Authors
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Medical Loss Ratio’s Role in the Large Group Insurer MarketThe authors used medical loss ratio forms to assess trends in premiums, medical claims, administrative costs, quality improvement, and margins in the large group insurer market.
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Potential Health Literacy Resources for Health Plans: A Narrative ReviewSeveral evidence-based health literacy resources may be beneficial in health plan settings to improve organizational health literacy, personal health literacy, and health equity.
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Managed Critical Care: Impact of Remote Decision-Making on Patient OutcomesThis work serves as a step toward better understanding the implications of remote critical care intervention by evaluating levels of tele–intensive care unit decision-making authority.
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Oncology Alternative Payment Models: Lessons From Commercial InsuranceDeveloping alternative payment models for commercial populations in specialties such as oncology is rife with practical challenges. Leading payers and practices share lessons to date.
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Factors Associated With Lung Cancer Risk Factor DocumentationThis cross-sectional observational study found several factors associated with whether a patient had sufficient lung cancer risk factor documentation in the electronic health record.
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Real-World Users of Triple Therapy for Asthma in the USThis retrospective cohort study evaluated baseline demographics, clinical characteristics, and treatment patterns of US patients with asthma who newly initiated single- or multiple-inhaler triple therapy.
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DVRd vs VRd in Transplant-Ineligible Myeloma: Insights From Saad Z. Usmani, MD, MBACEPHEUS trial lead investigator Saad Z. Usmani, MD, MBA, FACP, FASCO, explains how the trial both builds on current knowledge of newly diagnosed multiple myeloma and how transplant-ineligible status may affect therapeutic decision-making.
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Low-Cost Insulin for Socially At-Risk Patients: Evidence for EffectivenessHuman synthetic insulin may offer low-cost, effective treatment for certain patients with diabetes and financial constraints.
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Harnessing AI for Population Health: A Call to Action for Policy Makers and Health Care LeadersThe authors detail how artificial intelligence could be used in primary, secondary, and tertiary prevention to improve health outcomes and provide better value-based care.
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Discharge Prescribing and Subsequent Opioid Use After Traumatic Musculoskeletal InjuryThe authors use surgical resident assignment as an instrumental variable for discharge opioid prescribing and estimate the impact of discharge opioid supply on subsequent use.
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High-Intensity Home-Based Rehabilitation in a Medicare Accountable Care OrganizationHigh-intensity home-based rehabilitation (HIHR) may substitute for facility-based postacute rehabilitation. Patients in HIHR had better functional outcomes at lower costs than patients in facility-based care.
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Geographic Variability of Medicaid Acceptance Among Allergists in the USThe proportion of allergists accepting Medicaid in the US varied significantly among and within states.
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Racial and Ethnic Disparities in Prior Authorizations for Patients With CancerThe prior authorization process for patients with cancer demonstrates fewer days until submission and lower denial rates for Asian patients relative to White patients.
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Cost Analysis of Self-Monitoring Blood Glucose in Nonintensively Managed Type 2 DiabetesAnalysis of claims data showed reduced utilization and costs among patients with nonintensively managed type 2 diabetes using self-monitoring of blood glucose compared with continuous glucose monitoring.
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Improving Risk Stratification Using AI and Social Determinants of HealthPrediction models combining claims data with social determinants of health and additional, more-timely data sources using artificial intelligence (AI) can better identify individuals with the highest future medical spending.
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Stakeholder Insights on rtCGM in T2D Population Health ManagementLeading payer and health system stakeholders reviewed literature and shared insights on the value of real-time continuous glucose monitoring (rtCGM) in type 2 diabetes (T2D) population health.
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Population Health Strategies to Advance Health Equity: A Q&A With Dr Paul G. AlexanderPaul G. Alexander, MD, MPH, executive vice president and chief health equity and transformation officer, RWJBarnabas Health, speaks on strategies his organization implemented during the COVID-19 pandemic to address continuity of care and communication challenges in underserved communities and further efforts to improve health equity.
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Pharmaceutical Care Services for Patients With Diabetes: A Systematic Scoping ReviewMajor databases were systematically searched for articles reporting on pharmaceutical care services for patients with diabetes, and 86 pharmaceutical care services were qualitatively synthesized.
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An Assessment of Nurse Practitioner Low-Value Care Use in Primary CarePrimary care nurse practitioners were found to use low-value care at lower or relatively similar rates compared with the general clinician population.
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Impact of COVID-19 Pandemic on Accessibility of Taiwanese Medical CareThe COVID-19 pandemic disrupted access to routine medical care in community populations in Taiwan. The unmet needs should be emphasized as normal life resumes.
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Addressing Myasthenia Gravis Diagnostic Delays and Access Barriers: Marla Black Morgan, MDMarla Black Morgan, MD, looks to the future of research in both myasthenia gravis and rare neurological disorders by expanding data collection and identifying areas of potential difference in patient outcomes.
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Patient Feedback for MDS: Insights and Closing RemarksMedical experts offer their insights and closing remarks regarding patient feedback for MDS.
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Advanced Care at Home at Scale in an Integrated Health Care SystemAdvanced care at home (otherwise known as hospital at home) can be scaled and provide care for a sizable portion of a hospital’s inpatient census, creating hospital capacity in an integrated delivery system.
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Better Together? Costs of First-line Chemoimmunotherapy for Advanced Non–Small Cell Lung CancerCompared with first-line immunotherapy or chemotherapy alone, combination chemoimmunotherapy for advanced/metastatic non–small cell lung cancer has significantly higher antineoplastic drug and associated medical costs.
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Defining Value Among Treatment OptionsPayer decision-makers discuss defining value among agents for unintended pregnancy, uterine fibroids, and endometriosis.
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Dermocosmetics as Adjunctive Therapy Reduces Sensitivity and Improves Quality of Life in AcneDermocosmetics alongside traditional acne treatments improved skin tolerance and reduced acne severity in patients, particularly those using retinoids, leading to enhanced quality of life.
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Care Fragmentation Predicts 90-Day Durable Ventricular Assist Device OutcomesThis analysis evaluates the relationship between hospital care delivery network fragmentation and in-hospital and 90-day outcomes. These networks may be novel targets for improving outcomes.
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Emergency Department Risk Model: Timely Identification of Patients for Outpatient Care CoordinationThe 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.
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Identifying Chronic Kidney Disease Stage 3 With Excess Disease BurdenA high-risk cohort of beneficiaries with chronic kidney disease (CKD) stage 3 have a profile similar to patients with CKD stages 4 and 5, indicating potential benefit of earlier nephrology intervention.
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Collaboration to Transition Members to Preferred Formulary Dipeptidyl-Peptidase-4 InhibitorA collaboration between a drug plan and clinical pharmacists led to nearly 50% of members successfully switching to a preferred dipeptidyl-peptidase-4 inhibitor.
