Authors

Building a Payment Model for Health Coaching in Primary Care: Lessons From Tennessee

This case study describes Tennessee’s process for convening key stakeholders to develop uniform payment guidelines to encourage increased preventive service delivery.

Promoters of Therapeutic Inertia in Managing Hypertension: A Consensus-Based Study

The authors identified consensus-based promoters of clinical inertia in managing hypertension. Policy makers should address these promoters to improve health-related outcomes in hypertension.

Mental Health Diagnoses and Services Utilization Vary by Wage Level

Insured lower-wage employees had lower prevalence of mental health conditions but greater severity, with more hospital admissions and emergency department visits than high-wage employees.

Outcomes in Patients With IBD Stratified by Risk of Disease Progression

This study validates criteria to identify patients with inflammatory bowel disease (IBD) at risk of worsening disease who may benefit from early treatment with advanced therapies.

Veterans Health Administration Benefit Value Has Little Effect on Reliance

Relying on veteran survey responses and novel actuarial data, the authors examine the relationship between benefit value and reliance on the Veterans Health Administration.

Health Impacts of Health System Implementation of a Food-as-Medicine Strategy

This article describes the reach of a Food-as-Medicine strategy implemented by a regional health care system and its impact on adult participants’ cardiometabolic risk factors.

Health Outcomes Under Full-Risk Medicare Advantage vs Traditional Medicare

Physician groups under 2-sided risk–based Medicare Advantage provide care associated with higher quality and efficiency compared with care by these same groups under fee-for-service Medicare.

Contributor: Cellular Research Offers New Opportunities in Our Battle Against Cancer

William B. Miller, Jr, MD, evolutionary biologist, medical doctor, and author explains the importance of cellular research in finding inventive solutions to the growing burden of cancer.

MRD and Other Predictors From FELIX for Obe-Cel Success in R/R B-ALL

Health Care Resource Utilization, Quality Metrics, and Costs of Bladder Cancer Within the Oncology Care Model

Spending 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.

Having Someone Who Cares: Patient Perspectives of Care Management Programs

This article presents a single-organization qualitative case description of the perspectives of patients with high-need, high-cost illnesses who participated in care management programs.

Outcomes of Antiviral Treatment for Influenza in Type 2 Diabetes

Antiviral treatment was associated with lower health care resource utilization and costs in patients with type 2 diabetes and a diagnosis of influenza.

Adherence Patterns 1 Year After Initiation of SGLT2 Inhibitors: Results of a National Cohort Study

This article describes the trajectory of adherence patterns among users of sodium-glucose cotransporter 2 (SGLT2) inhibitors. The authors found that baseline factors were unable to predict the adherence trajectory groups.

Real-world HIV Diagnostic Testing Patterns in the United States

This retrospective study evaluated real-world implementation of the updated CDC HIV algorithm in a large US laboratory.

Contributor: Advancing Breast Cancer Treatment—The Role of Clinical Trials and the Path Ahead

Clinical studies have transformed how breast cancer is prevented, identified, and treated. Successful clinical trials improve patient outcomes, so trial administrators must ensure participants receive appropriate support at trial enrollment.

Gaps in the Coordination of Care for Older Adults With or at Risk for Cardiovascular Disease

Older adults with cardiovascular disease (CVD) or CVD risk factors report that gaps in communication among their providers are common and hazardous.

Use of Voluntary Alignment in the Next Generation ACO Model

Use of voluntary alignment attribution by Next Generation Accountable Care Organization (ACO) participants was limited. The authors highlight the reasons and describe organizational use cases via a mixed-methods approach.

Impact of Including Drug Spending in Oncology Alternative Payment Models

This study demonstrates a method for understanding the effects of drug spending in the design of alternative payment models.

The Hepatitis B Care Cascade Using Administrative Claims Data, 2016

Analysis of a large, nationally representative claims database to longitudinally monitor enrollees with hepatitis B showed that 36% received recommended care and 18% were prescribed treatment.

Health Impacts of Health System Implementation of a Food-as-Medicine Strategy

This article describes the reach of a Food-as-Medicine strategy implemented by a regional health care system and its impact on adult participants’ cardiometabolic risk factors.

Health-Related Social Needs, Methods, and Concerns for a Polysocial Risk Score: An Expert Panel

A polysocial risk score is a potentially useful addition to the growing methodologies to better understand and address health-related social needs.

Coverage With Evidence Development Study Shows Benefits in Patients With Migraine Treated With Remote Electrical Neuromodulation

A coverage with evidence development (CED) study demonstrated significant and clinically meaningful benefits in patients with migraine treated with remote electrical neuromodulation (REN). Health plans should support clinicians’ REN prescriptions by ensuring adequate coverage.

Neonatology Pricing and Network Participation Under State Balance Billing Regulations

This national study of neonatology services found no clear evidence that state surprise billing regulations influenced prices or provider network participation for the commercially insured.

A Standardized Care Pathway Increases Optimal Dialysis Starts

The authors observed a significant increase in optimal starts for dialysis and in peritoneal dialysis rates after implementing a standardized end-stage renal disease transition pathway.

The Spectrum of Progressive Fibrosing Interstitial Lung Disease: Clinical and Managed Care Considerations

Population-Based Return on Investment of Deploying Transient Elastography

Deploying vibration-controlled transient elastography/controlled attenuation parameter devices at the population level is a financially advantageous solution to address the epidemic of fatty liver disease.

Characteristics of Accountable Care Organizations’ Preferred Skilled Nursing Facility Networks

Medicare accountable care organizations use preferred skilled nursing facility networks for postacute care management, although the size, structure, and resource allocation of networks vary widely.

Contributor: It’s Important to Prioritize HIV Care During the COVID-19 Pandemic

Not all barriers to HIV-related care and services have been eliminated, and these gaps in care were exacerbated by treatment disruptions brought on by the COVIDC-19 pandemic.

Contributor: How Pediatric Mental Health May Influence the Risk of Heart Disease in Adulthood

In this contributor piece, the connection between the complexities of mental health and heart disease in at-risk communities is explored, with the authors stressing the importance of risk factor evaluation and multidisciplinary patient education from both mental and physical health providers.

Scaling Care Coordination Through Digital Engagement: Stepped-Wedge Trial Assessing Readmissions

This evaluation looks at a postdischarge digital engagement (PDDE) program using causal inference methods to examine the impact of PDDE on readmission.