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Initial Maintenance Therapy Adherence Among Older Adults With Asthma-COPD OverlapOlder adults with coexisting asthma and chronic obstructive pulmonary disease (COPD), known as asthma-COPD overlap, who take fixed-dose combinations of inhaled corticosteroids and long-acting β agonists may be less likely to have persistent low adherence to initial maintenance therapy.
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Neulasta Onpro: A Coup de Grâce?With the rapid decline in average sales price of reference pegfilgrastim products due to biosimilar competition, health care institutions and payers may grapple with coverage of Neulasta Onpro.
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Bridging to Value With Codes That Promote Care ManagementFee-for-service billing codes can serve as bridges for organizations to build care management capabilities and transition from volume- to value-based payment and care delivery.
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Revisiting Conclusions on the Empiric Segmentation of High-risk PatientsThe authors provide feedback on generalizations made regarding interventions for high-risk populations in previous research.
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Potential Impact of Hospital at Home on Postoperative ReadmissionsMany postoperative readmissions are amenable to diversion to a hospital at home program for surgical patients, representing an opportunity to generate revenue and improve patient experience.
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Incentivizing Data Sharing Among Health Plans, Hospitals, and Providers to Improve QualityHealth plans can gain efficiencies and improve quality by connecting to health information networks and incentivizing hospital and provider participation as part of pay-for-performance programs.
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Contributor: To Protect Patient Access, Congress Must Block Medicare Physician Payment CutsImpending cuts to Medicare physician services could have an overwhelmingly negative impact on millions of older patients and individuals with disabilities across the country.
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AJMC Roundtable: Evaluating the Management of Cancer Immunotherapy (CIT)Stuart Genschaw, MBA, discusses how his practice approaches cancer immunotherapy (CIT) management and the potential future pathways of care.
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Unmet Needs in the Treatment of Wet AMDNicholas G. Anderson, MD; Philip Niles, MD, MBA; Kevin U. Stephens, Sr., JD, MD; and Jim Kenney, RPh, MBA, provide insight on unmet needs and future directions for the treatment of wet AMD and DME.
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Contributor: The Need to Go Beyond Medication Adherence in the Medicare PopulationMedication adherence is not the only area to focus on for older adults who have Medicare coverage. Optimizing treatment and medication access are also important.
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Health Insurance, Blood Cancer Care, and Outcomes: A Literature Reviewdoi: 10.37765/ajmc.2021.88733
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Association of Co-pay Elimination With Medication Adherence and Total CostThis study evaluated cost and utilization attributed to members enrolled in a health care program with no pharmacy co-pay. Health care savings were identified in addition to medication adherence improvements.
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Mobile Health Clinic: Lessons Learned Building Partnerships Across Health SystemsEstablishing mobile health clinics in rural settings requires collaboration across health systems by aligning missions, building infrastructure to support research, and demonstrating proof of concept.
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Older Adults’ Perspectives on Emergency Department Costs During COVID-19Most older US adults have concerns about emergency department visit affordability. Lower income, being uninsured, poor or fair physical/mental health, and younger age were associated with increased concerns.
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The Impact of HDHPs on Service Use and Spending for Substance Use DisordersOffering a high-deductible health plan (HDHP) led to a 6.6% reduction in the probability of using substance use disorder services and a shift in spending from the plan to the enrollee.
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Health Systems and Telemedicine Adoption for Diabetes and Hypertension CareSmall practices reduced their use of telemedicine during early stages of the COVID-19 pandemic. Technical support may help expand and maintain telemedicine in small practices.
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Trends in Medicare Part D Coverage of Generics With Equivalent Brand-Name DrugsHigh-tier generic drug placement in Medicare Part D has increased over time, but it may be related to a drug’s clinical profile and availability of substitutes rather than preferred brand-name drug coverage.
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Contributor: Using Real-world Data to Study and Improve Health Outcomes in Aging PopulationsPaige Killian, MD, writes about the results of a new study that evaluated the impact of a new program on the health care utilization, costs, and quality outcomes in patients with Medicare Advantage coverage.
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A Cue-to-Action Pilot Project to Increase Screening MammographyA targeted cue-to-action campaign of outreach, education, and incentive can improve uptake of screening mammography.
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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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Clinical Profile of COVID-19 Infection in Postvaccination IndividualsThis article describes the findings of an observational study carried out in India to examine the clinical profile of individuals detected to be COVID-19 positive post vaccination.
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Primary Care Video and Telephone Telemedicine During the COVID-19 Pandemic: Treatment and Follow-up Health Care UtilizationTelephone visits may offer a simple and convenient option to address patient primary care needs without raising safety concerns.
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Eliminating Defects in Value: Turnaround of an MSSP ACOA health system transformational leadership framework and management system made visible and eliminated defects in value and was associated with reduced annual Medicare expenditures and increased quality between 2017 and 2020.
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Baloxavir vs Oseltamivir: Reduced Utilization and Costs in InfluenzaBaloxavir, compared with oseltamivir, was associated with lower health care resource utilization and costs in patients with influenza, particularly those at high risk of secondary complications.
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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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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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Estimating the Economic Burden of Migraine on US EmployersThe Migraine Impact Model is an interactive calculator that estimates migraine prevalence within a workforce and the associated economic burden of migraine on the employer.
