Authors

Integrating Clinical, Dispensing, and Fiscal Components for Continuity of Care: Chad Hatfield, PharmD, MHA, BCPS

UC Davis Health enhances patient care through a shared services center, ensuring continuity of care and optimizing pharmacy growth strategies.

A Multistakeholder Effort in Pennsylvania to Improve the Accuracy of Reporting Fatal Drug Overdoses

The authors describe a novel training program for death certifiers in Pennsylvania, which has been designed to specifically focus on some of the main challenges in the death certification process and resulted in a useful model that can potentially be adopted by other states or municipalities.

Characterizing Obesity in a Large Health Care Delivery System.

The prevalence of obesity in the Sutter Health system between 2015 and 2020 was 35%. Differences by race/ethnicity, health insurance, smoking status, and comorbidities were examined.

Assessment of Variation in Ambulatory Cardiac Monitoring Among Commercially Insured Patients

Ambulatory cardiac monitors’ clinical and economic outcomes vary; one long-term continuous monitor brand showed greater arrhythmia diagnosis, fewer retests and cardiovascular events, and lower health care resource use and costs.

Economic Burden of Joint Disease in Psoriasis: US Claims Analysis

This retrospective claims analysis found that concomitant joint disease in psoriasis is associated with greater health care resource utilization and health care costs than psoriasis alone.

Modeling the Economic Value of Cardiometabolic Virtual-First Care Programs

Using a microsimulation approach, this study modeled the potential multiyear health and economic benefits of participating in cardiometabolic virtual-first care programs.

Properties of the Overall Hospital Star Ratings and Consumer Choice

The CMS Star Ratings may be of limited value for patients choosing hospitals for specific care needs.

Venetoclax Combo Achieves Mixed Results in Relapsed/Refractory Multiple Myeloma

Venetoclax plus bortezomib and dexamethasone improved PFS in relapsed/refractory multiple myeloma, especially in patients with BCL2high disease.

Community Health Workers’ Critical Role in Trust Building Between the Medical System and Communities of Color

The 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.

Prolonged Cessation of Chronic Opioid Analgesic Therapy: A Multidisciplinary Intervention

This article evaluates the immediate and long-term efficacy of a group multidisciplinary program for chronic opioid analgesic therapy cessation in the setting of chronic, noncancer pain.

Service Line Care Delivery Model for COVID-19 Patient-Centric Care

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.

FDA Grants Platform Technology Designation to Limb-Girdle Muscular Dystrophy Gene Therapy Vector

The platform technology designation is a new designation established by the FDA.

Development of Multipayer Claims-Based Emergency Department Episodes of Care

Thirty-day episodes of care initialized by emergency department visits can inform future quality improvement efforts.

Policy Solutions to Facilitate the New eCQM ACO Reporting and Advancement of Interoperability

This article describes the challenges associated with aggregating and reporting quality data via electronic health records and discusses corresponding policy solutions.

Discharge Prescribing and Subsequent Opioid Use After Traumatic Musculoskeletal Injury

The authors use surgical resident assignment as an instrumental variable for discharge opioid prescribing and estimate the impact of discharge opioid supply on subsequent use.

Association Between Low-Income Subsidies and Inequities in Orally Administered Antimyeloma Therapy Use

Medicare Part D low-income subsidies alone are insufficient to improve the uptake and equitable use of high-cost, orally administered antimyeloma therapy.

Mortality Risk Stratification Can Predict Readmissions but Not Length of Stay

Mortality risk stratification can identify patients at higher risk of mortality and readmissions for prevention strategies. Other patients should be the focus of length-of-stay reduction strategies.

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.

Idiopathic Pulmonary Fibrosis: Exploring the Clinical and Economic Implications of the Evolving Treatment Landscape

Chronic Disease Management: Why Dementia Care Is Different

Because of its often slowly progressive nature, dementia is often included among chronic disease management programs. Yet, for many reasons, its management demands different approaches.

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.

Interventional Analytics in Skilled Nursing Facilities Associated With Reduced Readmissions

A retrospective analysis of 30-day risk-adjusted readmission rates among skilled nursing facilities (SNFs) between 2017 and 2022 compared those that had implemented an interventional analytics platform and other SNFs.

Managed Care Reflections: A Q&A With Dora Hughes, MD, MPH

To mark the 30th anniversary of The American Journal of Managed Care, each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The September issue features a conversation with Dora Hughes, MD, MPH, chief medical officer and director of the Center for Clinical Standards and Quality at CMS.

Association of Physician Coordination With Interfacility Transfer Acceptance Timeliness

The authors reviewed physician-to-physician conversations during emergency transfer of patients with ST-segment elevation myocardial infarction and found that higher-quality physician coordination was associated with faster time to acceptance.

Relationships Between Patient Portal Activation and Patient Satisfaction Scores Among CG-CAHPS and HCAHPS Respondents

Patients 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.

High-Intensity Home-Based Rehabilitation in a Medicare Accountable Care Organization

High-intensity home-based rehabilitation (HIHR) may substitute for facility-based postacute rehabilitation. Patients in HIHR had better functional outcomes at lower costs than patients in facility-based care.

Filling the Gaps in Guideline-Directed Care

Evaluating Proactive Outreach for Prior Authorization Recertifications in Medicaid Patients

Implementing a proactive provider outreach program resulted in significantly more prior authorization recertifications and a reduction in time to submission.

Real-world Usage of Bevacizumab-bvzr Biosimilar in US Oncology Practice

Real-world adoption of bevacizumab-bvzr biosimilar was retrospectively assessed, revealing switching between biosimilars and the reference product and utilization in extrapolated indications and combination regimens.

Community Health Workers’ Critical Role in Trust Building Between the Medical System and Communities of Color

The 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.