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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.

High-Risk Care Management Impact on Medicaid ACO Utilization and Spending

In Massachusetts’ largest Medicaid accountable care organization (ACO), high-risk care management significantly reduced spending, emergency department visits, and hospitalizations, demonstrating that targeted strategies can manage health care costs amid budget constraints.

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.

Projected US Savings From Biosimilars, 2021-2025

Projected savings from biosimilars from 2021 to 2025 were $38.4 billion vs conditions as of quarter 4 of 2020 and were driven by new biosimilar entry. Savings were $124.5 billion under an upper-bound scenario.

Workforce Innovation Reduces Medicaid Costs in Chronic Care

This study of community health workers as clinical extenders demonstrates significant cost savings in managing chronic conditions among Medicaid beneficiaries.

Insurance-Related Differences in Chronic Conditions Data Warehouse Comorbidities of Medicare Beneficiaries

Chronic Conditions Data Warehouse comorbidity data vary by insurance status. Analyses using these data that fail to account for insurance status are subject to information bias.

Are Work Relative Value Units Correlated With Operative Duration of Common Surgical Procedures?

Work relative value units (wRVUs) correlate with operative duration of common surgical procedures. Reimbursement for physicians depending on wRVUs is fair for commonly performed surgeries.

Utilization Management and Physician Burnout

This survey assesses physician experiences with utilization management and burnout and investigates whether there is a link between them.

A Novel Approach to Attribute Responsible Physicians Using Inpatient Claims

The authors propose a novel approach in which physicians’ responsibility for inpatient stays is expressed through physician-specific attribution ratios informed by patient characteristics.

A “Sludge Audit” for Health System Colorectal Cancer Screening Services

A systematic, mixed methods “sludge audit” identified novel health system delivery targets for improving colorectal cancer screening services.

Mental Health Diagnoses and Services Utilization Vary by Wage Level

Insured lower-wage employees had lower prevalence of mental health conditions but greater severity, with more hospital admissions and emergency department visits than high-wage employees.

Maternal COVID-19 Vaccination, Infection Boosts Infant Antibody Response

Natural infection plus COVID-19 vaccination in pregnant mothers conferred more durable antibody responses in infants than natural infection alone.

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.

Charitable Medication Distribution Improves Care for Uninsured Patients With Diabetes

This report illustrates how providing vital diabetes medications to uninsured patients through a charitable medication distributor improves clinical outcomes.

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.

ACE Inhibitor or ARB Treatment Among Patients With Diabetes and Chronic Kidney Disease

Treatment Approaches for Neovascular Age-Related Macular Degeneration and Diabetic Macular Edema

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.

Sex Differences in Medicare Beneficiaries’ Experiences by Low-Income Status

Only low-income male Medicare beneficiaries had worse patient experience than their female counterparts. The authors discuss opportunities to improve experiences for all patients.

Cost-effectiveness of Total State Coverage for Hepatitis C Medications

Expanded coverage under a Medicare-Medicaid partnership to treat all prevalent cases of hepatitis C appears to be cost-effective by saving money and improving patient outcomes.

Implementing Team-Based Telemedicine Workflows in Safety-Net Primary Care

Telemedicine in safety-net primary care faces particular challenges. Consistent, team-based workflows can support video visit implementation and health care maintenance in telemedicine visits.

Financial Impact of Telehealth: Rural Chief Financial Officer Perspectives

Interviews with chief financial officers of rural hospitals revealed that they perceived telehealth to have some financial advantages; however, they did not believe that telehealth improved their hospitals’ financial situations.

Contributor: The Mental Health Crisis, How We Got Here, and Where We Go Next

Addressing the mental health crisis in the United States warrants innovation in treatment and recovery, and the development of mechanisms to provide and pay for them accordingly.

Population Health Guide to the Evolution of Endpoints in Multiple Sclerosis

Assessing Utilization of a Marketwide Price Transparency Tool

Consumers strategically used a price transparency tool by searching more often in procedure markets with provider-specific information, higher charges, and more out-of-network claims and provider competition.

Integrated Care for Chronic Conditions: A Randomized Care Management Trial

The authors sought to understand the differential impact of payer-led community-based care management approaches on stakeholder-oriented outcomes for publicly insured adults with multiple chronic conditions.

Medication Persistence and Its Impact on Type 2 Diabetes

Most newly treated patients with type 2 diabetes exhibit suboptimal medication persistence, which is associated with higher risk of hospitalization and increased medical costs.

Digital Health Implementation Among Older Adults: Health Technology Navigators’ Perspectives

Health technology navigators share perspectives on barriers to and facilitators of digital health access for older, linguistically diverse patients in a Los Angeles safety-net system.

Final Panelist Thoughts on the Management of Pulmonary Arterial Hypertension

Panelists discuss how the future of PAH treatment looks promising with potential for disease remission through reverse remodeling agents, emphasizing the need for continued research focus on patients with other forms of pulmonary hypertension and those with significant comorbidities.

Patient Satisfaction With Letter-Based Communication of LCS Pulmonary Nodule Results

Patients were satisfied with receiving their lung cancer screening (LCS) pulmonary nodule results via letter and considered the amount of information provided in the letter appropriate.