and 30-Day Readmission During the COVID-19 Pandemic

This 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.

Implementation of Early Follow-up Care After Heart Failure Hospitalization

An 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.

Availability of Off-Marketplace Plans With Lower Premiums for Higher-Income Families

Off-marketplace plans are widely available, and individuals with higher incomes can obtain silver plans with low premiums off-marketplace.

Artificial Intelligence in Medicare: Utilization, Spending, and Access to AI-Enabled Clinical Software

This 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.

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.

Health Care Utilization and Cost of Diagnostic Testing for Respiratory Infections

Syndromic reverse transcriptase–polymerase chain reaction tests for respiratory infections were associated with lower health care resource utilization and costs, implicating potential for improved value in patient care.

Association of Social Risks With Avoiding or Delaying Health Care and With Emergency Department Visits: Evidence From 2017 Ohio Medicaid Assessment Survey

Social 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.

Contributor: The Era of Disease-Modifying Alzheimer Disease Treatments

New treatments for Alzheimer disease don’t reverse cognitive symptoms, but they do significantly slow progression. Evidence suggests that earlier treatment is most effective.

Assessing Opportunities to Advance Quality Measures in Adult Obesity

Obesity is a serious chronic disease and risk factor for a broad range of outcomes. This study identifies opportunities for improving quality in obesity care.

Impact of Delayed Adoption of Novel Atrial Fibrillation Treatments

Using direct oral anticoagulants as a case study, the authors examined how delayed adoption of novel treatments could impact patient health outcomes and cost.

A 10-Step Program to Successfully Reduce Low-Value Care

The frequency of low-value care can be reduced by a respectful, data-driven process anchored in nonjudgmental communication and explicit core values.

Determinants of Hospital Charges and Costs in Acute Myocardial Infarction: A Report from the Myocardial Infarction Cost Study (MICS) Group

Effect of a Patient Activation Intervention on Hypertension Medication Optimization: Results From a Randomized Clinical Trial

In patients with hypertension, a patient activation intervention increased rates of switching to a thiazide, suggesting that such interventions may address medication optimization challenges.

Physician-Mediated Interventions to Lower Medical Expenditures Under Risk-Based Contracts: A Systematic Review

Risk-bearing provider organizations rely on physicians to achieve cost savings. The literature on physician-mediated interventions to reduce costs is scant and provides little guidance on effective strategies.

Operating Room Efficiency of Orthopedic Surgery During the COVID-19 Era

The 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.

AMCP Nexus 2025: Advancing Health Policy and Patient Outcomes Together

AMCP Nexus connects pharmacy leaders, drives policy change, and empowers members to enhance health care access and improve patient outcomes.

Automated Detection of Retinal Disease

With 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.

Telehealth User Experiences During COVID-19: A Case Study of Outpatient Cardiovascular Clinics Affiliated With a Large Academic Practice

In 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.