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A Predictive Model of Hospitalization Risk Among Disabled Medicaid EnrolleesPredictive modeling can be used to identify disabled Medicaid beneficiaries at high risk of future hospitalizations who could benefit from appropriate interventions.
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The Effect of Implementing a Care Coordination Program on Team Dynamics and the Patient ExperienceA primary care redesign program embedding care coordinators into practices slightly improves the patient experience and does not disrupt team dynamics.
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Lack of Clarity on Medicare Advantage Palliative, Other Cancer Care Benefits Limits Consumer UptakeBenefits newly available under Medicare Advantage are not well-known to consumers and uptake has been limited. At the same time, CMS has propsed funding the hospice benefit differently, which would allow MA plans to “carve in” to this benefit, creating additional uncertainty.
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Diabetes Disease Management in Medicare Advantage Reduces Hospitalizations and CostsA disease management program for Medicare Advantage patients with diabetes and coronary artery disease resulted in significantly reduced hospital admissions and total healthcare costs.
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Two Steps Forward, One Step Back: 50 Years of Societal Value From LDL-C–Lowering TherapiesLow-density lipoprotein cholesterol (LDL-C)–lowering therapies have yielded significant value to society through reduced costs for both fatal and nonfatal cardiovascular disease events. The vast majority of this value has accrued to patients.
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Positive Quality Interventions: An Innovative Platform for Oncology Practice CollaborationAn in-depth look into a nationwide collaborative initiative to standardize and improve oncology dispensing practices for the benefit of patient/provider education, adherence, and overall care.
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Ease of Ordering High- and Low-Value Services in Various Electronic Health RecordsThis study evaluates the ease of ordering high- and low-value clinical services in a national sample of electronic health records.
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Opportunities to Improve the Value of Outpatient Surgical CareOutpatient surgeries in the United States account for roughly 7% of annual healthcare expenditures. To exploit substantial opportunities to improve the value of outpatient surgical care, the authors composed an evidence-based care delivery composite for national discussion and pilot testing.
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Patient Experience and Physician/Staff Satisfaction in Transforming Medical HomesBecoming a medical home appears to increase physician and staff job satisfaction, but it also risks decreasing patient satisfaction with access to care.
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Plan Designs That Encourage the Use of Generic Drugs Over Brand-Name Drugs: An Analysis of a Free Generic BenefitSmall increases and decreases in pharmacy copayments have little influence on patients’ switching to generic drugs or on improving adherence to medication regimens.
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Association of Care Management Intensity With Healthcare Utilization in an All-Condition Care Management ProgramHigher intensity of care management in an all-condition program addressing care coordination and care barriers was associated with increased healthcare utilization among Medicaid and Medicare patients.
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A Web-Based Clinical Decision Support System for Depression Care ManagementThis article describes the development and capabilities of a Webbased decision support system for care managers working in the context of the chronic care model.
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The Value of Specialty Pharmaceuticals - A Systematic ReviewThis study examines whether patients treated with specialty pharmaceuticals have improved outcomes compared with patients treated with conventional therapies, and evaluates costs associated with these treatments.
