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Inability to Access Health Care Due to COVID-19 Among Medicare BeneficiariesUp to one-fifth of Medicare beneficiaries were unable to access health care due to the COVID-19 pandemic in 2020.
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Differences in Savings and Quality by Type of ACO Model2016-2018 Next Generation Accountable Care Organization (ACO) and Medicare Shared Savings Program cost and quality data show similar performance, suggesting that increasing financial risk to health systems may not affect performance.
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Projected US Savings From Biosimilars, 2021-2025Projected savings from biosimilars from 2021 to 2025 were $38.4 billion vs conditions as of quarter 4 of 2020 and were driven by new biosimilar entry. Savings were $124.5 billion under an upper-bound scenario.
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Are Work Relative Value Units Correlated With Operative Duration of Common Surgical Procedures?Work relative value units (wRVUs) correlate with operative duration of common surgical procedures. Reimbursement for physicians depending on wRVUs is fair for commonly performed surgeries.
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A Novel Approach to Attribute Responsible Physicians Using Inpatient ClaimsThe authors propose a novel approach in which physicians’ responsibility for inpatient stays is expressed through physician-specific attribution ratios informed by patient characteristics.
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Mental Health Diagnoses and Services Utilization Vary by Wage LevelInsured 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.
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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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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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Addressing Cancer Health Disparities in a Multilateral Collaboration in an Independent Community Cancer Clinic: Translating Words Into ActionNo One Left Behind, a program to provide financial assistance and access to cancer care at Carolina Blood and Cancer Care Associates in South Carolina, will be discussed during a session of the Community Oncology Alliance 2022 Community Oncology Conference.
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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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Cost-effectiveness of Total State Coverage for Hepatitis C MedicationsExpanded coverage under a Medicare-Medicaid partnership to treat all prevalent cases of hepatitis C appears to be cost-effective by saving money and improving patient outcomes.
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Financial Impact of Telehealth: Rural Chief Financial Officer PerspectivesInterviews with chief financial officers of rural hospitals revealed that they perceived telehealth to have some financial advantages; however, they did not believe that telehealth improved their hospitals’ financial situations.
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Contributor: The Mental Health Crisis, How We Got Here, and Where We Go NextAddressing the mental health crisis in the United States warrants innovation in treatment and recovery, and the development of mechanisms to provide and pay for them accordingly.
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Assessing Utilization of a Marketwide Price Transparency ToolConsumers strategically used a price transparency tool by searching more often in procedure markets with provider-specific information, higher charges, and more out-of-network claims and provider competition.
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The Promising Future of Alzheimer Disease TreatmentPanelists conclude the discussion with personal insight into the promising future of Alzheimer disease treatment.
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Understanding Physicians’ Work via Text Analytics on EHR Inbox MessagesThis study leverages text analytics to identify work themes managed by primary care physicians in their electronic health record (EHR) inbox messages and inform managers on workflow redesign.
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Changes in Opioid Marketing Practices After Release of the CDC GuidelinesAfter the CDC guidelines’ release, total opioid marketing spending and encounters per physician decreased, but spending per encounter subsequently increased.
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Teamwork Measure Relates to Provider Experience, Burnout, and Intent to StayA 6-item teamwork measure with good construct validity correlated with favorable provider outcomes including work experience, burnout, and intent to stay with the organization.
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CMS Practice Assessment Tool Validity for Alternative Payment ModelsUsing data from 632 primary care practices, the authors show that the CMS Practice Assessment Tool has adequate predictive validity for participation in alternative payment models.
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AJMCtv® Interviews, February 2017AJMCtv® interviews let you catch up with experts in healthcare. Topics include challenges with immuno-oncology, including the patient voice in treatment decisions, and why payers should cover genomic testing.
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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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Defining Value Among Treatment OptionsPayer decision-makers discuss defining value among agents for unintended pregnancy, uterine fibroids, and endometriosis.
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Contributor: COVID-19 Vaccine May Not Be the Ultimate PanaceaWe should look forward to a safe, effective vaccine for coronavirus disease 2019 (COVID-19) but not expect it to be the ultimate panacea.
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Patient Value Co-creation Behavior Scale Based on the DART ModelThis study aimed to develop and evaluate the psychometric properties of a scale measuring patient value co-creation behavior based on the DART (Dialogue, Access, Risk assessment, Transparency) model.
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The Unintended Consequences of Medicare’s Wage Index Adjustment on Device-Intensive Hospital ProceduresThe authors found an association between Medicare’s wage index adjustment and the differential use of labor-intensive surgical procedures and medical device–intensive minimally invasive clinical procedures across the United States.
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Guideline-Informed Care Among Medicaid-Enrolled Children With Food AllergyThis article describes food allergy–related service utilization and identifies factors associated with guideline-informed care among Medicaid-enrolled US children with food allergy.
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Reduced Medical Spending Associated With Integrated Pharmacy BenefitsMembers covered by an integrated pharmacy benefit (as opposed to a pharmacy carve-out) experienced slower growth in medical spending.
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Telemedicine Catches On: Changes in the Utilization of Telemedicine Services During the COVID-19 PandemicThis analysis of health insurance claims data demonstrates rapid increase and sustained high utilization of telemedicine services during the COVID-19 pandemic.
