Aligning health information technology with population health requires organizations to think differently about data needs, exchange partners, and how to leverage both for evidence-based action.
Using health insurance claims, we identified common first-, second-, and third-line chemotherapy regimens for patients with lung cancer and associated utilization and costs of care.
Diagnosis-related group coding determines eligibility for many Medicare bundled payment initiatives. This approach excluded many patients with chronic obstructive pulmonary disease likely to benefit while including others without the disease.
Incomplete records of patient history can bias hospital profiling. Completing health records for Medicare-covered patients in VA hospitals resulted in modest changes in hospital performance.
The success of recommendations to improve screening often rests on the availability of efficacious therapies, coverage policies, and other factors that enable and justify screening.
Patients can be shielded from the most onerous cost-sharing burdens for specialty drugs while keeping premiums affordable for the entire enrolled population.
In a national survey, US internists reported high levels of adoption of overtreatment guidelines; despite this fact, they also reported recommending services targeted by the overtreatment guidelines.
Use of granulocyte colony-stimulating factor plus plerixafor for stem cell mobilization is cost-effective in pretreated patients with non-Hodgkin lymphoma.
This article outlines strategies insurers can use to mitigate their risks related to prescription opioid abuse by members, while addressing this serious public health problem.
Pharmacists’ roles in transitions of care continue to evolve. Evaluation of pharmacist-led interventions as patients transition from emergency department to home is needed.
The authors compare methods of retrospectively attributing patients to provider systems by the fraction of patients attributed and the stability of attribution over time.
Most non–inborn errors of metabolism (non-IEM) medical foods (MFs) do not meet the regulatory MF definition and lack scientific evidence for safety and efficacy. Non-IEM MFs are not yet ready for reimbursement by public insurers.
A randomized trial of eConsults for cardiology referrals from primary care resulted in significant reductions in total cost of care compared with traditional face-to-face consultations.
This commentary was adapted from an appearance by the authors at Patient-Centered Diabetes Care, a conference jointly presented by The American Journal of Managed Care and Joslin Diabetes Center.
Many older veterans do not receive appropriate nephrology care before beginning dialysis. Dual use of Veterans Affairs and Medicare-covered services was associated with better patterns of care.
Online prescription management accounts may help promote medication adherence, as utilizing patients had a higher proportion of days covered than nonusers.
The overall incidence of hypoglycemia was considerable in this large working-age population and was associated with $52 million (2008 dollars) in direct medical costs.
Between 2005 and 2011, rates of cardiac catheterization laboratory false activation doubled while mean door-to-balloon times for primary PCI declined.
Use of rt-PA is associated with long-term cost savings, but more high-quality, current cost-effectiveness research is needed for stroke centers, care networks, and telemedicine.
A systematic review of presenteeism instruments found that most have been validated to some extent, but evidence for criterion validity is virtually absent.