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Effects of Adjunctive Cariprazine Formulary Restrictions in Major Depressive Disorder

Patients who experienced a formulary-related rejection of cariprazine for adjunctive treatment of major depressive disorder had significantly higher hospitalization rates than those with approved claims.

Utilization of Low- and High-Value Health Care by Individuals With and Without Cognitive Impairment

Low-value service utilization is common among all older adults, and utilization of some high-value services decreases after the onset of cognitive decline.

Clinic Price Reductions in a Tiered Total Cost Benefit Design

Findings of this evaluation of primary care clinic responses in a tiered total cost of care benefit design suggest that clinics respond by reducing prices.

Responsibility for Treating Tobacco Dependence in Health Clinics Serving Medicaid Enrollees

This article describes the implementation of Medicaid smoking cessation guidance in a large, urban federally qualified health center to examine how state-level provisions translated into clinic-level policies.

The Promise of Liquid Biopsies for Cancer Diagnosis

An Accelerated Hospital Observation Pathway to Reduce Length of Stay for Patients With COVID-19

For select patients hospitalized due to COVID-19, an academic urban hospital implemented an observation pathway that incorporated mobile health technology, reducing hospital length of stay by more than 2 days.

FDA Approves Bosutinib for Pediatric Patients With CP-CML

Bosutinib has a new indication in leukemia as a well as a newly-approved formulation.

Combined Effect of Continuous Glucose Monitoring and Semaglutide: Analysis of Administrative Claims

Claims data reveal larger hemoglobin A1c decreases in people with type 2 diabetes who use continuous glucose monitoring and semaglutide compared with semaglutide alone.

Health Equity in the Era of Large Language Models

This article presents challenges and solutions regarding health care–focused large language models (LLMs) and summarizes key recommendations from major regulatory and governance bodies for LLM development, implementation, and maintenance.

Advancing Health Equity Through Medication Formulary Policy

Medication formulary policies represent a key determinant of access to medication and can be leveraged to advance pharmacoequity and health equity writ large.

Using Electronic Health Records and Claims Data to Identify High-risk Patients Likely to Benefit From Palliative Care

Deep learning algorithms could improve palliative care by predicting mortality from electronic health records and claims data.

The Economic and Societal Burden of Alzheimer Disease: Managed Care Considerations

Value-Based Management of Specialty Drugs: Practical Considerations and Implications for Pharmacy

Policy makers and health plans seek value-based management of specialty drugs. This study examines real-world factors that favor some approaches over others and their potential impact.

Association of Opioid Utilization Management With Prescribing and Overdose

Opioid utilization management in Medicare was associated with mixed effects on opioid prescribing, and prior authorization was associated with a decreased likelihood of subsequent overdose.

“Can You Hear Me Now?”: Postoperative Patient-Initiated Communication With Providers

Patient-provider communication after surgery is critical for patient safety. The growth of patient-provider communication technologies has created opportunities to study postoperative patient-initiated communication.

Barriers to Accessing Online Medical Records in the United States

Patients’ access to and use of online medical records (OMRs) can facilitate better management of their health care needs; however, disparities persist. This study highlights the disparities among individuals’ OMR use and why individuals who are offered OMRs do not use them.

Safety vs Price in the Generic Drug Market: Metformin

The generic drug market focuses on price. However, multiple generic metformin drugs have been recalled due to poor drug quality. The authors examine price and quality after these recalls.

Dosage and Outcomes in a Complex Care Intervention

Associations between intervention dosage and hospital use outcomes were observed among patients enrolled in a care management program serving individuals with complex needs.

Why EOM Participation Was Extremely Low—and How to Fix It

Hospital Performance in a Statewide Commercial Insurer Episode-Based Incentive Program

Some hospitals were able to outperform others in a commercial insurer episode-based incentive program, but there was little evidence of global reductions in episode spending.

Insights Into Lipoprotein(a) Screening Trends: Analysis of a Comprehensive US Health Care Dataset

Clinical Profile of COVID-19 Infection in Postvaccination Individuals

This article describes the findings of an observational study carried out in India to examine the clinical profile of individuals detected to be COVID-19 positive post vaccination.

Impacts of Community-Based Care Program on Health Care Utilization and Cost

A community-based care management program in Rhode Island reduced hospitalizations and inpatient costs. There were stark differences across subgroups based on intensity of care.

High-Risk Care Management Impact on Medicaid ACO Utilization and Spending

In Massachusetts’ largest Medicaid accountable care organization (ACO), high-risk care management significantly reduced spending, emergency department visits, and hospitalizations, demonstrating that targeted strategies can manage health care costs amid budget constraints.

Longitudinal, Relationship-Based Case Management: A Prospective Cohort Trial

A longitudinal, relationship-based case management approach significantly reduced health care costs and improved quality of life for Medicaid enrollees with complex needs over 1 year.

The Impact of Reinsurance of Gene Therapies on Employer Financial Risk

Opportunities and Obstacles Associated With the Medicare Diabetes Prevention Program

This study describes the current opportunities and obstacles associated with Medicare Diabetes Prevention Program implementation from the novel perspective of program suppliers across the US.

Hospital Performance in a Statewide Commercial Insurer Episode-Based Incentive Program

Some hospitals were able to outperform others in a commercial insurer episode-based incentive program, but there was little evidence of global reductions in episode spending.

A Machine Learning Technology for Addressing Medication-Related Risk in Older, Multimorbid Patients

A novel machine learning system effectively stratifies emergency department use and hospitalization risk of older patients with multimorbidity who take multiple medications and provides appropriate medication recommendations.

Cost Savings Associated With a Web-Based Physical Activity Intervention for COPD

The authors modeled costs associated with a pedometer-based, web-mediated physical activity intervention compared with a pedometer alone for chronic obstructive pulmonary disease (COPD) management. The intervention was cost-saving.