Authors
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The Ingredients of Success in a Medicare Accountable Care OrganizationFor 2 successive years, the Hackensack Alliance Accountable Care Organization achieved cost savings and maintained quality by using physicians with patient-centered medical homes and nurse care coordinators focused on high-risk patients.
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False Activation of the Cardiac Catheterization Laboratory for Primary PCIBetween 2005 and 2011, rates of cardiac catheterization laboratory false activation doubled while mean door-to-balloon times for primary PCI declined.
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Medicare Beneficiaries’ Out-of-Pocket Costs for Commonly Used Generic Drugs, 2009-2017Out-of-pocket costs required by Medicare prescription drug plans for drugs available through Walmart’s generic drug discount program have decreased from 2009 to 2017.
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Factors of Hyperlipidemia Medication Adherence in a Nationwide Health PlanMedication adherence in hyperlipidemia remains poor on a nationally representative level. Predictors of medication adherence from a nationally representative commercial health plan are reported.
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Forward-Thinking Insurers Adopt Genomics, Medicare Makes Perilous, Costly Leap BackwardAuthors from My Gene Counsel discuss gaps in CMS reimbursement policy for genetic testing and counseling, in light of advances in guidelines from groups that include the National Comprehensive Cancer Network.
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Insurers’ Perspectives on MA Value-Based Insurance Design ModelThis article describes perspectives of Medicare Advantage (MA) insurers about participating in the CMS value-based insurance design model test launched in 2017.
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HITECH Spurs EHR Vendor Competition and Innovation, Resulting in Increased AdoptionThis is the first empirical evidence to demonstrate increased competition and innovation in the EHR industry as a result of the HITECH program.
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Finally: CMS to Address Allowing Hospitals More Say in Selecting Post Acute Care ProvidersHospital CEO and former SNF administrator, Dr Josh Luke, who founded the National Readmission Prevention Collaborative, discusses MEDPAC's recommendation to CMS that anti-steering regulations for hospitals be done away with.
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Thirty-Day Readmissions: Relationship to Physician Attending Type and Social ConnectednessThis study examined patient clinical and demographic characteristics, healthcare system factors, and patients’ experiences of care associated with 30-day readmissions in a hospital with a Pioneer Accountable Care Organization.
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Cost Comparison of Peritoneal Dialysis Versus Hemodialysis in End-Stage Renal DiseasePatients with end-stage renal disease who began peritoneal dialysis had lower 1-year hospitalization rates and lower total healthcare costs than those who began therapy with hemodialysis.
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Behavioral Health Disorders and Adherence to Measures of Diabetes Care QualityPersons with substance use disorders were less likely and persons with schizophrenia/paranoia were more likely to be adherent to measures of diabetes care quality.
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Leveraging Remote Behavioral Health Interventions to Improve Medical Outcomes and Reduce CostsSuccessful patient engagement in a nationally available, remotely delivered behavioral health intervention can significantly improve medical outcomes and lower healthcare costs.
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Payer—Provider Patient Registry Utilized in a Behavioral Health HomeA payer—provider, patient registry to identify individuals with serious mental illness and chronic physical health conditions for utilization in behavioral health homes is described.
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Patient-Reported Denials, Appeals, and Complaints: Associations With Overall Plan RatingsPatient ratings of plans and care were lower among beneficiaries filing complaints or reporting denied care. Appeals did not further predict ratings, but successful complaint resolution did.
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Community Pharmacy Automatic Refill Program Improves Adherence to Maintenance Therapy and Reduces Wasted MedicationEvaluation of a national retail pharmacy automatic refill program for patients on medication for chronic disease demonstrated significantly improved patient adherence and reduced medication oversupply.
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Adherence to Osteoporosis Medications After Patient and Physician Brief Education: Post Hoc Analysis of a Randomized Controlled TrialPost hoc analysis of a randomized controlled trial found that a 1-session educational intervention targeted at patients and primary care physicians did not improve osteoporosis medication adherence.
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Molecular Testing Patterns in Metastatic Non—Small Cell Lung CancerAssessment of the timing of histologic and molecular testing indicates that testing occurred prior to treatment initiation for most patients with metastatic non—small cell lung cancer.
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Health Equity in the Era of Large Language ModelsThis article presents challenges and solutions regarding health care–focused large language models (LLMs) and summarizes key recommendations from major regulatory and governance bodies for LLM development, implementation, and maintenance.
