Authors

Racial and Ethnic Disparities in Prior Authorizations for Patients With Cancer

The prior authorization process for patients with cancer demonstrates fewer days until submission and lower denial rates for Asian patients relative to White patients.

Participating Factulty: Real-World Impact of Infliximab Precision-Guided Dosing on Management of Patients With IBD

Industry Payments to Cardiologists Are Associated With Higher Medicare Spending

This study of 26,805 cardiologists shows that industry payments (averaging $3958) are linked to increased Medicare costs, with each $10,000 in payment associated with $14.1 higher beneficiary spending.

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.

Investigating Real-world Consequences of Biases in Commonly Used Clinical Calculators

Clinical calculators that do not include demographic variables may be biased, and their equity should be understood in the context of clinical guidelines.

Assessing Surveillance Utilization and Value in Commercially Insured Patients With Colorectal Cancer

Trends 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.

Industry Payments to Cardiologists Are Linked to Increased Medicare Spending: Michael I. Ellenbogen, MD, and Yubin Park, PhD

Industry payments to cardiologists are linked to higher Medicare spending, with $10,000 in payments tied to $14.10 more per beneficiary.

Continuously Updated Forecasting of SARS-CoV-2 in a Regional Health System

This study presents a methodology for forecasting demand of COVID-19 on health resources in an integrated health system.

The US Oncology Network Tackles Patients’ Health-Related Social Needs by Collaborating With Nation’s Largest Social Services Support Network

The Persistent Pandemic of Violence Against Health Care Workers

The problem of violence against health care workers has escalated across the world, and tackling this issue requires the support of administrators.

A Scoping Review of US Insurers’ Use of Patient-Reported Outcomes

This scoping review found 350 articles that discuss US health insurance providers’ use of patient-reported outcomes about health-related quality of life.

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.

Cost-Effectiveness of Integrated Behavioral Health for Depression, Anxiety, and Chronic Pain

Integrating behavioral health into primary care is cost-effective from the US health system perspective, with reduced prescription drug expenses being a key driver of these savings.

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.

Contributor: Medicare’s ACO Model Begins, Kidney Care Cannot Be Left Behind

As CKCC nears its sunset, kidney care leaders urge CMS to preserve a dedicated, nephrologist-led accountable care model for advanced kidney disease.

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.

Neighborhood Opportunities and Pediatric Health Care Utilization: Implications for Medicaid Managed Care

Medicaid managed care organizations should prioritize children in low-opportunity neighborhoods to optimize health care utilization, improve minority health, and address health-related social needs.