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The Hepatitis B Care Cascade Using Administrative Claims Data, 2016Analysis of a large, nationally representative claims database to longitudinally monitor enrollees with hepatitis B showed that 36% received recommended care and 18% were prescribed treatment.
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Factors That Increase Utilization Management Risk: A Proof of ConceptA score was developed to measure patient risk from payer utilization management policies and its relationship to real-world US commercial payer utilization management policies.
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Enhancing the e-Consult: Empowering Efficient and Collaborative CareThis editorial provides suggestions for improving the process of e-consults, which are a promising method of expanding access to specialty care.
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Key Takeaways on Recent Advances in SCLCPanelists discuss how the landscape of small cell lung cancer (SCLC) treatment is rapidly evolving, highlighting key advances in immunotherapy, targeted treatments like tarlatamab, and ongoing research efforts, while emphasizing the importance of early diagnosis, appropriate staging, and personalized treatment approaches to improve patient outcomes and quality of life.
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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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Appropriate ED Utilization Leading to Better Care CoordinationAddressing avoidable emergency department (ED) utilization takes interventions in partnership with providers.
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Employer-Sponsored Behavioral Health Program Impacts on Care Utilization and CostProvision 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.
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Equity, Metrics, and the Future of Value-Based Models: Kate Baker, MDKate Baker, MD, MMHC, medical director of value-based care at Tennessee Oncology, talks about innovations in cancer care highlighted at the Community Oncology Conference.
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Development and Validation of the COVID-19 Hospitalized Patient Deterioration IndexThe authors developed and validated an accurate, well-calibrated, easy-to-implement COVID-19 hospitalized patient deterioration index to identify patients at high or low risk of clinical deterioration.
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Telehealth User Experiences During COVID-19: A Case Study of Outpatient Cardiovascular Clinics Affiliated With a Large Academic PracticeIn cardiovascular clinics during COVID-19, notable barriers to successful telehealth use included obtaining diagnostic information needed to deliver high-quality care and technology-related challenges for patients.
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Barriers and Facilitators to Managing Social Care in the Digital Era Among Michigan Health CentersThere is widespread interest in understanding the role of health care in meeting social needs. This study examines community-wide activities, resources, and information technology used to manage social care.
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Patient Need and Provider Referrals to Diabetes Self-management EducationThis article demonstrates that few patient encounters with indicators of need for diabetes self-management education result in a provider referral to the service.
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Economics of a Health System’s Direct-to-Consumer Telemedicine for Its EmployeesA direct-to-consumer telemedicine service resulted in lower per-episode unit costs for care within 7 days and only marginally increased the use of services overall.
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Optimizing the Management of TRDDrs Steven Levine, Patricia Ares-Romero, Samuel Nordberg, Martin Rosenzweig, and Carrie Jardine share insight on the future treatment landscape for TRD.
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Obe-Cel Is Effective Irrespective of Age in Relapsed/Refractory B-ALLObecabtagene autoleucel showed over 70% response rates in relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL), demonstrating efficacy across all age groups in recent trials.
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Leveraging Predictive Analytics to Target Payer-Led Medication Adherence InterventionsThis article explores how payers can enhance their medication adherence initiatives to reduce costs and improve member health outcomes by leveraging predictive analytics through machine learning.
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Mobile Health Clinic: Lessons Learned Building Partnerships Across Health SystemsEstablishing mobile health clinics in rural settings requires collaboration across health systems by aligning missions, building infrastructure to support research, and demonstrating proof of concept.
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Navigating Risk, Treatment, and Reimbursement in Precision Oncology: Sadie Dobrozsi, MDSadie Dobrozsi, MD, of Evolent, discusses how predictive genomics is pushing cancer care into a new era of personalization
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Experts Share Top Takeaways From AACR Annual Meeting 2025During interviews at the American Association for Cancer Research (AACR) Annual Meeting 2025, experts shared key insights from this year's conference.
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Chronic Overlapping Pain Conditions and Long-term Opioid TreatmentLittle is known about opioid prescribing patterns in patients with chronic overlapping pain conditions. This study suggests target populations for interventions to manage chronic pain.
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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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Cross-Validation of Insurer and Hospital Price Transparency DataReal-world cross-validation of insurer and hospital price transparency data finds low overlap but high concordance between data sources.
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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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Adolescent Anterior Cruciate Ligament Reconstruction: A Decade of Rising Surgical CostAdolescent anterior cruciate ligament reconstruction surgery can preserve health and restore function of the knee joint, but the surgical cost has outpaced inflation.
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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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Combination of Magrolimab and Rituximab Well Tolerated in Patients With Refractory/Relapsed Indolent NHLA 3-year follow-up of patients with refractory/relapsed indolent non-Hodgkin (NHL) treated with a combination of magrolimab and rituximab showed no new treatment-emergent adverse events, suggesting long-term safety. The treatment also confirmed magrolimab penetration into the tumor.
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TeleConnect: Digitally Connecting Physicians Across the Health Care SystemTeleConnect introduces the concept of connecting primary care physicians and specialists by leveraging technology. Improving communication in a health care system betters patient care.
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Responsibility for Treating Tobacco Dependence in Health Clinics Serving Medicaid EnrolleesThis article describes the implementation of Medicaid smoking cessation guidance in a large, urban federally qualified health center to examine how state-level provisions translated into clinic-level policies.
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Assessment of Structured Data Elements for Social Risk FactorsAn expert panel identified and assessed electronic health record and health information exchange structured data elements to support future development of social risk factor computable phenotyping.
