Authors
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Facilitators of and Barriers to Medicaid Investment in Electronic Consultation ServicesIn this qualitative investigation, leaders of Medicaid managed care plans were interviewed to identify facilitators of and barriers to electronic consultation for specialty care delivery.
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Doctors Can Work With Patients to Be More Proactive in Glaucoma Care: Christine Funke, MDChristine Funke, MD, spoke about the role of doctors in making sure their patients are receiving proper care after being diagnosed with glaucoma.
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Bridging the Gap Between Medical and Pharmacy BenefitsAs health care costs rise, especially for patients with complex conditions, a major barrier to access is the disconnect between medical benefits and pharmacy benefits.
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Medication Adherence Star Ratings Measures, Health Care Resource Utilization, and CostFor patients prescribed diabetes, hypertension, and hyperlipidemia medications, nonadherence to CMS Star Ratings quality measures of medication adherence was associated with increased health care resource utilization and costs.
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Primary Care Redesign and Care Fragmentation Among Medicare BeneficiariesThis article examines the association between a large-scale primary care redesign—the Comprehensive Primary Care Plus Initiative—and ambulatory care patterns of Medicare beneficiaries with highly fragmented care.
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Increased Likelihood of Psychiatric Readmission With Medicaid Expansion vs Legacy CoverageIndividuals who became eligible for Medicaid through Medicaid expansion have an increased likelihood of psychiatric readmission compared with their legacy-enrolled counterparts.
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Dr Ibrahim Aldoss on the Need for Targeted Therapy for KMT2Ar Acute LeukemiasIbrahim T. Aldoss, MD, of City of Hope Comprehensive Cancer Center, discusses the potential of revumenib in KMT2A-rearranged (KMT2Ar) acute leukemias, with pivotal results presented at the 65th Annual American Society of Hematology Annual Meeting and Exposition this week.
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Hidradenitis Suppurativa Onset and Treatment: Challenges and Hope for PatientsChristopher Sayed, MD, discusses how hidradenitis suppurativa typically presents and looks forward, following the November approval of bimekizumab.
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ctDNA Monitoring Can Predict Early Melanoma Recurrence Following ResectionData come from patients with stage 3 melanoma enrolled in a phase 3 randomized trial and showed that detection of circulating tumor DNA (ctDNA) prior to adjuvant systemic therapy can predict risk of early recurrence.
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Primary Care for New vs Established Medicaid EnrolleesUnder Affordable Care Act Medicaid expansion in New Jersey, new and distinct patterns of primary care utilization emerged for new vs established enrollees.
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Medication Adherence Star Ratings Measures, Health Care Resource Utilization, and CostFor patients prescribed diabetes, hypertension, and hyperlipidemia medications, nonadherence to CMS Star Ratings quality measures of medication adherence was associated with increased health care resource utilization and costs.
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Pervasiveness and Clinical Staff Perceptions of HPV Vaccination FeedbackThis article used regression analyses to quantify how clinical staff perceive provider feedback to improve human papillomavirus (HPV) vaccination rates and determine the prevalence of such feedback.
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Antihyperglycemic Treatment Patterns for Chronic Kidney Disease and Type 2 DiabetesThis study characterized antihyperglycemic medication use after chronic kidney disease onset among patients with type 2 diabetes to uncover potential unmet needs in clinical practice.
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Telehealth Insights From an Integrated Care SystemExperiences from a large, integrated, value-based health system suggest that telehealth can be an effective care delivery approach. Public policies can improve telehealth access and care.
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Implementing Multistate Behavioral Health Pay-for-Performance Initiatives in Medicaid Managed CareThe authors describe a pay-for-performance initiative targeting behavioral health providers, which was introduced by a large Medicaid managed care organization across multiple states.
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Humira: The First $20 Billion DrugThe authors review a House Oversight Committee investigation report on AbbVie’s practices pertaining to adalimumab (Humira) to shed light on broader pharmaceutical market dynamics hindering a competitive market.
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In Evaluating Rheumatoid Arthritis Treatments, Involving Patients Is KeyStacy Courtnay is the community network chair for the Arthritis Foundation in Atlanta highlights a report that discusses how understanding patient experiences in RA can shift questions researchers ask.
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Patient Perspectives on Technology-Based Approaches to Social Needs ScreeningPatients are essential stakeholders in designing systems to capture social needs. The authors present key findings from patient interviews regarding social needs screening through technology-based modalities.
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Budget Impact Analysis of Biosimilar Natalizumab in the USProjected savings from biosimilar natalizumab were $452,611 over 3 years, driven by decreased drug acquisition costs and a utilization shift from reference to biosimilar natalizumab.
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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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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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Medicare Payment Rule Threatens Access to Life-Sustaining Kidney CareThe authors call on Congress to reform Medicare reimbursement for dialysis, saying the recent rule puts clinics at risk of closure.
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Social Determinants of Health: Are Colonoscopies Always Fit for Duty?Social determinants of health are associated with colonoscopy noncompletion in a Medicaid patient population at the Providence Community Health Centers.
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HIVconsvX Vaccine Shows Safety, Immune Response in People on ARTThis research on a T-cell–targeting vaccine in HIV has implications for future study design to incorporate consideration of age and years on antiretroviral therapy (ART) to evaluate the level of immune reconstitution.
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Therapists’ Perspectives on Access to Telemental Health Among Medicaid-Enrolled YouthThis qualitative study elucidates therapists’ perspectives on barriers to and facilitators of access to telemental health among Medicaid-enrolled youth served by a large safety-net organization.
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Impact of Payment Models on Medical Specialist Physician Practice PatternsThis article explores the impact of payment models (fee for service vs salary based) on practice patterns, including wait times and care for patients with chronic diseases.
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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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Final Panel Thoughts on Uncomplicated UTI ManagementPanelists discuss how the management of uncomplicated urinary tract infections (UTIs) is evolving, with promising new therapies that address antibiotic resistance concerns, while emphasizing the continued importance of antimicrobial stewardship, personalized treatment approaches, preventive strategies, and comprehensive patient education to reduce recurrence rates and improve outcomes in this common but burdensome condition.
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Increased Likelihood of Psychiatric Readmission With Medicaid Expansion vs Legacy CoverageIndividuals who became eligible for Medicaid through Medicaid expansion have an increased likelihood of psychiatric readmission compared with their legacy-enrolled counterparts.
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Coverage With Evidence Development Study Shows Benefits in Patients With Migraine Treated With Remote Electrical NeuromodulationA 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.
