Authors
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Dialysis Costs for a Health System Participating in Value-Based CareIn a large, integrated health system participating in value-based care, higher costs and utilization were observed before and after unplanned dialysis initiation.
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Coverage With Evidence Development: Where Are We Now?Review of CMS’ coverage with evidence development program exposes a need to improve program transparency and clarify requirements and timetables for reporting to improve access to novel therapies.
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Final Panel Thoughts on the Management of SMAPanelists discuss how spinal muscular atrophy (SMA) treatment will evolve over the next 5 years, likely incorporating improved gene therapy delivery systems, combination therapies, and rehabilitation models, while maintaining individualized approaches for each patient.
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Predicting Mortality Risk Using the PREVENT Equation Across Diverse Racial GroupsThis study validates the Predicting Risk of CVD Events (PREVENT) score across diverse racial and ethnic populations, highlighting its effectiveness in predicting cardiovascular risk and mortality, regardless of race or ethnicity.
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Key Takeaways on RSV VaccinationThe panel concludes its discussion by providing key takeaways on the evolving RSV vaccination landscape.
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COVID-19 Control in the United States: The Case for MaskingIn the control of COVID-19, the future perfect of the vaccine should not be the enemy of the present good, which is masking.
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Out-of-Pocket Costs for Diabetes Medications in Employer-Sponsored Health Insurance PlansOut-of-pocket costs of diabetes medications other than insulin can be quite high for individuals with employer-sponsored health insurance.
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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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Impact of Payment Models on Medical Specialist Physician Practice PatternsThis 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.
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Contributor: The Convergence of Value-Based Care and Lab Testing GrowthToday, health plans are shifting dollars to more value-based contracts along with investments in population health management. Digitizing lab results across all care settings and unlocking the potential of lab values can help health plans reach the Triple Aim of improving the patient experience, improving the health of populations, and reducing the per-member cost of health care.
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Continuously Updated Forecasting of SARS-CoV-2 in a Regional Health SystemThis study presents a methodology for forecasting demand of COVID-19 on health resources in an integrated health system.
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Keeping Up With Guideline Recommendations: Does Patient Volume Matter in Diabetes Care?In the process of implementing a new practice guideline for treating patients with diabetes, physicians with higher patient volumes are more likely to adhere to the guideline recommendation.
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Overcoming Weight Bias in Clinical PracticePanelists discuss how unconscious bias and weight stigma create barriers to care, requiring providers to acknowledge their own biases, create welcoming clinical environments with appropriate accommodations, and approach patients with compassion rather than judgment about willpower.
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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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Effects of Maryland’s All-Payer Model on Elective Joint Replacement SurgeryThe Maryland All-Payer Model was associated with an increase in population-based rates of elective major joint replacements, with a more pronounced effect observed in Maryland-only hospitals.
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Access to Therapy and Future Treatment Directions in Lupus NephritisGerman Hernandez, MD, FASN, FACP, and Ellen Ginzler, MD, MPH, discuss barriers to treatment access in lupus nephritis, and address future directions and unmet needs of the disease.
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Actions to Improve Quality: Results From a National Hospital SurveyHospitals reported widespread adoption of quality improvement (QI) changes to improve on CMS quality measures, and QI adoption was associated with improved performance on quality measures.
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An Integrated Practice Unit Tool for the Military Health SystemResearchers developed and tested an assessment tool to measure coordinated care for traumatic brain injury against the criteria of an integrated practice unit.
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The Impact of Evolving Treatment Options in Multiple Myeloma, Part 10Bruce A. Feinberg, DO; Ryan Haumschild, PharmD, MS, MBA; Thomas Ollis, MS, RPh; and Joseph Mikhael, MD, discuss the future treatment landscape for the management of multiple myeloma.
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Commercial and Medicare Advantage Payment for Anesthesiology ServicesMean in-network commercial allowed amounts and charges per anesthesia conversion factor are 314% and 659% of traditional Medicare rates, respectively. Medicare Advantage payments align with traditional Medicare prices.
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Association of Physician Specialty With Psoriatic Arthritis Treatment and CostsIn this retrospective cohort study of patients with newly diagnosed psoriatic arthritis, the authors examine the association of treatment selection and costs with physician specialty.
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Evaluating Access to Care for Medicare Beneficiaries Younger Than 65 YearsEnrollment in Medicare coverage without out-of-pocket protections was associated with a higher likelihood of reporting cost and access barriers to care.
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Two Steps Forward, One Step Back: 50 Years of Societal Value From LDL-C–Lowering TherapiesLow-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.
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Telemetry: Appropriateness of Initial Assignment and Duration in Nonintensive SettingThe authors report overutilization of telemetry monitoring in a community setting, increasing the cost of health care and potential harm to patients with unnecessary interventions.
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Leveraging Longitudinal Clinical Laboratory Results to Improve Prenatal CareCollaboration between a clinical laboratory and a managed care organization improved prenatal care and outcomes through real-time, actionable, laboratory-derived insights and care coordination.
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Differences in Spending for Diabetes and Multiple Chronic Conditions in Michigan Medicare BeneficiariesDiabetes and multiple chronic conditions increase overall Medicare spending, but spending increases even more in minority beneficiaries compared with White beneficiaries with similar comorbidity combinations.
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Physician Preferences for an Electronic Lung Cancer Screening Decision AidThis qualitative study on primary care physicians yielded suggestions that can inform the design of an effective lung cancer screening decision aid tool and implementation into the electronic health record.
