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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.

Predictors of Discharge From the VA Caregiver Support Program

The year of application predicts discharge from the Department of Veterans Affairs (VA) caregiver program. Unexpected, disallowed criteria also predict discharge, with significant others facing higher discharge risk than spouses.

Poor Self-rated Mental Health and Medicare Beneficiaries’ Routine Care-Seeking

Efforts are needed to ensure that Medicare beneficiaries with poor mental health receive regular routine care, which may be facilitated by having a personal doctor.

Service Utilization by High-Need, High-Cost Patients Following Emergency Department Visits

This article provides insights into patterns of health care use following emergency department visits by high-need, high-cost patients with different types of California Medicaid primary care providers.

Small Practice Participation and Performance in Medicare Accountable Care Organizations

Medicare beneficiaries attributed to small practices in accountable care organizations (ACOs) achieve greater savings than beneficiaries attributed to large practices in ACOs.

An Accelerated Hospital Observation Pathway to Reduce Length of Stay for Patients With COVID-19

For select patients hospitalized due to COVID-19, an academic urban hospital implemented an observation pathway that incorporated mobile health technology, reducing hospital length of stay by more than 2 days.

Two Steps Forward, One Step Back: 50 Years of Societal Value From LDL-C–Lowering Therapies

Low-density lipoprotein cholesterol (LDL-C)–lowering therapies have yielded significant value to society through reduced costs for both fatal and nonfatal cardiovascular disease events. The vast majority of this value has accrued to patients.

The Price Paradox of Biosimilar-Like Long-Acting Insulin

Findings suggest that Basaglar was not less expensive for patients than Lantus. Empirical evaluation of biosimilar costs prior to automatic substitution is necessary.

Addressing the Individualized Needs in Hereditary Angioedema: Managed Care Strategies to Optimize Access to Care

Contributor: It’s Important to Prioritize HIV Care During the COVID-19 Pandemic

Not all barriers to HIV-related care and services have been eliminated, and these gaps in care were exacerbated by treatment disruptions brought on by the COVIDC-19 pandemic.

Evaluating Racial Concordance in a Telephonic Care Management Program Among Black Patients

The race of a telephonic care manager did not impact closure rates for gaps in care among Black Medicare Advantage beneficiaries.

The “New” New Normal: Changes in Telemedicine Utilization Since COVID-19

Telemedicine utilization has declined since the peak of the COVID-19 pandemic, but non–primary care specialties continue to see an increase in moderate- and high-complexity telemedicine visits.

Low Colorectal Cancer Screening Among Adults Aged 45-49 Years in the US, 2023

Less than half of US adults aged 45 to 49 years were up to date on colorectal cancer (CRC) screening in 2023, suggesting that age group–specific interventions may improve CRC screening in the US.

Consumer-Centric Approach to Enhance Access to Pediatric Specialty Care

The authors’ organization optimized scheduling techniques that improved patient access to pediatric specialists to within 7 calendar days for new patients.

Closing the Gap in Thromboprophylaxis: A Multidisciplinary Quality Improvement Approach Among Medical Inpatients

This system-level initiative significantly increased guideline-concordant venous thromboembolism prophylaxis rates in hospitalized patients through coordinated education, clinical decision tools, audit-feedback, and pharmacist integration.

How English- and Spanish-Preferring Patients With Cancer Decide on Emergency Care

Care delivery innovations to help patients with cancer avoid emergency department visits are underused. The authors interviewed English- and Spanish-preferring patients at 2 diverse health systems to understand why.

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.

Subjective and Objective Impacts of Ambulatory AI Scribes

Although the vast majority of physicians using an artificial intelligence (AI) scribe perceived a reduction in documentation time, those with the most actual time savings had higher relative baseline levels of documentation time.

Two steps for success in value-based oncology care

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.

Trends and Disparities in High-Risk Nonsteroidal Anti-Inflammatory Drug Utilization

High-risk nonsteroidal anti-inflammatory drug use declined modestly in Virginia during the COVID-19 pandemic but remained prevalent from 2019 to 2021. Demographic disparities reveal distinct opportunities for targeted deprescribing interventions.

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.

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.

Emergency Department Risk Model: Timely Identification of Patients for Outpatient Care Coordination

The authors created a machine learning–based model to identify patients with major depressive disorder in the primary care setting at high risk of frequent emergency department visits, enabling prioritization for a care coordination program.

Utilization and Costs Among Oncologists Participating in a Private Insurance Shared Savings Model

A private oncology shared savings plan reduced colon cancer treatment costs. Results varied by tumor, with none in breast cancer and mixed effects in lung cancer.

Opportunities and Obstacles Associated With the Medicare Diabetes Prevention Program

This study describes the current opportunities and obstacles associated with Medicare Diabetes Prevention Program implementation from the novel perspective of program suppliers across the US.

Impact of Telemedicine Use on Outpatient-Related CO2 Emissions: Estimate From a National Cohort

Telemedicine was associated with a monthly avoidance of greenhouse gas emissions equivalent to the emissions of 61,255 to 130,076 passenger vehicles.

Association of Travel Nursing With Quality Outcomes in Hospitalized Patients

Greater reliance on travel nurses may be associated with more hospital complications.

Acoramidis Lowers Mortality in Wild-Type and Variant Amyloid Cardiomyopathy

ATTRibute-CM data show acoramidis reduced mortality in ATTRwt-CM and ATTRv-CM and raised serum transthyretin through 42 months.

Inadequate Insurance Coverage for Overweight/Obesity Management

This article reviews the obesity epidemic in America and discusses inadequate insurance coverage.