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Initial Maintenance Therapy Adherence Among Older Adults With Asthma-COPD OverlapOlder adults with coexisting asthma and chronic obstructive pulmonary disease (COPD), known as asthma-COPD overlap, who take fixed-dose combinations of inhaled corticosteroids and long-acting β agonists may be less likely to have persistent low adherence to initial maintenance therapy.
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Contributor: Destigmatizing Ketamine for Legitimate Pain UseKetamine has been safely used as an anesthetic in the hospital environment for years, but with the proper training, it can also be administered by a medical professional in a clinical setting to provide pain relief.
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Health Care Resource Utilization, Quality Metrics, and Costs of Bladder Cancer Within the Oncology Care ModelSpending on novel therapies in high-risk bladder cancer had minimal impact on Oncology Care Model payments to practices, according to this cohort study and an average performance estimation.
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Value-Based Care Through Postacute Home Health Under CMS PACT RegulationsAmong a patient population defined by CMS postacute care transfer regulations, home health vs no postacute care was associated with reduced 30-day readmissions and costs.
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Contributor: How Patients and Caregivers Can Be a Catalyst for Rare Disease InnovationPatient input and experiences play a crucial role in advancing rare disease research and therapy development, as they help define the disease, inform clinical trial design, and influence regulators and payers' decisions, ultimately serving as catalysts for innovation in the field.
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Contingency Management in a Perinatal Substance Exposure ClinicProject CARA, a perinatal substance exposure clinic, has implemented a contingency management program that targets appointment attendance for patients with any use disorder, regardless of substance or urine drug screen results.
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Intensive Care Management of a Complex Medicaid Population: A Randomized EvaluationThe authors present findings of a randomized evaluation of Medicaid patients at an academic medical center, which found that intensive care management was associated with reduced total medical expense.
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Changes in Electronic Notification Volume and Primary Care Provider BurnoutPrimary care provider burnout was analyzed before and after a national initiative to optimize the electronic health record inbox notification system at the Veterans Health Administration.
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Managed Care COVID-19 Outcomes in a Population Health ProgramData 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.
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US Cost-effectiveness and Budget Impact of Point-of-Care NAAT for StreptococcusThis study evaluates the cost-effectiveness and budget impact to US payers of point-of-care nucleic acid amplification tests (NAAT) for group A streptococcus.
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Two-Step Testing Helps Predict and Treat Recurrent C difficile InfectionThis study explores the effectiveness of toxin testing in predicting Clostridioides difficile infection (CDI) outcomes, revealing that patients with negative toxin results were less likely to experience CDI recurrence within 30 days.
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mCRC Treatment Access: IRA Cost Cap Impact and Final InsightsMedical experts discuss how the Inflation Reduction Act’s out-of-pocket prescription drug cost cap, effective in 2025, may impact access to oral chemotherapy options for metastatic colorectal cancer.
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Care Transitions for Young Adults With Special Health Care NeedsA Medicaid managed care plan developed a pilot program to assist special needs youth with transition to adult care. Case studies and discussion present findings.
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Predicting Hospital Readmission in Medicaid Patients With Diabetes Using Administrative and Claims DataA statistical model based entirely on claims data can accurately predict 30-day hospital readmission in Medicaid patients with diabetes.
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Collaboration to Transition Members to Preferred Formulary Dipeptidyl-Peptidase-4 InhibitorA collaboration between a drug plan and clinical pharmacists led to nearly 50% of members successfully switching to a preferred dipeptidyl-peptidase-4 inhibitor.
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Lessons Learned From 15-Plus Years of Clinical Quality ImprovementThe author shares observations on several common factors across various clinical settings that can determine success or failure in quality improvement.
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COVID-19 and MCO-Community Partnerships to Address Enrollee Social NeedsCOVID-19 strained already-burdened community partners, affecting service delivery, communication, and partnerships. Managed care organization (MCO) partnerships with these organizations evolved in response to changing needs and resources.
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Intensive Care Management of a Complex Medicaid Population: A Randomized EvaluationThe authors present findings of a randomized evaluation of Medicaid patients at an academic medical center, which found that intensive care management was associated with reduced total medical expense.
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Association of 340B Contract Pharmacy Growth With County-Level CharacteristicsThe growth of 340B contract pharmacies since 2010 is unprecedented. This study’s findings suggest that patterns of growth differ between safety-net clinics and hospitals.
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Treatment Modification After Initiating Second-Line Medication for Type 2 DiabetesAmong adults with type 2 diabetes who started noninsulin second-line therapy, most modified treatment within 1 year. Discontinuation was by far the most common modification.
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Identifying Complex Patients Using Adjusted Clinical Groups Risk Stratification ToolIn this study, the authors developed a method for use in primary care to identify a group of patients with complex care needs using Aggregated Diagnosis Groups.
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Association of 340B Contract Pharmacy Growth With County-Level CharacteristicsThe growth of 340B contract pharmacies since 2010 is unprecedented. This study’s findings suggest that patterns of growth differ between safety-net clinics and hospitals.
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Impact of Payment Models on Medical Specialist Physician Practice PatternsThis article explores the impact of payment models (fee for service vs salary based) on practice patterns, including wait times and care for patients with chronic diseases.
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Integrating Primary Care and Public Health for Advance Care PlanningThis article proposes a new model, Public-Primary ACP, that leverages coordination between primary care and public health workforces to improve delivery of advance care planning.
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People Experiencing Homelessness in Miami: Insurance Enrollment Rates, Hypertension TrendsPeople experiencing homelessness face significant barriers to health care access, leading to higher rates of hypertension even among those with health insurance.
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Reimbursement for Genetic Variant Reinterpretation: Five Questions Payers Should AskPeriodic reinterpretation of genetic sequencing results presents a challenge for developing transparent and systematic coverage and reimbursement policies.
