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Authors
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Primary Care Referrals to Nephrology in Patients With Advanced Kidney DiseasePrimary care physicians did not refer the majority of patients with severe nephropathy to specialists; nonreferred patients had fewer comorbidities and might be better kidney transplant candidates.
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Contributor: Employers Are Turning to Virtual Care Options to Mitigate CostsVirtual care not only means saved time and costs for employees, but improvements to employers' bottom lines, through more proactive management of health concerns, notes UCM Digital Health CEO and co-founder Keith Algozzine.
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Clinical and Economic Outcomes of a Collaborative Cardiology Care ProgramPatients with chronic cardiac conditions benefited from a health care program that strengthened collaboration between general practitioners and cardiology specialists in Baden-Wuerttemberg, Germany.
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Statin Prescribing Patterns in Patient-Centered Medical Home Patients With NAFLDIn this study, authors assessed the proportion of patients with nonalcoholic fatty liver disease (NAFLD) receiving prescriptions for statins in primary care.
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Association of Physician Coordination With Interfacility Transfer Acceptance TimelinessThe 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.
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Remote Monitoring Saves Costs in Outpatient Negative Pressure Wound TherapyHealth insurance records of patients using negative pressure wound therapy (NPWT) revealed lower adjusted 90-day wound-related costs with remote therapy monitoring vs NPWT alone.
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An Analysis of Medicare Accountable Care Organization Expense ReportsThe authors of this study examined expense reports to understand how participants in Medicare’s Accountable Care Organization Investment Model spent to achieve program goals.
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Out-of-Pocket Costs for Diabetes Medications in Employer-Sponsored Health Insurance PlansOut-of-pocket costs of diabetes medications other than insulin can be quite high for individuals with employer-sponsored health insurance.
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Impact of Food Affordability on Diabetes-Related Preventable HospitalizationMedicaid enrollees residing in counties with greater food affordability had lower odds of preventable hospitalization related to diabetes.
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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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Primary Care Visit Cadence and Hospital Admissions in High-Risk PatientsPatients with congestive heart failure and/or chronic obstructive pulmonary disease who had more quarterly primary care visits had lower rates of hospitalizations during the COVID-19 pandemic.
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Scaling Care Coordination Through Digital Engagement: Stepped-Wedge Trial Assessing ReadmissionsThis evaluation looks at a postdischarge digital engagement (PDDE) program using causal inference methods to examine the impact of PDDE on readmission.
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Service Line Care Delivery Model for COVID-19 Patient-Centric CareThe 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.
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How Medicare Advantage Plans Use Data for Supplemental Benefits Decision-MakingThis article presents findings from interviews conducted with executives from 29 Medicare Advantage plans regarding plan decision-making processes related to new social risk factor–related benefits.
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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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Large Self-insured Employers Lack Power to Effectively Negotiate Hospital PricesThis study examines the ability of self-insured employers to negotiate hospital prices and the relationship between hospital prices and employer market power in the United States.
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Contributor: Objective Documentation Protects Patient Access to Home Oxygen TherapyFacing the challenges created by the COVID-19 pandemic, the US medical community has been forced to rapidly change and modernize the manner in which it delivers health care over the last year-and-a-half.
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Advanced Care at Home at Scale in an Integrated Health Care SystemAdvanced care at home (otherwise known as hospital at home) can be scaled and provide care for a sizable portion of a hospital’s inpatient census, creating hospital capacity in an integrated delivery system.
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A Case-Control Study of Length of Stay OutliersLength of stay outliers are associated with hospital-acquired infections, complications, and discharge to facility, as opposed to nonmodifiable risk factors like age and comorbidities.
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Impact of COVID-19 Pandemic on Accessibility of Taiwanese Medical CareThe COVID-19 pandemic disrupted access to routine medical care in community populations in Taiwan. The unmet needs should be emphasized as normal life resumes.
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Best Practices Drive Better Payer NegotiationsIn today's managed care environment, it is important that contracts between practices and payers include reciprocal language that affords a practice protection over processes, decisions, and changes to the agreement over time, while aligning with its business operation.
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Scaling Care Coordination Through Digital Engagement: Stepped-Wedge Trial Assessing ReadmissionsThis evaluation looks at a postdischarge digital engagement (PDDE) program using causal inference methods to examine the impact of PDDE on readmission.
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Identifying Complex Patients Using Adjusted Clinical Groups Risk Stratification ToolIn this study, the authors developed a method for use in primary care to identify a group of patients with complex care needs using Aggregated Diagnosis Groups.
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Contemporary Care Patterns in the Management of Small Renal MassesAn investigation of management patterns after initial radiographic diagnosis of small renal masses showed that early urologist referral was associated with guideline-concordant care.
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Collaborative Care Implementation: Lessons LearnedThe authors drafted a “Shared Values of Collaborative Care” document with fundamental principles to make better group decisions in implementing collaborative care.
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Collaborative Care Implementation: Lessons LearnedThe authors drafted a “Shared Values of Collaborative Care” document with fundamental principles to make better group decisions in implementing collaborative care.
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Psoriatic Arthritis Treatment Patterns and Costs Among Pharmacologic Treatment–Naïve PatientsWe present results of an analysis of IBM MarketScan databases that evaluates treatment patterns and health care costs for treatment-naïve patients with psoriatic arthritis.
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The Price Paradox of Biosimilar-Like Long-Acting InsulinFindings suggest that Basaglar was not less expensive for patients than Lantus. Empirical evaluation of biosimilar costs prior to automatic substitution is necessary.
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Impact of Co-pay Assistance on Patient, Clinical, and Economic OutcomesLimited evidence from a literature review suggests that co-pay assistance was associated with improved treatment persistence/adherence across various diseases, with indirect evidence suggesting improvements in clinical outcomes.
