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Risk Adjusting for Medicaid Participation in Medicare Advantage

When comparing risk-adjustment approaches based on Medicaid status of Medicare beneficiaries, this analysis found that predicted spending levels varied depending on states’ Medicaid eligibility criteria.

Assessment of Variation in Ambulatory Cardiac Monitoring Among Commercially Insured Patients

Ambulatory cardiac monitors’ clinical and economic outcomes vary; one long-term continuous monitor brand showed greater arrhythmia diagnosis, fewer retests and cardiovascular events, and lower health care resource use and costs.

Prednisone Superior to Other Corticosteroids for Patients With COPD, Heart Failure

Research presented at CHEST 2024 examined the effect of steroid choice on individuals who have a dual diagnosis of heart failure and chronic obstructive pulmonary disease (COPD).

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.

Hospital Participation in Medicare ACOs: No Change in Admission Practices and Spending

Hospital accountable care organization (ACO) participation did not impact emergency department admission rates, length of stay, or costs, suggesting limited effectiveness in reducing spending for unplanned admissions and challenging hospital-led ACO cost-saving strategies.

How Do Primary Community Hospitals Enact Early Response to COVID-19? The Experience From Chengdu, China

Our hospital is a primary hospital in Chengdu, China. Since February 5, our hospital has been listed as the primary designated medical unit for treating new patients with coronavirus disease 2019 (COVID-19) in Jinniu District. In this letter, we share our COVID-19 experience with readers.

Development and Validation of the COVID-19 Hospitalized Patient Deterioration Index

The authors developed and validated an accurate, well-calibrated, easy-to-implement COVID-19 hospitalized patient deterioration index to identify patients at high or low risk of clinical deterioration.

The Role of Race, Ethnicity, and Language in Care Transitions

Diverse patients experience disparities in care transitions. A survey of 224 patients showed differences by race, ethnicity, and language in technology access and in patient worries post discharge.

Experience Incentivizing Reduction of Racial and Ethnic Disparities in a Medicaid Hospital Quality Incentive Program

Construction of a composite measure, use of a summary disparity statistic, and measure selection are key considerations in the design of equity-focused payment programs.

Cost-Benefit Analysis of Sacubitril/Valsartan in a Medicaid Population

The cost avoidance of heart failure–related hospitalizations and emergency department visits may outweigh the additional drug cost in Medicaid members adherent to sacubitril/valsartan.

Care Coordination in Primary Care: Mapping the Territory

A survey completed by 100% of leaders of diverse care systems in Minnesota participating in an observational study showed little difference in approach to care coordination.

A Health Economic Evaluation of Digital Digestive Care Management

Chronic gastrointestinal disorders are common and costly for employers. Use of a digital digestive care program was associated with reduced health care spending.

Social Determinants of Health and Emergency Department Utilization in Alabama Children’s Health Insurance Program

Community social determinants of health such as rurality and low socioeconomic status moderate the association between an individual’s race and emergency care use.

A Systematic Literature Search and Narrative Synthesis of Economic Drivers in Hospitalizations for Heart Failure With Preserved or Mildly Reduced Ejection Fraction in the United States

Provider and Patient Insights Into the Cancer Care Journey

A survey was conducted to determine opportunities to aid primary care providers and patients in the difficult journey of an oncology patient.

Diabetes Associated With Higher Health Care Utilization and Poor Outcomes After COPD-Related Hospitalizations

Patients with diabetes and chronic obstructive pulmonary disease (COPD) have worse outcomes when hospitalized and appear to be more vulnerable to respiratory and nonrespiratory complications after a COPD exacerbation, which highlights the need for targeted interventions in this population.

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.

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.

ACE Inhibitor or ARB Treatment Among Patients With Diabetes and Chronic Kidney Disease

Impact of Functional Recovery on Patients Having Heart Surgery

This article describes the positive impact that actively managing functional recovery has on postacute placement for patients undergoing coronary artery bypass surgery.

Industry-Informed Perspectives on the Benefits of Rideshare-Based Medical Transportation

Previous research on rideshare-based nonemergency medical transportation has limited generalizability due to the specific model studied, and the lack of trip-level data raises concerns of ecological fallacy.

Transitional Care Management Visits to Improve Coordination of Care

Inspira Care Connect, LLC, an accountable care organization, incorporated transitional care management services into its postdischarge follow-up process to prevent avoidable utilization of health care services and costs.

Perspectives on Nonmedical Switching and the COVID-19 Pandemic: A Narrative Review

This review describes the impact of nonmedical switching of biologic therapies on US patients and providers, with a focus on switching to in-class alternatives.

Participating Faculty: Perspectives in Bronchiectasis Management

Trends in Sepsis and Pneumonia During COVID-19: Lessons From BPCIA

The authors analyzed cost and utilization changes for sepsis and pneumonia non–COVID-19 episodes prior to and during the pandemic, and during the pandemic for patients with and without COVID-19.

Improving Risk Stratification Using AI and Social Determinants of Health

Prediction models combining claims data with social determinants of health and additional, more-timely data sources using artificial intelligence (AI) can better identify individuals with the highest future medical spending.

Impact of Functional Recovery on Patients Having Heart Surgery

This article describes the positive impact that actively managing functional recovery has on postacute placement for patients undergoing coronary artery bypass surgery.

Contributor: Internal Communication and How It Affects Engagement

Utilization Management and Physician Burnout

This survey assesses physician experiences with utilization management and burnout and investigates whether there is a link between them.

Bundled Payments Lead to Quality Improvements in Hospitals’ Skilled Nursing Facility Referral Networks

The Bundled Payments for Care Improvement program was associated with improved quality of skilled nursing facilities in hospital referral networks for patients undergoing surgery for joint replacement.