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Trends in Medicare Part D Coverage of Generics With Equivalent Brand-Name DrugsHigh-tier generic drug placement in Medicare Part D has increased over time, but it may be related to a drug’s clinical profile and availability of substitutes rather than preferred brand-name drug coverage.
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Removing Medicare’s Outpatient Ban and Medicare and Private Surgical TrendsThis article documents a 100% increase in privately insured outpatient knee replacement surgeries following Medicare’s decision to remove knee replacements from its Inpatient Only list.
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Considerations to Increase Rates of Breast Cancer Screening Across PopulationsAuthors from the Community Oncology Alliance and Avalere Health present data that show breast cancer screening rates recovered more slowly among some racial/ethnic groups following on the onset of the COVID-19 pandemic.
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Contributor: Providers and Patients Push Back, Payers Push Forward—Co-pay Mitigation ProgramsResearch shows how commercial health plans impact payer trends in the co-pay landscape and provides key areas that pharmaceutical and biotech manufacturers can explore to ensure patient access.
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Clinical Profile of COVID-19 Infection in Postvaccination IndividualsThis article describes the findings of an observational study carried out in India to examine the clinical profile of individuals detected to be COVID-19 positive post vaccination.
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Health Insurance, Blood Cancer Care, and Outcomes: A Literature Reviewdoi: 10.37765/ajmc.2021.88733
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Hospital Discharge Diagnosis Position: Impact on Adult Pneumonia Burden EstimatesDisease burden estimates of pneumonia-associated hospitalizations are more sensitive when including pneumonia coded in any diagnosis field vs in only the first discharge diagnosis field.
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Incentivizing Data Sharing Among Health Plans, Hospitals, and Providers to Improve QualityHealth plans can gain efficiencies and improve quality by connecting to health information networks and incentivizing hospital and provider participation as part of pay-for-performance programs.
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When Does Nonadherence Indicate a Deviation From Patient-Centered Care?The authors suggest that assessment of patient-centered care may be improved by flagging probable discordance between a patient’s preferences and their treatment care plan.
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Primary Care Referrals to Nephrology in Patients With Advanced Kidney DiseasePrimary care physicians did not refer the majority of patients with severe nephropathy to specialists; nonreferred patients had fewer comorbidities and might be better kidney transplant candidates.
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Interest in and Concerns About Telehealth Among Adults Aged 50 to 80 YearsIn this survey of adults aged 50 to 80 years, sociodemographic factors, as well as experience with video chat, were associated with interest in and concerns about telehealth video visits.
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Evaluating Alternative Methods of Comparing Antihypertensive Treatment IntensityMedication dose captures modification of hypertension treatment intensity more precisely than medication count, and this measure should be preferred in studies that aim to improve hypertension management.
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Cost of Home vs Clinic Administration of Paclitaxel in Metastatic Breast CancerHome administration of oral paclitaxel and encequidar is associated with potential cost savings for payers compared with clinic administration of intravenous chemotherapy in metastatic breast cancer patients.
