Authors

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.

Geographical Variation in Kidney Function Testing and Associations With Health Care Costs Among Patients With Chronic Kidney Disease and Type 2 Diabetes

Utilization and Costs Among Oncologists Participating in a Private Insurance Shared Savings Model

A private oncology shared savings plan reduced colon cancer treatment costs. Results varied by tumor, with none in breast cancer and mixed effects in lung cancer.

Diagnosis and Management of TRK Fusion Cancer

Risk Assessments of Drug-Related Problems for Cardiac Surgery Patients

Risk assessments of drug-related problems for cardiac surgery patients can be conducted by implementing a framework for patient safety.

Variation in Fracture Risk Estimation Among East Asian Women

Fracture prediction tools for East Asian individuals vary by country. In the United States, the US-Asian Fracture Risk Assessment Tool provides hip fracture probabilities that correspond to observed estimates.

Reduced Medical Spending Associated With Integrated Pharmacy Benefits

Members covered by an integrated pharmacy benefit (as opposed to a pharmacy carve-out) experienced slower growth in medical spending.

Using a Brief Tool to Assess Healthy School Environments: A Pilot Study

The authors evaluated a brief assessment tool that accountable care organizations can use to help elementary schools improve student nutrition and increase physical activity.

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.

Measuring the Effectiveness and Value of Virtual Health Care

The authors call for the collection and use of data on virtual health care to shape an informed and thoughtful approach to telehealth payment that equitably serves all stakeholders.

Determinants of ICS Therapy Adherence in Patients With Asthma

This study describes determinants affecting disease control and inhaled glucocorticosteroid therapy adherence for patients with asthma in western China.

Participating Faculty: The Course and Management of Interstitial Lung Diseases

Provider and Patient Insights Into the Cancer Care Journey

A survey was conducted to determine opportunities to aid primary care providers and patients in the difficult journey of an oncology patient.

Interventional Analytics in Skilled Nursing Facilities Associated With Reduced Readmissions

A retrospective analysis of 30-day risk-adjusted readmission rates among skilled nursing facilities (SNFs) between 2017 and 2022 compared those that had implemented an interventional analytics platform and other SNFs.

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.

Impact of Payment Models on Medical Specialist Physician Practice Patterns

This article explores the impact of payment models (fee for service vs salary based) on practice patterns, including wait times and care for patients with chronic diseases.

The Role of Advanced Technologies in Improving Diabetes Outcomes

This article reviews underlying barriers to health care access and discusses how a value-based diabetes care model could improve patient outcomes and reduce long-term costs.

Influence of Prior Authorization Requirements on Provider Clinical Decision-Making

An online survey identified that documentation requirements and communication issues with health plans are associated with providers modifying clinical decisions to avoid medication prior authorization.

Increasing Medicare Annual Wellness Visits in Accountable Care Organizations

Through innovations increasing the ease of scheduling and the efficiency of conducting annual wellness visits (AWVs), a large Medicare accountable care organization has been able to increase AWV rates among eligible beneficiaries.

ACA Medicaid Expansion Association With Racial Disparity Reductions in Timely Cancer Treatment

Medicaid expansion was associated with a reduction in the racial disparity in timely treatment of patients with advanced cancer in the United States.

Inpatient-Outpatient Shared Electronic Health Records: Telemedicine and Laboratory Follow-up After Hospital Discharge

Using a seamlessly shared inpatient-outpatient electronic health record was associated with greater rates of postdischarge follow-up delivered through telemedicine or laboratory monitoring and without an in-person office visit.

Pharmacist Hypertension Management Using an Electronic Health Record–Based Approach

The authors studied the impact of a pharmacist intervention on blood pressure control compared with usual care.

Potential Health Literacy Resources for Health Plans: A Narrative Review

Several evidence-based health literacy resources may be beneficial in health plan settings to improve organizational health literacy, personal health literacy, and health equity.

Clinical and Economic Outcomes of a Collaborative Cardiology Care Program

Patients with chronic cardiac conditions benefited from a health care program that strengthened collaboration between general practitioners and cardiology specialists in Baden-Wuerttemberg, Germany.

Value-Based Management of Specialty Drugs: Practical Considerations and Implications for Pharmacy

Policy makers and health plans seek value-based management of specialty drugs. This study examines real-world factors that favor some approaches over others and their potential impact.

Opportunities for Advancing Alopecia Areata Care Through Equitable Access

ACE Inhibitor or ARB Treatment Among Patients With Diabetes and Chronic Kidney Disease

Impact of Medical Care Coordination Intervention on Patient Activation

This observational evaluation compared an adult medical care coordination intervention with usual care and found that the intervention was associated with significant improvements in patient activation.

High-Need Beneficiary Enrollment Patterns in Medicare Advantage and Traditional Medicare

Accounting for 32% of all Medicare enrollees in 2019, high-need beneficiaries were more likely to be in traditional Medicare than Medicare Advantage.