Authors
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Care Management Improves Total Cost of Care for Patients With DementiaCompared with usual care, a dementia care management program improved various cost of care and utilization metrics in a Medicare managed care population at 12 months.
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The Price Paradox of Biosimilar-Like Long-Acting InsulinFindings suggest that Basaglar was not less expensive for patients than Lantus. Empirical evaluation of biosimilar costs prior to automatic substitution is necessary.
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Impact of Expanded Carrier Screening on Health Care UtilizationThis study shows little evidence of harms or increased health care utilization for people receiving negative (normal) results of expanded carrier screening through genome sequencing.
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Preventive Care: Vaccines MatterA database of information about more than 30,000 patients verified improved morbidity and mortality due to vaccines and preventive health care in prospective trials.
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Contributor: A Fresh Approach to Medication Adherence—Best Practices for Improving Outcomes and Star RatingsBest practices can help MA plans improve their Star Ratings performance while allow for strategies for medication adherence to grow.
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COVID-19 and Clinic Workflow Optimization Using Lean Six SigmaThe authors report an approach of outpatient clinic workflow reorganization utilizing simple, inexpensive measures to improve patient engagement and experience in addition to providing a safe setting for patients for clinic visits in the wake of COVID-19.
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Primary Care Nurse Practitioner Management of Adolescent Behavioral HealthPersonnel costs ($90,514) of a primary care–embedded adolescent behavioral health nurse practitioner over 2 years were 63% of the potential revenue generated ($144,449).
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Impact of Medical Care Coordination Intervention on Patient ActivationThis observational evaluation compared an adult medical care coordination intervention with usual care and found that the intervention was associated with significant improvements in patient activation.
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Predictors of Discharge From the VA Caregiver Support ProgramThe year of application predicts discharge from the Department of Veterans Affairs (VA) caregiver program. Unexpected, disallowed criteria also predict discharge, with significant others facing higher discharge risk than spouses.
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Imposing a Health Insurance Surcharge on the UnvaccinatedImposing a surcharge on unvaccinated employees will require employers to think through legal and policy implications.
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Reducing “Avoidable” ED Visits for Mental Health Could Cut Billions in Costs, Improve Patient OutcomesThe changing landscape of health care during COVID-19 placed focus on increasing accessibility to mental health resources other than the emergency department (ED), with potential savings of over $4 billion in annual costs and improvements in patient outcomes.
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COVID-19 Telehealth Expansion Can Help Solve the Health Care Underutilization ChallengeThe telehealth policy changes enacted for short-term control of the coronavirus disease 2019 (COVID-19) pandemic present an opportunity to address the fundamental gap in health care underutilization.
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Contributor: Medicare Needs to Ensure People With ALS Have Access to Clinically Appropriate Respiratory CareThe pandemic has shown a spotlight on how critically important respiratory care is to Americans who struggle to breathe on their own. Yet, Medicare policy must be updated to ensure that access to lifesaving equipment will never be disrupted.
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Impact of Delayed Adoption of Novel Atrial Fibrillation TreatmentsUsing direct oral anticoagulants as a case study, the authors examined how delayed adoption of novel treatments could impact patient health outcomes and cost.
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Hospitals’ Strategies to Reduce Costs and Improve Quality: Survey of Hospital LeadersHospitals pursue a broad range of efforts to improve quality, with those participating in bundled payments attempting to reduce postacute care to a greater degree than nonparticipants.
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Predictors of Orphan Drug Coverage Restrictions in Medicare Part DThe majority of orphan drugs are subject to utilization controls in Medicare Part D plans. The use of utilization controls varies by certain drug characteristics.
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Provider Directory Inaccuracy and Timely Access for Mental Health CareSome of the nation’s strictest provider network regulations have led to neither high rates of provider directory accuracy nor timely access to mental health care.
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Patient Education, Provider Education, and Overall Final ThoughtsIn this discussion, panelists offer their final thoughts.
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Variation in Generic Dispensing Rates in Medicare Part DGeneric use has increased over time in Medicare Part D, but substantial variation across plans persists in a number of common classes.
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Medicaid ACOs and Managed Care: A Tale of 2 StatesThis article presents a detailed descriptive analysis of how Massachusetts and Minnesota implemented Medicaid accountable care organization (ACO) models for their managed care population.
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Cost of Home vs Clinic Administration of Paclitaxel in Metastatic Breast CancerHome administration of oral paclitaxel and encequidar is associated with potential cost savings for payers compared with clinic administration of intravenous chemotherapy in metastatic breast cancer patients.
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Cost-effectiveness of a 3-Year Tele-Messaging Intervention for Positive Airway Pressure UseLong-term tele-messaging was more effective than no messaging and short-term messaging for positive airway pressure use, and it was highly likely to be cost-effective with an acceptable willingness-to-pay threshold.
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Reimagining “Covered Lives” as Communities: Communitarian Ethics for ACOsEthical analysis of population health management calls for a communitarian vs individual approach, starting with reconceiving “covered lives” as “patient communities.”
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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.
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Experts Recount What Aspects of SECO Will Be Vital to Their Future PracticeAttendees and experts from the Southeastern Educational Congress of Optometry (SECO) 2025 meeting highlight research and sessions they will take away.
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Longer Appointment Duration Reduces Future Missed Appointments in Safety-Net ClinicsLonger appointment duration was associated with lower likelihood of missed appointments for patients receiving care at a federally qualified health center network.
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ACA Medicaid Expansion Association With Racial Disparity Reductions in Timely Cancer TreatmentMedicaid expansion was associated with a reduction in the racial disparity in timely treatment of patients with advanced cancer in the United States.
