Authors

More Employers Offer Preventive Drug Lists Over Time

More large employers with high-deductible health plans with health savings accounts offer preventive drug list benefits over time.

Health Care Resource Utilization, Quality Metrics, and Costs of Bladder Cancer Within the Oncology Care Model

Spending 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.

Value-Based Care Through Postacute Home Health Under CMS PACT Regulations

Among 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.

Contributor: How Patients and Caregivers Can Be a Catalyst for Rare Disease Innovation

Patient 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.

Tangle of Tech: How Community Oncology Practices Can Successfully Navigate the Health Technology Landscape

Intensive Care Management of a Complex Medicaid Population: A Randomized Evaluation

The 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.

Changes in Electronic Notification Volume and Primary Care Provider Burnout

Primary 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.

Participating Faculty: Perspectives in Bronchiectasis Management

Avoiding Surgical Resection of Recurrent BRAF V600E–Mutated Iodine-Refractory Papillary Thyroid Cancer Involving Trachea/Thyroid Cartilage via Resensitization With Dabrafenib and Trametinib: Report of 3 Cases

Laundromats as a New Frontier in Community Health, Medicaid Outreach

Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.

Managed Care COVID-19 Outcomes in a Population Health Program

Data 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.

US Cost-effectiveness and Budget Impact of Point-of-Care NAAT for Streptococcus

This study evaluates the cost-effectiveness and budget impact to US payers of point-of-care nucleic acid amplification tests (NAAT) for group A streptococcus.

Two-Step Testing Helps Predict and Treat Recurrent C difficile Infection

This 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.

Care Transitions for Young Adults With Special Health Care Needs

A Medicaid managed care plan developed a pilot program to assist special needs youth with transition to adult care. Case studies and discussion present findings.

Predicting Hospital Readmission in Medicaid Patients With Diabetes Using Administrative and Claims Data

A statistical model based entirely on claims data can accurately predict 30-day hospital readmission in Medicaid patients with diabetes.

Collaboration to Transition Members to Preferred Formulary Dipeptidyl-Peptidase-4 Inhibitor

A collaboration between a drug plan and clinical pharmacists led to nearly 50% of members successfully switching to a preferred dipeptidyl-peptidase-4 inhibitor.

Lessons Learned From 15-Plus Years of Clinical Quality Improvement

The author shares observations on several common factors across various clinical settings that can determine success or failure in quality improvement.

COVID-19 and MCO-Community Partnerships to Address Enrollee Social Needs

COVID-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.

Intensive Care Management of a Complex Medicaid Population: A Randomized Evaluation

The 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.

Association of 340B Contract Pharmacy Growth With County-Level Characteristics

The 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.

Treatment Modification After Initiating Second-Line Medication for Type 2 Diabetes

Among 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.

Identifying Complex Patients Using Adjusted Clinical Groups Risk Stratification Tool

In 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.

Real-World Insights on Biomarker Testing Patterns and Implications for mNSCLC Therapy Selection

Impact of Medicaid Institution for Mental Diseases Exclusion on Serious Mental Illness Outcomes

Medicaid’s Institution for Mental Diseases (IMD) rule bars federal funding for psychiatric facilities with more than 16 beds, but findings indicate that state waivers allowing treatment of serious mental illness in IMDs do not increase overall psychiatric hospitalizations.

Association of 340B Contract Pharmacy Growth With County-Level Characteristics

The 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.

Impact of Payment Models on Medical Specialist Physician Practice Patterns

This 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.

Phase 3 Study to Evaluate Remibrutinib in Generalized Myasthenia Gravis

Remibrutinib shows promise in treating generalized myasthenia gravis, with ongoing trials assessing its efficacy and safety for patients.

Use of Voluntary Alignment in the Next Generation ACO Model

Use of voluntary alignment attribution by Next Generation Accountable Care Organization (ACO) participants was limited. The authors highlight the reasons and describe organizational use cases via a mixed-methods approach.

Integrating Primary Care and Public Health for Advance Care Planning

This 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.

Prevalence and Inclusiveness of Pay-for-Performance Incentives for HPV Vaccination

This article examines the prevalence of pay-for-performance incentives to promote human papillomavirus vaccination and other quality metrics as reported by frontline clinical staff.