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Employer-Sponsored Behavioral Health Program Impacts on Care Utilization and Cost

Provision of enhanced access to behavioral health services by a large employer to its employees is associated with reductions in all-cause care utilization and cost.

Long-Chain Fatty Acid Oxidation Disorders and Current Management Strategies

Quality, Health, and Spending in Medicare Advantage and Traditional Medicare

In a review of literature published since the Affordable Care Act’s passage, more than half of analyses find that Medicare Advantage outperforms traditional Medicare on quality, health, and cost outcomes.

Insurance Payer Is Associated With Length of Stay After Traumatic Brain Injury

Among hospitalized patients with traumatic brain injury, Medicaid fee-for-service was associated with longer hospital stays than private insurance and Medicaid managed care organizations.

Is the QALY Fit for Purpose?

The quality-adjusted life-year (QALY) is a popular tool for value assessment but is flawed. This paper highlights potential solutions.

Appropriate ED Utilization Leading to Better Care Coordination

Addressing avoidable emergency department (ED) utilization takes interventions in partnership with providers.

Contributor: Sustaining the “New Normal”—The Future Is Still Bright for Telehealth in the Wake of COVID-19

Consumers want telehealth and telehealth can help achieve organizational goals of avoiding unplanned care, closing care gaps, and achieving care targets.

Use of Second-Generation Antidiabetic Medication Among a Nationally Representative Sample

Among individuals with a diagnosis of type 2 diabetes across the United States, income level, hemoglobin A1c, and comorbidity burden were the primary patient-level drivers of the use of newer antidiabetic agents.

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.

Patient Perceptions of In-home Urgent Care via Mobile Integrated Health

Comparing patients’ experiences with in-home urgent care from community paramedics vs urgent care provided in emergency departments, we found higher satisfaction among patients receiving in-home treatment.

Heart Failure Without a Reduced Ejection Fraction

Bimekizumab-bkzx, the Newest Psoriasis Treatment, Is Now Available

Bimekizumab-bkzx (Bimzelx) is the first dual interleukin 17A (IL-17A) and interleukin 17F (IL-17F) inhibitor to treat moderate-to-severe plaque psoriasis. It launches with a list price of $7200 per syringe.

Changes in Opioid Marketing Practices After Release of the CDC Guidelines

After the CDC guidelines’ release, total opioid marketing spending and encounters per physician decreased, but spending per encounter subsequently increased.

TeleConnect: Digitally Connecting Physicians Across the Health Care System

TeleConnect introduces the concept of connecting primary care physicians and specialists by leveraging technology. Improving communication in a health care system betters patient care.

Impact of Functional Recovery on Patients Having Heart Surgery

This article describes the positive impact that actively managing functional recovery has on postacute placement for patients undergoing coronary artery bypass surgery.

Ajai Chari, MD, on the Challenges of Bringing CAR T, Bispecifics to Patients With Multiple Myeloma

Measuring Continuity of Care for Diabetes: Which Visits to Include?

This study examined how inclusion of different provider specialties affected Continuity of Care Index values, year-to-year stability, and association with emergency department visits.

Accountable Care Organizations and HPV Vaccine Uptake: A Multilevel Analysis

The authors evaluated whether adolescents receiving care at accountable care organizations (ACOs) vs non-ACOs were more likely to initiate and complete the human papillomavirus (HPV) vaccination series.

Evaluating Alternative Methods of Comparing Antihypertensive Treatment Intensity

Medication 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.

Safety vs Price in the Generic Drug Market: Metformin

The generic drug market focuses on price. However, multiple generic metformin drugs have been recalled due to poor drug quality. The authors examine price and quality after these recalls.

Non–Face-to-Face Care Management and Service Utilization in Patients With Diabetes

CMS began reimbursement for non–face-to-face chronic care management in 2015, and results from Louisiana show that it increases outpatient visits but decreases inpatient and emergency department encounters.

Journey to Anticoagulant Access Following Payer Rejection of Apixaban

Formulary restrictions can create treatment barriers for patients with atrial fibrillation, including unnecessary delays in treatment and prescription abandonment, with vulnerable populations at greater risk.

Patient Experience After Modifying Visit Delivery During the COVID-19 Pandemic

Coronavirus disease 2019 (COVID-19) was associated with immediate weekly visit trend decreases for overall, primary care, and specialty care with long-term recovery trends; transformation to virtual visits; and increasing long-term trends for meeting patient scheduling and visit needs.

Planning for the Future of Population Health: The Johns Hopkins Medicine Experience

Johns Hopkins Medicine underwent a reorganization of its population health services, with a new structure, set of priorities, and development of a 3-year strategic plan.

Stripped of Fucose, Powerful Monoclonal Antibody Shows Promising Results in MDS Dosing Study

Nicole Grieselhuber, MD, PhD, of The Ohio State University, discusses results from Part D of a dosing study involving patients with previously untreated higher-risk myelodysplastic syndrome (MDS) who were treated with a combination of SEA-CD70 and azacitidine.

Pharmacist-Led Review of Empagliflozin and Ertugliflozin Following Formulary Update

Management of empagliflozin and ertugliflozin may be suboptimal following an insurance carrier’s formulary updates. Pharmacists may improve the management.

Treating Depression to Prevent Dementia

According to new research, treating depression in older adults could decrease risk of dementia by 51%.

The Implementation of Opioid Prescribing Report Cards in Medicaid Managed Care: A Community Quality Collaborative

This article describes the Philadelphia Medicaid Opioid Prescribing Initiative that was launched by a multidisciplinary team and mailed local Medicaid providers individualized prescribing report cards.

Contributor: Congress Must Do More to Cover Nonopioid Alternatives

Preventing addiction is key to ending the opioid epidemic—2020 alone saw more than 93,000 overdose deaths—as are expanding access to treatment, promoting recovery, and building a multifaceted strategy that incorporates nonopioid alternative and their coverage by providers. Although appropriate in certain situations, opioids are not a one-size-fits-all approach.

Experience Incentivizing Reduction of Racial and Ethnic Disparities in a Medicaid Hospital Quality Incentive Program

Construction of a composite measure, use of a summary disparity statistic, and measure selection are key considerations in the design of equity-focused payment programs.