Authors

Rethinking Prior Authorization: Bridging Clinical Needs and Administrative Burdens

This article highlights challenges in prior authorization and offers practical, experience-based strategies to streamline workflows, reduce delays, and improve patient access to necessary treatments.

Impact of Expanded Carrier Screening on Health Care Utilization

This study shows little evidence of harms or increased health care utilization for people receiving negative (normal) results of expanded carrier screening through genome sequencing.

AI in Health Care: Closing the Revenue Cycle Gap

This commentary explores the current state, challenges, and potential of artificial intelligence (AI) in health care revenue cycle management, emphasizing collaboration, data standardization, and targeted implementation to enhance adoption.

Potentially Inappropriate Medication Use Following Hospital Discharge Among Medicare Beneficiaries

Despite financial incentives for Medicare Advantage (MA) plans to reduce potentially inappropriate medication use post hospitalization, this study found that MA does not provide a clear advantage over traditional Medicare.

5 FAQs: Ebola Outbreaks and the Challenge of Public Trust

Distrust, misinformation, and conflict complicate Ebola response efforts in the DRC, highlighting broader challenges to public health trust.

Differences in Spending for Diabetes and Multiple Chronic Conditions in Michigan Medicare Beneficiaries

Diabetes and multiple chronic conditions increase overall Medicare spending, but spending increases even more in minority beneficiaries compared with White beneficiaries with similar comorbidity combinations.

Oncology Patients in Clinical Trials: A Health Care Cost Analysis

Patients with colorectal or ovarian cancer enrolled in a clinical trial have lower pharmacy and medical costs during the 9 months after trial initiation.

Closing the Gaps in Ocular Emergency Care: James D. Auran, MD

Access to emergency eye care remains a public health challenge, with gaps that affect patients and communities across the country.

Participating Faculty: A Review of the Current Management and Burden of Prurigo Nodularis in the United States

Timely Preterm-Birth Prediction Among Pregnant Women in Medicaid Without Preterm-Birth History

A novel prediction model is developed that accurately predicts preterm birth in a timely manner among pregnant women in Medicaid without preterm-birth history.

Addressing Cancer Health Disparities in a Multilateral Collaboration in an Independent Community Cancer Clinic: Translating Words Into Action

No One Left Behind, a program to provide financial assistance and access to cancer care at Carolina Blood and Cancer Care Associates in South Carolina, will be discussed during a session of the Community Oncology Alliance 2022 Community Oncology Conference.

Should I Stay, or Should I Go? Provider Considerations for Leaving Medicaid Managed Care Organizations

This qualitative study examines the factors that provider organizations consider when contracting with managed care organizations under North Carolina’s Section 1115 demonstration waiver.

Glomerular Filtration Rate Change and Outcomes in Type 2 Diabetes

The Role of Specialty Pharmacies in Improving Prescription Drug Access and Affordability for Consumers

Telemedicine Catches On: Changes in the Utilization of Telemedicine Services During the COVID-19 Pandemic

This analysis of health insurance claims data demonstrates rapid increase and sustained high utilization of telemedicine services during the COVID-19 pandemic.

Preoperative Acute Care Spending Predicts Costs in Bundled Payment Programs

Preoperative acute care costs significantly predicted postoperative costs in Bundled Payments for Care Improvement model year 3 surgeries, suggesting that accounting for preoperative factors may improve bundled payment outcomes.

The Kidney Community Advances Innovative Solutions and Improves Patient Care—Even During a National Pandemic Crisis

Authors from the American Society of Nephrology and Kidney Care Partners discuss the response of the kidney care community to the COVID-19 pandemic.

The Impact of HDHPs on Service Use and Spending for Substance Use Disorders

Offering a high-deductible health plan (HDHP) led to a 6.6% reduction in the probability of using substance use disorder services and a shift in spending from the plan to the enrollee.

Linking Data to Determine Risk for 30-Day Readmissions in Dementia

This study found that certain characteristics in linked electronic health record data across episodes of care can help identify patients with Alzheimer disease and related dementias at high risk of 30-day readmissions.

Insights Into Patient Portal Engagement Leveraging Observational Electronic Health Data

This analysis of more than 250,000 adults at least 50 years old with chronic conditions showed lower portal use among older, non–English-speaking, and Black patients, underscoring digital health equity gaps.

Relationship Between Medication Adherence and Other Medicare Star Rating Measures

Performance on Medicare Star Ratings medication adherence measures is significantly tied to performance on the intermediate outcome and statin process measures.

Bleeds and Resource Use in Hemophilia B: Retrospective Observational Study

This real-world US study describes individuals with hemophilia B who experience bleeds despite factor replacement therapy and quantifies the associated comorbidity and health care resource utilization burden.

Setting the Course for Comprehensive Care Navigation in Oncology

Almost No Public Awareness of Lp(a), Elevated CVD Risk in the US: Katherine Wilemon

Katherine Wilemon, Family Heart Foundation, described the biggest unmet need when it comes to public awareness of Lp(a) and its associated risk factors.

What Matters to Me: An Equity Lens on Patient Experience

This commentary explores what matters to patients and their experience through an equity lens, with action points and recommendations given the current health care environment.

A Standardized Care Pathway Increases Optimal Dialysis Starts

The authors observed a significant increase in optimal starts for dialysis and in peritoneal dialysis rates after implementing a standardized end-stage renal disease transition pathway.

Veterans Health Administration Benefit Value Has Little Effect on Reliance

Relying on veteran survey responses and novel actuarial data, the authors examine the relationship between benefit value and reliance on the Veterans Health Administration.

Economic Burden of Osteoporotic Fractures: The Tip of the Iceberg?

The economic burden of osteoporotic fractures may be much higher than estimated: just the tip of the iceberg. In this letter, we suggest that the cost of these fractures might be underestimated by considering only direct medical cost.

Effect of Home Care After Cardiac Surgery

A multidisciplinary approach and symptom management are both vital components of home care to provide continuity of care after cardiac surgery because they decrease symptoms and readmissions to the hospital and increase self-efficacy.

Differences in Savings and Quality by Type of ACO Model

2016-2018 Next Generation Accountable Care Organization (ACO) and Medicare Shared Savings Program cost and quality data show similar performance, suggesting that increasing financial risk to health systems may not affect performance.