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Physician Satisfaction with Formulary Policies: Is it Access to Formulary or Nonformulary Drugs that Matters Most?

Factors Associated With Timeliness in Academic General Surgery Clinics: A Prospective Quality Assessment

The participation of residents and physician assistants significantly increased patient wait time without reducing the attending surgeon’s consultation length in outpatient surgery clinics.

The Cost of Learning: Participating in APMs Despite Projected Financial Losses

This article explores Northwestern Medicine’s decision to participate in a Medicare alternative payment model (APM) despite projected losses.

Post-SNF Outcomes and Cost Comparison: Medicare Advantage vs Traditional Medicare

Patients enrolled in Medicare Advantage had better outcomes and lower cost following skilled nursing facility (SNF) discharge than patients enrolled in traditional fee-for-service Medicare.

High-Touch Care Leads to Better Outcomes and Lower Costs in a Senior Population

Evaluating the impact of a high-touch primary care model among a Medicare Advantage population in comparison with a standard practice–based model. Check out our website’s new table/figure pop-up feature! Click on the name of a table or figure in the text to see it in your browser.

Impact of Medical Care Coordination Intervention on Patient Activation

This observational evaluation compared an adult medical care coordination intervention with usual care and found that the intervention was associated with significant improvements in patient activation.

Association of Co-pay Elimination With Medication Adherence and Total Cost

This study evaluated cost and utilization attributed to members enrolled in a health care program with no pharmacy co-pay. Health care savings were identified in addition to medication adherence improvements.

Management of Procalcitonin Test Overuse in an Emergency Department Through a Computer Algorithm

Procalcitonin test demand from the emergency department is growing, necessitating the implementation of strategies to address overuse. Successful interventions must be based on information technology.

Old Habits Die Hard: Chest Radiography for Screening Purposes in Primary Care

Medicare Prescription Drug Plans as Perceived by Public Health Providers

Even experienced providers say prescribing has become too complex and time consuming with Medicare Part D plans, which differ in formularies and prior authorization processes.

Health Literacy and Cardiovascular Disease Risk Factors Among the Elderly: A Study From a Patient-Centered Medical Home

A study to determine the health literacy of elderly patients and establish whether an association exists between health literacy and cardiovascular disease risk factors.

Managed Care Reflections: Insights From Richard J. Gilfillan, MD; and Donald M. Berwick, MD, MPP

To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes reflections from a thought leader on what has changed over the past 3 decades and what’s next for managed care. The February issue features a retrospective by Richard J. Gilfillan, MD, former director of the Center for Medicare and Medicaid Innovation; and Donald M. Berwick, MD, MPP, former administrator of CMS.

Improving Adherence to Cardiovascular Disease Medications With Information Technology

Improving adherence to long-term medication therapy remains a challenge. Health information technology interventions that leverage electronic medical records are promising, low-cost approaches for increasing adherence.

Scalable Hospital at Home With Virtual Physician Visits: Pilot Study

Results suggest that this scalable model of Hospital at Home is safe, feasible, highly satisfactory, and may be associated with substantial reductions in hospital readmissions.

Multi-Level Approach to Addressing Iatrogenic Infertility

A socioecological approach focused on patient care, education and resources for providers, and programs within cancer institutions will ensure that the risk of infertility, frequently associated with cancer treatment, will be addressed and routinely included as part of cancer care. This article discusses LIVESTRONG's efforts to achieve this goal.

Paying for Telemedicine

With effective methods of promoting telemedicine yet to be established, new risk-based payment models offer the greatest potential for telemedicine's effective and efficient use.

Analyzing Admission Rates for Multiple Ambulatory Care–Sensitive Conditions

Ambulatory care–sensitive conditions can be systematically assessed in a large electronic medical database to describe admission rates by year, catchment area, and hospital affiliation.

Quality Measure Attainment in Patients With Type 2 Diabetes Mellitus

Cost of Delivering Centralized and Decentralized Reminder/Recall for Vaccinations to Children and Adolescents in an ACO

Centralized reminder/recall (R/R) is less costly to deliver than decentralized R/R for both children and adolescents when implemented for patients within an accountable care organization.

Capitation Payment, Length of Visit, and Preventive Services: Evidence from a National Sample of Outpatient Physicians

Relationship Between Short-Acting β-Adrenergic Agonist Use and Healthcare Costs

Overuse of rescue medication among asthma patients is associated with increased exacerbations and higher total and asthma-related healthcare costs.

Economic Implications of Weight Change in Patients With Type 2 Diabetes Mellitus

Modest weight loss (>3%) among metformin-treated patients with type 2 diabetes mellitus was associated with decreased costs, lower resource utilization, and lower rates of treatment discontinuation.

The Cost of Implementing and Sustaining the Massachusetts Model

This article presents a microcosting analysis of resources needed for the implementation and sustainment of the Massachusetts model evaluated in the PROUD trial.

Contributor: How Much? Addressing Medicines’ Cost and Value

Discussions about drug pricing require consideration of values and preferences, according to Jonathan D. Campbell, PhD, chief science officer of the National Pharmaceutical Council.

Aggressive Treatment of Early Rheumatoid Arthritis: Recognizing the Window of Opportunity and Treating to Target Goals