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Evaluation of a Pediatric Asthma High-risk Scoring Algorithm

An asthma risk score using 7 clinically relevant parameters evaluated in a pediatric Medicaid managed care population can stratify risk for following-year asthma hospitalization.

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.

Longitudinal, Relationship-Based Case Management: A Prospective Cohort Trial

A longitudinal, relationship-based case management approach significantly reduced health care costs and improved quality of life for Medicaid enrollees with complex needs over 1 year.

Workforce Innovation Reduces Medicaid Costs in Chronic Care

This study of community health workers as clinical extenders demonstrates significant cost savings in managing chronic conditions among Medicaid beneficiaries.

Economic Burden of Joint Disease in Psoriasis: US Claims Analysis

This retrospective claims analysis found that concomitant joint disease in psoriasis is associated with greater health care resource utilization and health care costs than psoriasis alone.

Impact of Travel Distance on Quality Outcomes in Colorectal Cancer

This study identified characteristics of patients with colorectal cancer who traveled farther for surgery and found that those who traveled tended to stay longer at the hospital.

Contributor: An Urgent Call to Action as Colorectal Cancer Rates Skyrocket Among Young People

As rates of CRC skyrocket in young individuals, means of addressing the growing problem must be considered.

Value-Based Care Interventions and Management of CKD Progression

Patients with chronic kidney disease (CKD) stages 3b or 4 experienced slower decline in estimated glomerular filtration rate 20 months after enrollment in a value-based kidney care program.

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.

Mental Health Service Utilization Review Patterns in a Medicaid Managed Care Program

Medicaid managed care utilization review data for mental health services were analyzed for the calendar years 2017 and 2018. These data indicate low rates of utilization review denials for both inpatient and outpatient mental health services.

Medicaid ACOs and Managed Care: A Tale of 2 States

This article presents a detailed descriptive analysis of how Massachusetts and Minnesota implemented Medicaid accountable care organization (ACO) models for their managed care population.

Geographic Variability of Medicaid Acceptance Among Allergists in the US

The proportion of allergists accepting Medicaid in the US varied significantly among and within states.

Payment Incentives and the Use of Higher-Cost Drugs: A Retrospective Cohort Analysis of Intravenous Iron in the Medicare Population

During a period of rapid fluctuation in the intravenous iron market, there was increased use of a more expensive drug that afforded providers additional revenue.

Differences in Spending for Diabetes and Multiple Chronic Conditions in Michigan Medicare Beneficiaries

Diabetes and multiple chronic conditions increase overall Medicare spending, but spending increases even more in minority beneficiaries compared with White beneficiaries with similar comorbidity combinations.

The Implementation of Opioid Prescribing Report Cards in Medicaid Managed Care: A Community Quality Collaborative

This article describes the Philadelphia Medicaid Opioid Prescribing Initiative that was launched by a multidisciplinary team and mailed local Medicaid providers individualized prescribing report cards.

Dosage and Outcomes in a Complex Care Intervention

Associations between intervention dosage and hospital use outcomes were observed among patients enrolled in a care management program serving individuals with complex needs.

Endoscopy Underuse for New-Onset Iron Deficiency Anemia in Younger Veterans

Bidirectional endoscopy (upper endoscopy and colonoscopy) was underutilized in the evaluation of new-onset iron deficiency anemia in younger veterans from 2005 to 2019.

Prolonged Cessation of Chronic Opioid Analgesic Therapy: A Multidisciplinary Intervention

This article evaluates the immediate and long-term efficacy of a group multidisciplinary program for chronic opioid analgesic therapy cessation in the setting of chronic, noncancer pain.

Longitudinal, Relationship-Based Case Management: A Prospective Cohort Trial

A longitudinal, relationship-based case management approach significantly reduced health care costs and improved quality of life for Medicaid enrollees with complex needs over 1 year.

Safety vs Price in the Generic Drug Market: Metformin

The generic drug market focuses on price. However, multiple generic metformin drugs have been recalled due to poor drug quality. The authors examine price and quality after these recalls.

Assessing the Impact of Transplant Case Management on Clinical Outcomes

This article examines the effect of a transplant case management program on clinical outcomes following transplant surgery.

Scaling Early Palliative Care in Value-Based Community Oncology: A Technology-Enabled Approach

Adolescent Anterior Cruciate Ligament Reconstruction: A Decade of Rising Surgical Cost

Adolescent anterior cruciate ligament reconstruction surgery can preserve health and restore function of the knee joint, but the surgical cost has outpaced inflation.

Impact of the Collaborative Care Model on Medical Spending

Modest spending on integrated mental health services in primary care, facilitated by use of new collaborative care billing codes, did not increase overall health care costs.

Variation in Early Diffusion of Sacubitril/Valsartan and Implications for Understanding Novel Drug Diffusion

Rates of sacubitril/valsartan diffusion have been slow and there has been significant geographic variation, highlighting the importance of local prescribing patterns in early drug diffusion.

Building Trust: Public Priorities for Health Care AI Labeling

A Michigan-based deliberative study found strong public support for patient-informed artificial intelligence (AI) labeling in health care, emphasizing transparency, privacy, equity, and safety to build trust.

Diagnosis Patterns and Stress Testing Trends After Implementing High-Sensitivity Troponin Assay

This study found that switching from a conventional troponin assay to a high-sensitivity troponin assay resulted in changes to diagnosis patterns and stress testing trends.

HEDIS Glycemic Goal Achieved Using Control-IQ Technology

A greater proportion of patients with type 1 diabetes who used automated insulin delivery systems vs multiple daily injections achieved the Healthcare Effectiveness Data and Information Set (HEDIS) glycemic measure.

Primary Care Redesign and Care Fragmentation Among Medicare Beneficiaries

This article examines the association between a large-scale primary care redesign—the Comprehensive Primary Care Plus Initiative—and ambulatory care patterns of Medicare beneficiaries with highly fragmented care.

Service Line Care Delivery Model for COVID-19 Patient-Centric Care

The authors provide steps hospitals can take to align their care delivery model to effectively meet the demands of a public health crisis such as the current pandemic.