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Contributor: Using Technology to Streamline Enrollment Into Available Medicare Subsidy ProgramsMedicare Advantage plans can drive significant, sustainable, and scalable improvements to health outcomes; reduce cost; and boost retention and top-line revenue by enrolling beneficiaries into the comprehensive set of state and federal low-income programs available to them.
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Influence of Prior Authorization Requirements on Provider Clinical Decision-MakingAn online survey identified that documentation requirements and communication issues with health plans are associated with providers modifying clinical decisions to avoid medication prior authorization.
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Inadequate Insurance Coverage for Overweight/Obesity ManagementThis article reviews the obesity epidemic in America and discusses inadequate insurance coverage.
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Oncologists’ Perceptions and Utilization of US Therapeutic Oncology BiosimilarsBiosimilar use in clinical practice is determined by oncologists’ perceptions of and willingness to prescribe them. The authors investigated US oncologists’ perceptions and use of biosimilars.
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Searching for the Policy-Relevant Treatment Effect in Medicare’s ACO EvaluationsThe authors discuss multiple challenges to the production of policy-relevant results from evaluation of Medicare accountable care organizations (ACOs).
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Modeling of an Alternative Reimbursement Method for Palliative CareThe authors modeled a version of the Patient and Caregiver Support for Serious Illness alternative reimbursement structure for palliative care using data from the Statin Trial.
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Social Determinants of Health Score: Does It Help Identify Those at Higher Cardiovascular Risk?Calculating a social score is feasible and it predicts cardiovascular outcomes. In order to do this, institutions have to collect social determinants of health.
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Racial and Ethnic Disparities in Prior Authorizations for Patients With CancerThe prior authorization process for patients with cancer demonstrates fewer days until submission and lower denial rates for Asian patients relative to White patients.
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Sex Differences in Medicare Beneficiaries’ Experiences by Low-Income StatusOnly low-income male Medicare beneficiaries had worse patient experience than their female counterparts. The authors discuss opportunities to improve experiences for all patients.
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TROPION-Breast01: The Evolving Role of TROP2-Directed ADCs in Breast CancerAditya Bardia, MD, MPH, FASCO, medical oncologist, UCLA Health, provides new insights on the role of TROP2-directed antibody drug conjugates (ADCs) for patients with breast cancer.
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Effective Prevention and Management of COVID-19 in Outpatient Hemodialysis PatientsThe authors introduce a mobile phone app that may effectively prevent and manage coronavirus disease 2019 (COVID-19) in outpatient hemodialysis patients in Sichuan Province, China.
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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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The Essential Role of Population Health During and Beyond COVID-19The authors detail how population health management enables health systems to promote public health, strengthen health system resiliency, and support financial recovery during and beyond coronavirus disease 2019 (COVID-19).
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Predictive Models for Low Birth Weight: A Comparative Analysis of Algorithmic Fairness–Improving ApproachesThis study compared 6 algorithmic fairness–improving approaches for low-birth-weight predictive models and found that they improved accuracy but decreased sensitivity for Black populations.
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Experts Recount What Aspects of SECO Will Be Vital to Their Future PracticeAttendees and experts from the Southeastern Educational Congress of Optometry (SECO) 2025 meeting highlight research and sessions they will take away.
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PROs Similar With Tivozanib Monotherapy vs Combination in RCCPatient-reported outcomes (PROs) were similar among those treated with tivozanib monotherapy and those given combination tivozanib and nivolumab in for renal cell carcinoma (RCC) in the TiNivo-2 study, according to a poster presented at the American Society of Clinical Oncology Genitourinary Cancers Symposium by Katy Beckermann, MD, PhD.
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Improving System-Based Tobacco Cessation in a Community Health ClinicThis case study demonstrates how system-based tobacco cessation was enhanced in a community clinic.
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Continuity of Opioid Prescribing Among Older Adults on Long-term OpioidsAmong older adults with chronic noncancer pain on long-term opioid therapy, greater continuity of opioid prescribing was significantly associated with fewer opioid-related adverse outcomes.
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High-Intensity Home-Based Rehabilitation in a Medicare Accountable Care OrganizationHigh-intensity home-based rehabilitation (HIHR) may substitute for facility-based postacute rehabilitation. Patients in HIHR had better functional outcomes at lower costs than patients in facility-based care.
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Improving Risk Stratification Using AI and Social Determinants of HealthPrediction models combining claims data with social determinants of health and additional, more-timely data sources using artificial intelligence (AI) can better identify individuals with the highest future medical spending.
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The Evolving Annual Wellness VisitThe annual wellness visit is beneficial for patients, providers, and payers with an emphasis on preventive care for early intervention.
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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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Oncologists’ Perceptions and Utilization of US Therapeutic Oncology BiosimilarsBiosimilar use in clinical practice is determined by oncologists’ perceptions of and willingness to prescribe them. The authors investigated US oncologists’ perceptions and use of biosimilars.
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Patient-Centered Oncology Care: Impact on Utilization, Patient Experiences, and QualityPractices implementing a patient-centered oncology care pilot had improved quality, but utilization and patient experiences did not differ from comparison practices.
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Evaluation of a Pediatric Asthma High-risk Scoring AlgorithmAn asthma risk score using 7 clinically relevant parameters evaluated in a pediatric Medicaid managed care population can stratify risk for following-year asthma hospitalization.
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Discharge Before Noon: Is the Sun Half Up or Half Down?Discharge before noon was associated with longer length of stay in patients with medical diagnoses and shorter length of stay in surgical patients.
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Embracing EOM, Enhancing Collaboration and Cost Management: Dr Kirollos HannaThe design of the Enhancing Oncology Model (EOM) was a perfect fit for Minnesota Oncology.
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Using Telemedicine Interventions During COVID-19 to Expand Care Post COVID-19The Patient-Centered Rheumatology Collaborative identified several critical areas for further intervention to improve the delivery of high-quality, patient-centered care during the COVID-19 pandemic and beyond.
