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High-Risk Care Management Impact on Medicaid ACO Utilization and Spending

In Massachusetts’ largest Medicaid accountable care organization (ACO), high-risk care management significantly reduced spending, emergency department visits, and hospitalizations, demonstrating that targeted strategies can manage health care costs amid budget constraints.

Neighborhood Opportunities and Pediatric Health Care Utilization: Implications for Medicaid Managed Care

Medicaid managed care organizations should prioritize children in low-opportunity neighborhoods to optimize health care utilization, improve minority health, and address health-related social needs.

Mental Health Concerns Prevalent in Patients With AD, Poster Says

A new study presented at this year’s American College of Allergy, Asthma and Immunology Annual Scientific Meeting highlights the need for mental health support in patients with atopic dermatitis (AD).

Adjuvant Pembrolizumab Maintains Benefit-Risk Profile for High-Risk Stage II Melanoma in KEYNOTE-716 Analysis

Adjuvant pembrolizumab maintained recurrence-free survival in resected stage IIB/IIC melanoma without increasing new melanoma risk.

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.

Changes in Persistence to Basal Insulin Following the Medicare Out-of-Pocket Cost Cap

The authors evaluated changes in persistence to basal insulin in a Medicare Advantage population in the first year of the Medicare insulin out-of-pocket cost cap.

How Medicare Advantage Plans Use Data for Supplemental Benefits Decision-Making

This article presents findings from interviews conducted with executives from 29 Medicare Advantage plans regarding plan decision-making processes related to new social risk factor–related benefits.

The Timing and Characteristics of Supplemental Indications for Medicines

Roughly one-fifth of supplemental indications were approved many years after a drug’s initial launch, many of which target populations with high unmet medical needs.

Dermoscopy Enables Early, Noninvasive Detection of ICI-Related Skin Toxicities in Melanoma

Immunotherapy-related skin adverse events may correlate with improved tumor response and survival, underlining their clinical significance.

End-of-Life Values and Value-Based Care

An editorial in response to the editor in chief’s December 2021 letter discusses evidence supporting the cost-effectiveness of an innovative advance care planning initiative.

Screening for Health Literacy, Social Determinants, and Discrimination in Health Plans

This study provides insight on the experiences of patients of a national health plan with 2 structural determinants of health—health care discrimination and health literacy—and how those interact with social determinants of health and patient demographics.

Avoiding Surgical Resection of Recurrent BRAF V600E–Mutated Iodine-Refractory Papillary Thyroid Cancer Involving Trachea/Thyroid Cartilage via Resensitization With Dabrafenib and Trametinib: Report of 3 Cases

High-Risk Care Management Impact on Medicaid ACO Utilization and Spending

In Massachusetts’ largest Medicaid accountable care organization (ACO), high-risk care management significantly reduced spending, emergency department visits, and hospitalizations, demonstrating that targeted strategies can manage health care costs amid budget constraints.

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.

Clinical and Economic Burden of Uncontrolled Severe Noneosinophilic Asthma

Among patients with severe asthma with low eosinophils untreated with biologics, there is a high burden of disease among those who have suboptimal disease control.

Social Determinants of Health and Emergency Department Utilization in Alabama Children’s Health Insurance Program

Community social determinants of health such as rurality and low socioeconomic status moderate the association between an individual’s race and emergency care use.

Employer-Sponsored Behavioral Health Program Impacts on Care Utilization and Cost

Provision 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.

Long-Chain Fatty Acid Oxidation Disorders and Current Management Strategies

Quality, Health, and Spending in Medicare Advantage and Traditional Medicare

In a review of literature published since the Affordable Care Act’s passage, more than half of analyses find that Medicare Advantage outperforms traditional Medicare on quality, health, and cost outcomes.

Insurance Payer Is Associated With Length of Stay After Traumatic Brain Injury

Among hospitalized patients with traumatic brain injury, Medicaid fee-for-service was associated with longer hospital stays than private insurance and Medicaid managed care organizations.

Is the QALY Fit for Purpose?

The quality-adjusted life-year (QALY) is a popular tool for value assessment but is flawed. This paper highlights potential solutions.

Appropriate ED Utilization Leading to Better Care Coordination

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

Contributor: Sustaining the “New Normal”—The Future Is Still Bright for Telehealth in the Wake of COVID-19

Consumers want telehealth and telehealth can help achieve organizational goals of avoiding unplanned care, closing care gaps, and achieving care targets.

Use of Second-Generation Antidiabetic Medication Among a Nationally Representative Sample

Among individuals with a diagnosis of type 2 diabetes across the United States, income level, hemoglobin A1c, and comorbidity burden were the primary patient-level drivers of the use of newer antidiabetic agents.

Toward Equitable Access to Cell and Gene Therapies: Rethinking Co-Payments

High co-payments for potentially curative cell and gene therapies create avoidable access barriers; value-based insurance design should eliminate patient cost sharing for these therapies.

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.

Patient Perceptions of In-home Urgent Care via Mobile Integrated Health

Comparing patients’ experiences with in-home urgent care from community paramedics vs urgent care provided in emergency departments, we found higher satisfaction among patients receiving in-home treatment.

Heart Failure Without a Reduced Ejection Fraction

Bimekizumab-bkzx, the Newest Psoriasis Treatment, Is Now Available

Bimekizumab-bkzx (Bimzelx) is the first dual interleukin 17A (IL-17A) and interleukin 17F (IL-17F) inhibitor to treat moderate-to-severe plaque psoriasis. It launches with a list price of $7200 per syringe.