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Growth of Dual-Eligible Special Needs Plans Following Permanent Authorization

The 2018 permanent authorization of dual-eligible special needs plans marked a significant long-term commitment by policy makers and coincided with substantial growth in plan offerings and enrollment.

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

The Effect of Medicaid Reimbursement for Psychiatrists on the Health Care Burden of Serious Mental Illness

This analysis compared health care resource utilization and costs for Medicaid patients with serious mental illness between US states with low vs high reimbursement rates for psychiatric services.

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.

Contributor: Prioritizing Patient-Centered Value Over International Reference Pricing in US Drug Policy

The authors argue that sustainable drug pricing reform should focus on patient-centered value, not price alone.

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.

Reimbursement for Genetic Variant Reinterpretation: Five Questions Payers Should Ask

Periodic reinterpretation of genetic sequencing results presents a challenge for developing transparent and systematic coverage and reimbursement policies.

Contributor: The Connection Between Gout and CVD Requires Cross-Specialty Collaboration

The Panicos are on a mission to change how we think about gout. Why? As a husband-and-wife DO duo, the Panicos each have a unique perspective on gout and how physicians in their respective fields can better collaborate to help patients who live with this systemic disease.

The Timing and Characteristics of Supplemental Indications for Medicines

Roughly one-fifth of supplemental indications were approved many years after a drug’s initial launch, many of which target populations with high unmet medical needs.

Telehealth User Experiences During COVID-19: A Case Study of Outpatient Cardiovascular Clinics Affiliated With a Large Academic Practice

In cardiovascular clinics during COVID-19, notable barriers to successful telehealth use included obtaining diagnostic information needed to deliver high-quality care and technology-related challenges for patients.

Orca-T Gains FDA Approval for Matched Donor Stem Cell Transplants

FDA approves Orca-T precision Treg cell therapy for matched donor transplants, cutting chronic GVHD risk and boosting survival in blood cancers.

Oral JAK1 Inhibitor Povorcitinib Shows Durable 54-Week Efficacy, Favorable Safety in HS: Martina Porter, MD

Martina Porter, MD, discusses long-term results from the phase 3 STOP-HS program evaluating povorcitinib in patients with hidradenitis suppurativa.

Education and Referral Program for Inpatient Engagement in Dental Care

Many hospitalized adults could benefit from linkage to dental care. This article describes a planned study to refer inpatients to community dental providers.

Proactive Care Management of AI-Identified At-Risk Patients Decreases Preventable Admissions

Proactive care management for artificial intelligence (AI)–identified at-risk patients reduced potentially preventable hospital admissions.

Musculoskeletal Quality Collaborative Improves Value-Based Health Care Delivery Across Hospital System

Implementation of surgeon-led Musculoskeletal Quality Collaborative protocols reduced high-cost consumable utilization without compromising patient safety. Systemwide collaboratives can reduce high-cost consumable utilization while maintaining low infection rates.

To Report or Not Report Health Care Data Breaches

This study presents information regarding the decisions that health care privacy officers make about reporting a data breach, including factors that can affect the decision process, such as personal/organizational knowledge, prior breach status, and framed scenarios.

Pharmacist Hypertension Management Using an Electronic Health Record–Based Approach

The authors studied the impact of a pharmacist intervention on blood pressure control compared with usual care.

Rising Use of Surveillance Colonoscopy and Potential Impacts

The proportion of colonoscopies performed for postpolypectomy surveillance has increased significantly, particularly among older patients with limited life expectancy, raising concern for possible overuse.

Association of the MedWise Risk Score With Health Care Outcomes

Tracking the Performance, Challenges, and Evolution of Value-Based Contracts: Neha Kashalikar, PharmD

Neha Kashalikar, PharmD, director of strategic pharmacy consulting at MassHealth, breaks down the outcome measures often used in pharmacy and medical claims to evaluate the performance of value-based contracts.

Challenges of Fracture Risk Assessment in Asian and Black Women

Differences in bone density and FRAX fracture risk scores among Black and Asian women yield greater discordance in fracture risk estimation compared with White women.

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.

“Expanding Access Isn’t Just About Fairness—It’s About Building Better Treatments for Everyone”

Regina Barragan-Carrillo, MD, a postdoctoral fellow at City of Hope Comprehensive Cancer Center, discussed findings that show 76% of renal cell carcinoma trials take place in wealthy countries, amid news that clinical trial access for the world's poor may become even more challenging.

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.