Authors
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Patient and Supporter Factors Affecting Engagement With Diabetes TelehealthFamily support with medication management and recent urgent self-management concerns are 2 novel factors, among others, that predict completion of diabetes telehealth calls.
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Health Care Leader Perspectives on State Government–Sponsored Accountable Care for Public EmployeesQualitative interviews reveal health care leader perspectives on how state governments influenced payment reform by developing an accountable care program for public employees.
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Use of Diabetes Medications in Traditional Medicare and Medicare AdvantageMedicare Advantage enrollees are more likely to be treated with metformin and sulfonylureas and less likely to receive costly newer medications than those in traditional Medicare.
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Determinants of ICS Therapy Adherence in Patients With AsthmaThis study describes determinants affecting disease control and inhaled glucocorticosteroid therapy adherence for patients with asthma in western China.
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Rideshare Transportation to Health Care: Evidence From a Medicaid ImplementationOur study on ridesharing by a managed care transportation broker found no change in ride quality compared with traditional nonemergency medical transportation, but differences were observed for access-to-care measures.
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Variation in Spending Associated With Primary Care PracticesPhysician practices account for a significant amount of variation in spending.
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Diagnosis Patterns and Stress Testing Trends After Implementing High-Sensitivity Troponin AssayThis study found that switching from a conventional troponin assay to a high-sensitivity troponin assay resulted in changes to diagnosis patterns and stress testing trends.
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Better Data Is Needed to Tackle Health EquityThe US federal government is finally updating its standards for reporting data on race and ethnicity – and it’s an urgently needed chance to enable a national overview of crucial data on health inequities
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Differences in Spending for Diabetes and Multiple Chronic Conditions in Michigan Medicare BeneficiariesDiabetes and multiple chronic conditions increase overall Medicare spending, but spending increases even more in minority beneficiaries compared with White beneficiaries with similar comorbidity combinations.
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Dialysis Costs for a Health System Participating in Value-Based CareIn a large, integrated health system participating in value-based care, higher costs and utilization were observed before and after unplanned dialysis initiation.
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Older Adults’ Perspectives on Emergency Department Costs During COVID-19Most older US adults have concerns about emergency department visit affordability. Lower income, being uninsured, poor or fair physical/mental health, and younger age were associated with increased concerns.
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Contributor: How Payers Can Be Effective in New Value-Based Models for CKDThe author discusses how value-based payment models in chronic kidney disease can improve total cost and quality of care for patienst with chronic kidney disease (CKD).
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Evaluating Proactive Outreach for Prior Authorization Recertifications in Medicaid PatientsImplementing a proactive provider outreach program resulted in significantly more prior authorization recertifications and a reduction in time to submission.
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Health Care Resource Utilization, Quality Metrics, and Costs of Bladder Cancer Within the Oncology Care ModelSpending on novel therapies in high-risk bladder cancer had minimal impact on Oncology Care Model payments to practices, according to this cohort study and an average performance estimation.
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Successes and Failures With Bundled Payments in the Commercial MarketThe relatively few examples of commercially funded condition-specific bundled payments provide insights into how to spread this alternative payment model further in the private insurance market.
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Post-SNF Outcomes and Cost Comparison: Medicare Advantage vs Traditional MedicarePatients 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.
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Current Status and Influencing Factors of Nursing Interruption EventsThis study investigated the current status of nursing interruption events and analyzed the time costs, priority of events, and factors influencing interruptions.
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Community Health Workers’ Critical Role in Trust Building Between the Medical System and Communities of ColorThe authors interrogate elements of routine medical practice in New York City to argue for reforms of hospital culture through relational trust-building capabilities of community health workers.
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The Implementation of Opioid Prescribing Report Cards in Medicaid Managed Care: A Community Quality CollaborativeThis article describes the Philadelphia Medicaid Opioid Prescribing Initiative that was launched by a multidisciplinary team and mailed local Medicaid providers individualized prescribing report cards.
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Social Determinants of Health Score: Does It Help Identify Those at Higher Cardiovascular Risk?Calculating a social score is feasible and it predicts cardiovascular outcomes. In order to do this, institutions have to collect social determinants of health.
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Intersection of Complexity and High Utilization Among Health Center Patients Aged 18 to 64 YearsThis paper utilizes latent class analysis to identify subgroups of complex conditions and of super-utilizers among health center patients to inform clinically tailored efforts.
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Timely Preterm-Birth Prediction Among Pregnant Women in Medicaid Without Preterm-Birth HistoryA novel prediction model is developed that accurately predicts preterm birth in a timely manner among pregnant women in Medicaid without preterm-birth history.
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Medicaid Expansion, Managed Care Plan Composition, and Enrollee ExperienceMedicaid expansion was associated with substantial changes in Medicaid managed care plan composition, which may influence a plan’s performance on enrollee experience metrics.
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Prior Authorization Requirements for Calcitonin Gene-Related Peptide AntagonistsThis quantitative and qualitative analysis highlights differences in prior authorization requirements for migraine drugs from nearly 50 managed care organizations and summarizes broad types of criteria used.
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Differences in Spending for Diabetes and Multiple Chronic Conditions in Michigan Medicare BeneficiariesDiabetes and multiple chronic conditions increase overall Medicare spending, but spending increases even more in minority beneficiaries compared with White beneficiaries with similar comorbidity combinations.
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Relationships Between Patient Portal Activation and Patient Satisfaction Scores Among CG-CAHPS and HCAHPS RespondentsPatients with activated patient portal accounts report higher patient satisfaction in respective dimensions of the Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) and Hospital CAHPS (HCAHPS) surveys compared with patients without portal accounts.
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Patients, Clinicians Need Hemophilia Gene Therapy Shared Decision-Making ToolClinicians and nurses who treat patients with hemophilia with a gene therapy identified important factors and considerations needed in a potential shared decision making tool.
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Management of MPN: Benchmarks For Quality CareRuben Mesa, MD, leads a discussion on key benchmarks and final thoughts about good-quality care programs for patients with MPNs, including parameters for judging efficacy and safety.
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Good Health Policy Requires High-Quality Evidence. Let’s Remember That With Drug Pricing.In the health spending debate, what policy makers need most is an honest, realistic, and evidence-based discussion. Unfortunately, many studies in the public arena fall far short.
