Analysis of 2012-2021 commercial claims demonstrates that spending growth was concentrated among the highest spenders and there was increasing subsidy across enrollees through cost-sharing design.
The US health system has undergone notable transformations over the last 2 decades. Independent community hospitals haveconsolidated horizontally with others to form hospital healthcare systems, with many of the larger ones covering wide-ranging geographies, generating billions of dollars in operating revenues.
The authors find that 340B-covered hospitals and grantees are contracting mainly with pharmacies in significantly more affluent neighborhoods than their own.
The prevalence and predictors of hypoglycemia in South Korean patients with type 2 diabetes were evaluated using a nationwide healthcare database.
We found that, in 2008, variations across Texas in total spending and inpatient utilization are similar in Blue Cross Blue Shield of Texas and Medicare.
The Wellth smartphone app significantly increased medication adherence and lowered unnecessary health care utilization and costs over 9 months among Medicaid beneficiaries who were self-managing chronic conditions.
In a pilot patient-centered medical home transformation including Lean quality improvement methodology with payment reform, patient experience was sustained or improved across key domains.
From the Adult Diabetes and Clinical Research sections, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts.
In order to encourage dissemination, this commentary is freely available in PLoS Medicine, and will also be published in Medical Decision Making, Croatian Medical Journal, The Cochrane Library, Trials, and Journal of Clinical Epidemiology.
Enrollment, claims, and spatial data are used to demonstrate the importance of outreach strategies for families in rural areas who have children with diabetes. Spatial barriers, alone, do not fully elucidate racial/ethnic disparities in pediatric diabetes for street-level location. (For Tables and the Figure, please access the PDF on the last page.)
Medicare beneficiaries with diabetes who are at the lowest levels of healthcare consumption often become some of the highest level consumers in subsequent years.
We surveyed biopharmaceutical manufacturers and payers to understand the prevalence and characteristics of value-based payment arrangements, as well as their implementation obstacles and success factors.
A review of evidence about what works in 3 areas of value-based purchasing emphasized under healthcare reform: service delivery integration, payment, and value-based insurance design.
This study assesses the cost-effectiveness of adding a sodium-glucose cotransporter 2 inhibitor versus switching to a glucagon-like peptide-1 receptor agonist in patients with diabetes on metformin and a dipeptidyl peptidase-4 inhibitor.
This qualitative study examines the methods that Medicare Advantage plans use to control or reduce postacute spending and their associated unintended consequences.
Among older adults who have a spine condition, access to chiropractic care may reduce medical spending on diagnostic services.
The authors discuss multiple challenges to the production of policy-relevant results from evaluation of Medicare accountable care organizations (ACOs).
Automated telephone reminders resulted in a small but significant increase in adherence to inhaled corticosteroids among adult asthma patients in a large managed care organization.
Benefits of a patient-centered multimorbidity care management program occurred early, and were evident only among patients with depression and unfavorable medical control of diabetes and heart disease.
This 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.
Premiums in federally facilitated Affordable Care Act Health Insurance Marketplaces are higher in geographic areas with more concentrated hospitals and physician practices and fewer insurers.