Authors

Behavior-Based Diabetes Management: Impact on Care, Hospitalizations, and Costs

The Diabetes Care Rewards program offers a business case for health plans to promote engagement through use of contingent incentives, thus improving health outcomes and lowering costs.

Prevalence, Resource Utilization, and Economic Impact of Kidney Function and Proteinuria in Patients With Focal Segmental Glomerulosclerosis

Measuring Continuity of Care for Diabetes: Which Visits to Include?

This study examined how inclusion of different provider specialties affected Continuity of Care Index values, year-to-year stability, and association with emergency department visits.

Collaborative Care Implementation: Lessons Learned

The authors drafted a “Shared Values of Collaborative Care” document with fundamental principles to make better group decisions in implementing collaborative care.

Association Between Screening for Suspected COVID-19 Cases and Outcomes of Patients Revisiting the Emergency Department

Patients who revisit the emergency department shortly after discharge are at high risk for complications and death, exacerbated by COVID-19 screening workload. Detection efforts impact outcomes.

Managed Care COVID-19 Outcomes in a Population Health Program

Data from 38,193 patients showed that managed care patients have COVID-19 risk factors similar to those of the general population and that a population health program decreased mortality.

Venetoclax Combo Achieves Mixed Results in Relapsed/Refractory Multiple Myeloma

Venetoclax plus bortezomib and dexamethasone improved PFS in relapsed/refractory multiple myeloma, especially in patients with BCL2high disease.

Cardiovascular Outcomes, Safety, and Tolerability With Oral Semaglutide: Insights for Managed Care

Transition-to-Dialysis Planning, Health Care Use, and Mortality in End-Stage Renal Disease

A planned transition to dialysis was associated with improved outcomes and lower mortality. These findings may inform care coordination policies for end-stage renal disease.

Health Outcomes of Socially Vulnerable Populations in Different Medicare Payment Arrangements

Beneficiaries in socially vulnerable communities received higher-quality, more-efficient care under value-based care (at-risk Medicare Advantage) compared with those in fee-for-service Medicare payment arrangements.

Contributor: Opportunities for Provider Engagement, Intervention, and Coordination Highlighted in CVS Health Study

As providers strive to deliver seamless, collaborative, and deeply engaging care, advances focused on treating the whole health of a person, wherever they are in their care journey, will be necessary as the health care system continues to evolve to meet the needs of patients and providers alike.

Insurer Costs of COVID-19 by Disease Severity and Duration

Payer costs for COVID-19 ranged from a mean of $505 for asymptomatic cases to $126,094 for severe cases with post–COVID-19 condition.

Cash and Commercial Negotiated Prices of Physician-Administered Drugs in US Hospitals

Using nationally representative data, the authors found that for common physician-administered drugs, hospitals’ unilaterally set cash prices are frequently lower than their median—and sometimes even their lowest—commercial negotiated prices.

Inpatient-Outpatient Shared Electronic Health Records: Telemedicine and Laboratory Follow-up After Hospital Discharge

Using a seamlessly shared inpatient-outpatient electronic health record was associated with greater rates of postdischarge follow-up delivered through telemedicine or laboratory monitoring and without an in-person office visit.

Continuously Updated Forecasting of SARS-CoV-2 in a Regional Health System

This study presents a methodology for forecasting demand of COVID-19 on health resources in an integrated health system.

Risk Factors for Financial Toxicity in Health Care

Risk factors for financial toxicity in a nationally representative survey included involuntary unemployment, transient loss of health insurance, and high-deductible health plans.

Linking Insured Adults to Behavioral Health Care: A Cost-Saving Solution

Connecting primary care providers and commercially insured adults to outpatient behavioral health services via a digital platform improved health outcomes and reduced medical costs.

Contemporary Care Patterns in the Management of Small Renal Masses

An investigation of management patterns after initial radiographic diagnosis of small renal masses showed that early urologist referral was associated with guideline-concordant care.

Medicare APMs at a Crossroads

To be sustainable and successful, Medicare alternative payment models (APMs) have to attract and retain high and low performers. That requires a different approach to pricing and evaluation.

Screening for Cancer: The Economic, Medical, and Psychosocial Issues

The Spectrum of Progressive Fibrosing Interstitial Lung Disease: Clinical and Managed Care Considerations

Oncology Experts Spotlight Breakthrough Therapies, AI-Driven Care at PCOC 2025

Oncology experts at PCOC 2025 discuss breakthrough therapies, AI-driven care, and evolving care delivery models shaping the future of oncology.

Patient-Centered Communication and Outcomes in Heart Failure

Among community patients living with heart failure, excellent and good patient-centered communication was associated with a reduced risk of death.

Association of Medicare Enrollment With Increased Inpatient Coding Intensity

Inpatient encounters for Medicare patients 65 years and older are associated with higher coding intensity compared with commercially insured, Medicaid, or self-pay hospitalizations for those same individuals prior to age 65 years.

Primary Care Redesign and Care Fragmentation Among Medicare Beneficiaries

This article examines the association between a large-scale primary care redesign—the Comprehensive Primary Care Plus Initiative—and ambulatory care patterns of Medicare beneficiaries with highly fragmented care.

Trends in Glucagon-Like Peptide 1 Receptor Agonist Prescribing Patterns

Glucagon-like peptide 1 receptor agonists, including semaglutide, have increased in use and will continue to increase due to their effectiveness in weight loss.

Setting the Course for Comprehensive Care Navigation in Oncology

Patient Perceptions of In-home Urgent Care via Mobile Integrated Health

Comparing patients’ experiences with in-home urgent care from community paramedics vs urgent care provided in emergency departments, we found higher satisfaction among patients receiving in-home treatment.

Endoscopist-Directed Sedation Rarely Fails: Implications for the Value of Anesthesia Assistance for Routine GI Endoscopy

Failed sedation for routine gastrointestinal (GI) endoscopy is extremely rare, warranting a return to endoscopist-directed sedation, rather than costly anesthesia-assisted sedation, as the default sedation standard.

US Cost-effectiveness and Budget Impact of Point-of-Care NAAT for Streptococcus

This study evaluates the cost-effectiveness and budget impact to US payers of point-of-care nucleic acid amplification tests (NAAT) for group A streptococcus.