Authors

Price Transparency and Patient Engagement: Social Messaging Matters

This study examined the impact of price transparency and prosocial messaging on patient engagement of price-protected consumers in seeking value-based care.

Contributor: The Future of Prior Authorization Under the Improving Seniors’ Timely Access to Care Act

Streamlining the prior authorization process can improve care accuracy and patient access to care, writes Siva Namasivayam, CEO of Cohere Health.

Social Needs Screening and Supplemental Benefits in Medicare Advantage

The authors describe Medicare Advantage plans that screen for and provide supplemental benefits addressing social needs and explore how these benefits meet communities’ social needs.

Management Updates in Heart Failure With Mildly Reduced or Preserved Ejection Fraction

Insurance-Related Differences in Chronic Conditions Data Warehouse Comorbidities of Medicare Beneficiaries

Chronic Conditions Data Warehouse comorbidity data vary by insurance status. Analyses using these data that fail to account for insurance status are subject to information bias.

The Biosimilar Shift: Trending Infliximab Biosimilar Utilization and Associated Cost Savings for Commercial Insurance

Infliximab biosimilars created price competition causing insurance claims costs for infliximab originator and infliximab biosimilars to decrease, generating significant savings to the health care system.

Preventive Care: Vaccines Matter

A database of information about more than 30,000 patients verified improved morbidity and mortality due to vaccines and preventive health care in prospective trials.

Making the Most of Limited Resources: Predicting Food Insecurity

Lessons learned from developing an inferential model for predicting food insecurity yield essential insights and actionable steps for policy makers seeking to address health-related social needs.

Cost-effectiveness of a 3-Year Tele-Messaging Intervention for Positive Airway Pressure Use

Long-term tele-messaging was more effective than no messaging and short-term messaging for positive airway pressure use, and it was highly likely to be cost-effective with an acceptable willingness-to-pay threshold.

Making Obesity Care Affordable: Patient Views on Deprescribing GLP-1 RAs

Most surveyed individuals with obesity support lower-cost options for weight maintenance, which would allow better coverage for injectable incretin mimetics for weight management during active weight loss.

Emerging Data Suggest Select Benefit for Venetoclax in MDS: Ivo Carre, PhD

Ivo Carre, PhD, shares subgroup data that points to potential benefit in younger patients with high-risk MDS.

Budget Impact Analysis of Biosimilar Natalizumab in the US

Projected savings from biosimilar natalizumab were $452,611 over 3 years, driven by decreased drug acquisition costs and a utilization shift from reference to biosimilar natalizumab.

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.

Clinical Profile of COVID-19 Infection in Postvaccination Individuals

This 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.

Growth of Dual-Eligible Special Needs Plans Following Permanent Authorization

The 2018 permanent authorization of dual-eligible special needs plans marked a significant long-term commitment by policy makers and coincided with substantial growth in plan offerings and enrollment.

Association Between Use of Clinician Performance Information and Patient Experience

High patient experience scores were associated with the collection and use of any clinician performance information, especially with whether the practice shared this information internally to compare.

Continuity of Opioid Prescribing Among Older Adults on Long-term Opioids

Among older adults with chronic noncancer pain on long-term opioid therapy, greater continuity of opioid prescribing was significantly associated with fewer opioid-related adverse outcomes.

Rising Use of Surveillance Colonoscopy and Potential Impacts

The proportion of colonoscopies performed for postpolypectomy surveillance has increased significantly, particularly among older patients with limited life expectancy, raising concern for possible overuse.

Industry-Informed Perspectives on the Benefits of Rideshare-Based Medical Transportation

Previous research on rideshare-based nonemergency medical transportation has limited generalizability due to the specific model studied, and the lack of trip-level data raises concerns of ecological fallacy.

Evaluating Satisfaction With Pharmacist-Provided MTM Services in a Medicaid Population

Medication therapy management (MTM) services were performed with a cohort of Medicaid patients, and their satisfaction with the program was assessed as part of a quality improvement initiative.

Factors Associated With Lung Cancer Risk Factor Documentation

This cross-sectional observational study found several factors associated with whether a patient had sufficient lung cancer risk factor documentation in the electronic health record.

Validation of the FINE-CKD Model for Future Health Technology Assessments for Finerenone in Patients With Chronic Kidney Disease And Type 2 Diabetes

Increased Payments to Medicare Advantage Plans for Dually Eligible Beneficiaries

Increasing Medicare Advantage payments for full Medicaid enrollees was not associated with meaningful changes in inpatient or nursing home use.

Hospital Participation in Medicare ACOs: No Change in Admission Practices and Spending

Hospital accountable care organization (ACO) participation did not impact emergency department admission rates, length of stay, or costs, suggesting limited effectiveness in reducing spending for unplanned admissions and challenging hospital-led ACO cost-saving strategies.

Consumer-Centric Approach to Enhance Access to Pediatric Specialty Care

The authors’ organization optimized scheduling techniques that improved patient access to pediatric specialists to within 7 calendar days for new patients.

An Assessment of Nurse Practitioner Low-Value Care Use in Primary Care

Primary care nurse practitioners were found to use low-value care at lower or relatively similar rates compared with the general clinician population.

Factors Associated With Lung Cancer Risk Factor Documentation

This cross-sectional observational study found several factors associated with whether a patient had sufficient lung cancer risk factor documentation in the electronic health record.

Primary Care Nurse Practitioner Management of Adolescent Behavioral Health

Personnel costs ($90,514) of a primary care–embedded adolescent behavioral health nurse practitioner over 2 years were 63% of the potential revenue generated ($144,449).

How Value-Based Care With Provider Enablement Improves Maternal and Infant Outcomes in Medicaid

Supported value-based care improves prenatal care while reducing neonatal intensive care unit stays, preterm birth rates, low birth weight rates, and costs for mothers and infants.

Addressing Cancer Care Barriers Through Community Outreach and Support

February 4 is World Cancer Day, and in these interviews with our Strategic Alliance Partner, NYU Langone Health, we learn about the importance of forming strong relationships with the communities you are located in and with whom you work to optimize cancer-related outcomes.