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Translating Clinical Evidence Into Value-Based Payment Models: Pooled Analyses of Innovative Real-World Outcomes Agreements for Ticagrelor in the United States

Appropriate ED Utilization Leading to Better Care Coordination

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

Potential Inequities in Access to In-Person SHIP Counseling Services

The federal State Health Insurance Assistance Program (SHIP) provides counseling and education on Medicare coverage options. This article highlights potential inequities in in-person SHIP service access.

The Merits of Administrative Benchmarks for Population-Based Payment Programs

The different approaches to setting benchmarks for population-based payment models (empirical, bidding based, and administratively set) have unique advantages and challenges.

Incorporating Health IT Into Primary Care Transformation

Longitudinal evaluation of an advanced primary care reform effort found some improvements in health information technology (IT) offerings and use as well as opportunities to improve future collaboration.

Contributor: How Telemedicine Augments the Resources of the Indian Health Service to Reach New Patients, Improve Outcomes

Telemedicine may be the future of health care for American Indians and Alaskan Natives who live in tribal communities and remote areas.

Heart Failure Without a Reduced Ejection Fraction

The Role of Race, Ethnicity, and Language in Care Transitions

Diverse patients experience disparities in care transitions. A survey of 224 patients showed differences by race, ethnicity, and language in technology access and in patient worries post discharge.

Pediatric Oral Health Services in Medicaid Managed Care and Fee for Service

Rates of preventive oral health services among pediatric medical visits in Florida were similar whether visits were paid via Medicaid comprehensive managed care or fee for service.

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.

Telemedicine Catches On: Changes in the Utilization of Telemedicine Services During the COVID-19 Pandemic

This analysis of health insurance claims data demonstrates rapid increase and sustained high utilization of telemedicine services during the COVID-19 pandemic.

Approaches for Overcoming Barriers to Cross-Sector Data Sharing

The authors identified challenges to cross-sector data sharing and the approaches used to overcome these challenges in the Mid-Ohio Farmacy, a partnership to address food insecurity.

Impact of Advance Care Planning Consults on Advance Directives Completion

Implementing advance care planning consults can increase advance directive completion rates. The authors demonstrate the impact of consults on completed advance directives in the medical record.

Improving Glycemic Control in Diabetes Through Virtual Interdisciplinary Rounds

Patients with diabetes whose providers received advice from remote, virtual interdisciplinary rounds had a greater 1-year reduction in hemoglobin A1c than comparable patients.

Reducing Readmissions in the Safety Net Through AI and Automation

Artificial intelligence (AI) and electronic health record–based automation tools helped a safety-net health system meet performance-based readmission metrics, thereby retaining critical funding while improving clinical and equity outcomes.

Glucose-Lowering Treatment Patterns in Patients With Diabetic Kidney Disease

Real-world treatment of diabetic kidney disease in the United States, based on national-level health care claims and electronic health records data, is inconsistent with the current guidelines.

Cost-effectiveness of Total State Coverage for Hepatitis C Medications

Expanded coverage under a Medicare-Medicaid partnership to treat all prevalent cases of hepatitis C appears to be cost-effective by saving money and improving patient outcomes.

Baloxavir vs Oseltamivir: Reduced Utilization and Costs in Influenza

Baloxavir, compared with oseltamivir, was associated with lower health care resource utilization and costs in patients with influenza, particularly those at high risk of secondary complications.

Mortality Risk Stratification Helps Identify Patients With COVID-19 at Risk of Adverse Outcomes

Mortality risk stratification can identify patients with COVID-19 who are at higher risk of mortality, discharge to skilled nursing facility, and readmission, and may benefit from focused intervention strategies.

A Square Peg in a Round Hole: Treating Hepatitis C

The authors propose an investment in patient-centered care strategies to initiate and engage vulnerable populations with curative hepatitis C treatment.

Cost-effectiveness of Total State Coverage for Hepatitis C Medications

Expanded coverage under a Medicare-Medicaid partnership to treat all prevalent cases of hepatitis C appears to be cost-effective by saving money and improving patient outcomes.

Mortality Risk Stratification Helps Identify Patients With COVID-19 at Risk of Adverse Outcomes

Mortality risk stratification can identify patients with COVID-19 who are at higher risk of mortality, discharge to skilled nursing facility, and readmission, and may benefit from focused intervention strategies.

Intersection of Complexity and High Utilization Among Health Center Patients Aged 18 to 64 Years

This paper utilizes latent class analysis to identify subgroups of complex conditions and of super-utilizers among health center patients to inform clinically tailored efforts.

Clinical Outcomes in Heart Failure Monitoring: A Pooled Rates Analysis

This systematic literature review and pooled rates analysis investigated the standard of care for patients with heart failure in the US post hospital discharge.

Characterizing Patient Flow After an Academic Hospital Merger and Acquisition

This study assessed health care utilization and patient flow after a recent merger of community practices, a community hospital, and an academic medical center.

Standardized Total Knee Arthroplasty Pathway Improves Outcomes in Minority Patients

In a minority-predominant patient population, a standardized pathway for total knee arthroplasty was associated with improved outcomes with no change in postoperative complication rates.

Using Data Exchange to Improve Quality Reporting, Target Outreach, and Reduce Cost

Covered California and Health Net’s novel data exchange initiative significantly improved quality measurement and potentially reduced costs by more than $640,000.

PCORI’s Expanded Mandate Creates New Opportunities for Value Assessment Research

The recent reauthorization of the Patient-Centered Outcomes Research Institute (PCORI) comes with an expanded mandate to study the economic impacts of treatments presenting new opportunities for the value assessment research community.

Care Transitions: Opportunities to Better Serve the Traveling Patient

The authors share a model that facilitates patient-centered care and can be adopted by other health systems to encourage successful care transitions for the traveling patient.

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.