Implementing a proactive provider outreach program resulted in significantly more prior authorization recertifications and a reduction in time to submission.
This article presents a descriptive review of a team-based care transformation model in a large primary care network, including core staffing, process improvement, and extended care teams.
An online survey identified that documentation requirements and communication issues with health plans are associated with providers modifying clinical decisions to avoid medication prior authorization.
This retrospective cohort evaluation found that patients receiving electronic, compared with face-to-face, specialty consultation had significantly lower health care costs for at least 3 months.
This qualitative study elucidates therapists’ perspectives on barriers to and facilitators of access to telemental health among Medicaid-enrolled youth served by a large safety-net organization.
Vertically integrated health care delivery systems may be well positioned to help reduce overall mortality and specifically mitigate racial/ethnic disparity gaps in cancer care outcomes.
A Q&A With Bhakti Arondekar, PhD, MBA; Alexander Niyazov, PharmD, MPH; and Jay Weaver, PharmD, MPH
Diabetes and multiple chronic conditions increase overall Medicare spending, but spending increases even more in minority beneficiaries compared with White beneficiaries with similar comorbidity combinations.
Integrated health system specialty pharmacies provide specialized services to patients, resulting in high rates of adherence to and financial assistance with specialty disease-modifying antirheumatic drugs.
Neil Minkoff; Natasha Mesinkovska, MD; and Brett King, MD, PhD discuss the diagnosis and disease assessment in alopecia areata along with clinical considerations.
Long-term tele-messaging was more effective than no messaging and short-term messaging for positive airway pressure use, and it was highly likely to be cost-effective with an acceptable willingness-to-pay threshold.
This article describes food allergy–related service utilization and identifies factors associated with guideline-informed care among Medicaid-enrolled US children with food allergy.
Pharmacists’ roles in transitions of care continue to evolve. Evaluation of pharmacist-led interventions as patients transition from emergency department to home is needed.
An expert panel identified and assessed electronic health record and health information exchange structured data elements to support future development of social risk factor computable phenotyping.
Patients are less comfortable with predictive models used for health care administration compared with those used in clinical practice, signaling misalignment between patient comfort, policy, and practice.
Little is known about opioid prescribing patterns in patients with chronic overlapping pain conditions. This study suggests target populations for interventions to manage chronic pain.
An expert panel identified and assessed electronic health record and health information exchange structured data elements to support future development of social risk factor computable phenotyping.
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.
This study investigated the 1-year incidence of extrapyramidal symptoms (EPS), as well as the incremental economic burden, in patients with schizophrenia initiating atypical antipsychotics.
The authors provide steps hospitals can take to align their care delivery model to effectively meet the demands of a public health crisis such as the current pandemic.
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.
Patients with complex chronic disease can be grouped by varying propensity for health care continuity patterns, which could be harnessed to personalize health care utilization interventions.
The authors investigated whether patient coordination and caregiver support for Alzheimer disease reduced health care utilization and expenditures among enrollees in the Memory Program in South Carolina.
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.
This study compared beneficiary characteristics and Medicare per capita expenditures among seriously ill Medicare accountable care organization (ACO) populations defined using prospective and retrospective claims-based attribution methods.
The authors examined the association of diabetes with self-reported gaps in care coordination and self-reported preventable adverse events using data from a national sample of older adults.
Most trust literature investigates missing trust and health care underuse. The authors show that mistrust also leads to health care overuse, a rapidly growing problem in the United States.