Authors
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Adjusting Starting Points for Initial Price Offers: The Example of IbrutinibIbrutinib has been selected for Medicare price negotiation under the Inflation Reduction Act. The authors summarize the House Oversight Committee investigation to be considered by CMS during the price negotiation process.
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Private Sector Risk-Sharing Agreements in the United States: Trends, Barriers, and ProspectsAssessment of current trends, success factors, and challenges in the use of risk-sharing agreements in the US private sector.
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Health Information Technology and the Medical School CurriculumThere are opportunities for and obstacles to adding core biomedical informatics competencies to medical school curricula.
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Cost-Sharing and Initiation of Disease-Modifying Therapy for Multiple SclerosisThis study examines the association between cost-sharing and initiation of disease-modifying therapies among privately insured patients with multiple sclerosis.
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Effects of a Medicaid Prior Authorization Policy for PregabalinState Medicaid programs’ pregabalin prior authorization accomplished the objective of lower pregabalin utilization; the unintended effects were increased opioid use and increased disease-related healthcare costs.
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Effect of Management Strategies and Clinical Status on Costs of Care for Advanced HIVAntiretroviral drugs have replaced hospitalization and other services as the most costly component of HIV care, except in patients with especially advanced HIV.
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Pharmacist-Provided Telephonic Medication Therapy Management in an MAPD PlanPharmacist-provided telephonic medication therapy management consultations can lead to decreases in total all-cause healthcare expenditures in a Medicare Advantage Prescription Drug plan population.
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VHA Pharmacy Use in Veterans With Medicare Drug CoverageGreater Medicare managed care benefit levels reduce both the likelihood and magnitude of Veterans Health Administration pharmacy use by Medicare dually enrolled veterans.
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Hospitals’ Strategies to Reduce Costs and Improve Quality: Survey of Hospital LeadersHospitals pursue a broad range of efforts to improve quality, with those participating in bundled payments attempting to reduce postacute care to a greater degree than nonparticipants.
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Voice Response System to Measure Healthcare Costs:A STAR*D ReportModerate underreporting biases were found when patient responses to an interactive voice response system were compared with medical records in the STAR*D clinical trial.
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Impact of a Pharmacy-Based Transitional Care Program on Hospital ReadmissionsPatients receiving postdischarge care from pharmacists had a 28% lower risk of readmission at 30 days and a 31.9% lower risk at 180 days compared with usual care.
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Genomic Testing and Therapies for Breast Cancer in Clinical PracticeDespite almost universal testing for human-epidermal-growth-factor-receptor-2 (HER2), many women with a HER2-positive cancer may not receive trastuzumab. Fewer women received the newer gene-expression-profile (GEP) test.
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Cost of Delivering Centralized and Decentralized Reminder/Recall for Vaccinations to Children and Adolescents in an ACOCentralized 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.
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Evidence-Based Guidelines to Determine Follow-up Intervals: A Call for ActionEvidence-based guidelines are needed to determine appropriate follow-up intervals for chronic medical conditions to maximize the quality of patient care and minimize unnecessary costs.
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Mental Health in ACOs: Missed Opportunities and Low-Hanging FruitThis paper describes the rationale and benefits of incorporating mental health into accountable care organizations using the Chronic Care Model.
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Classification of Health Plans Based on Relative Resource Use and Quality of CareThis study examines variation among health plans in resource use and quality of care for patients with diabetes mellitus or cardiovascular disease.
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Effects of Physician Payment Reform on Provision of Home DialysisThe Medicare program’s transition in 2004 to tiered fee-for-service physician reimbursement for dialysis care had the unintended consequence of reducing use of home dialysis.
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Testing Novel Patient Financial Incentives to Increase Breast Cancer ScreeningThis study tested 3 financial incentives encouraging breast cancer screening (mammograms) among women deemed overdue. None were effective overall; "person-centered" incentives worked in the most recently screened subgroup.
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The Patient-Centered Medical Home in the Veterans Health AdministrationWe describe the Veterans Health Administration's nationwide patient-centered medical home (PCMH) initiative and evaluate interim changes in PCMH-related patient care processes.
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The Role of Nurse Practitioners in Primary HealthcareThe potential of nurse practitioners is not being fully realized in primary care medical practices. Consequently, cost and quality gains are not being achieved.
