The author discusses how value-based payment models in chronic kidney disease can improve total cost and quality of care for patienst with chronic kidney disease (CKD).
Implementing a proactive provider outreach program resulted in significantly more prior authorization recertifications and a reduction in time to submission.
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.
The relatively few examples of commercially funded condition-specific bundled payments provide insights into how to spread this alternative payment model further in the private insurance market.
Patients enrolled in Medicare Advantage had better outcomes and lower cost following skilled nursing facility (SNF) discharge than patients enrolled in traditional fee-for-service Medicare.
This study investigated the current status of nursing interruption events and analyzed the time costs, priority of events, and factors influencing interruptions.
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.
This article describes the Philadelphia Medicaid Opioid Prescribing Initiative that was launched by a multidisciplinary team and mailed local Medicaid providers individualized prescribing report cards.
This report illustrates how providing vital diabetes medications to uninsured patients through a charitable medication distributor improves clinical outcomes.
Calculating a social score is feasible and it predicts cardiovascular outcomes. In order to do this, institutions have to collect social determinants of health.
This paper utilizes latent class analysis to identify subgroups of complex conditions and of super-utilizers among health center patients to inform clinically tailored efforts.
A novel prediction model is developed that accurately predicts preterm birth in a timely manner among pregnant women in Medicaid without preterm-birth history.
Medicaid expansion was associated with substantial changes in Medicaid managed care plan composition, which may influence a plan’s performance on enrollee experience metrics.
This 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.
Diabetes and multiple chronic conditions increase overall Medicare spending, but spending increases even more in minority beneficiaries compared with White beneficiaries with similar comorbidity combinations.
Reporting on the real-world utilization of reference rituximab and its biosimilars can help show prescribing habits and reveal cost-saving opportunities.
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.
From 2017 to 2022, patients with better communication with providers were more likely to report being offered and accessing a patient portal, but disparities persist.
The FDA and the European Medicines Agency have accepted marketing authorization applications and decisions are pending.
Ruben Mesa, MD, leads a discussion on key benchmarks and final thoughts about good-quality care programs for patients with MPNs, including parameters for judging efficacy and safety.
The Inflation Reduction Act will likely change incentives surrounding single-indication launches and postapproval research for additional indications in small molecule drugs, affecting patient access.
For select patients hospitalized due to COVID-19, an academic urban hospital implemented an observation pathway that incorporated mobile health technology, reducing hospital length of stay by more than 2 days.
Collaboration between a clinical laboratory and a managed care organization improved prenatal care and outcomes through real-time, actionable, laboratory-derived insights and care coordination.
A survey completed by 100% of leaders of diverse care systems in Minnesota participating in an observational study showed little difference in approach to care coordination.
The trends in the hemophilia treatment market are gaining momentum with increasing incidences of hemophilia A and B and staggering need for their treatments, including gene, anti-tissue factor pathway inhibitor, and factor replacement therapies.
Synthesis of multistakeholder perspectives from a mixed-methods study identifies guiding characteristics for outcomes-based quality measures in future, more patient-centered alternative payment models.
The Great Resignation is sending health care workers out of the industry in massive numbers, and this, coupled with the ongoing transformation of health care, is creating the perfect storm. Alleviating their stress, burnout, and disengagement is a necessary first step. But the proper development, training, and upskilling is also crucial.
Patients with complex chronic disease can be grouped by varying propensity for health care continuity patterns, which could be harnessed to personalize health care utilization interventions.
Using Plan-Do-Study-Act cycles, the studied intervention reduced hospital inpatient telemetry time by 51.25% while increasing American Heart Association (AHA) guideline–based usage.