Up to one-fifth of Medicare beneficiaries were unable to access health care due to the COVID-19 pandemic in 2020.
2016-2018 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.
Projected 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.
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.
The authors propose a novel approach in which physicians’ responsibility for inpatient stays is expressed through physician-specific attribution ratios informed by patient characteristics.
Insured 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.
This 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.
This 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.
No 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.
Only low-income male Medicare beneficiaries had worse patient experience than their female counterparts. The authors discuss opportunities to improve experiences for all patients.
Expanded 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.
Interviews 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.
Addressing 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.
Consumers 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.
Panelists conclude the discussion with personal insight into the promising future of Alzheimer disease treatment.
This 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.
After the CDC guidelines’ release, total opioid marketing spending and encounters per physician decreased, but spending per encounter subsequently increased.
A 6-item teamwork measure with good construct validity correlated with favorable provider outcomes including work experience, burnout, and intent to stay with the organization.
Using 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.
AJMCtv® 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.
Patients with chronic cardiac conditions benefited from a health care program that strengthened collaboration between general practitioners and cardiology specialists in Baden-Wuerttemberg, Germany.
Payer decision-makers discuss defining value among agents for unintended pregnancy, uterine fibroids, and endometriosis.
We should look forward to a safe, effective vaccine for coronavirus disease 2019 (COVID-19) but not expect it to be the ultimate panacea.
This 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.
The 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.
This article describes food allergy–related service utilization and identifies factors associated with guideline-informed care among Medicaid-enrolled US children with food allergy.
Members covered by an integrated pharmacy benefit (as opposed to a pharmacy carve-out) experienced slower growth in medical spending.
This analysis of health insurance claims data demonstrates rapid increase and sustained high utilization of telemedicine services during the COVID-19 pandemic.