Review of CMS’ coverage with evidence development program exposes a need to improve program transparency and clarify requirements and timetables for reporting to improve access to novel therapies.
A navigation program demonstrated decreased odds of repeat emergency department (ED) visits in patients with low baseline ED utilization and increased odds of follow-up primary care appointments.
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.
This study presents an integrated, exploratory assessment of physical activity, patient activation, health-related quality of life, and clinical outcomes among older adults with type 2 diabetes (T2D) using survey, wellness, and claims data.
The COVID-19 pandemic disrupted access to routine medical care in community populations in Taiwan. The unmet needs should be emphasized as normal life resumes.
A survey was conducted to determine opportunities to aid primary care providers and patients in the difficult journey of an oncology patient.
An early heart failure follow-up intervention succeeded in increasing referral to and completion of cardiology appointments within 7 days of discharge. The intervention was associated with lower risk of 30-day all-cause emergency department visits, all-cause hospitalizations, or death.
High-tier generic drug placement in Medicare Part D has increased over time, but it may be related to a drug’s clinical profile and availability of substitutes rather than preferred brand-name drug coverage.
Projected savings from biosimilars from 2021 to 2025 were $38.4 billion vs conditions as of quarter 4 of 2020 and were driven by new biosimilar entry. Savings were $124.5 billion under an upper-bound scenario.
The authors examine the origin, benefits, and challenges of pragmatic clinical trials to assess the ultimate value of this research design.
This study evaluates the cost-effectiveness and budget impact to US payers of point-of-care nucleic acid amplification tests (NAAT) for group A streptococcus.
A Medicaid managed care organization developed a machine learning model to identify opioid use disorder (OUD) risk factors and predict OUD incidence in its multistate population.
Drs Steven Levine, Patricia Ares-Romero, Samuel Nordberg, Martin Rosenzweig, and Carrie Jardine share insight on the future treatment landscape for TRD.
Work relative value units (wRVUs) correlate with operative duration of common surgical procedures. Reimbursement for physicians depending on wRVUs is fair for commonly performed surgeries.
The authors detail how population health management enables health systems to promote public health, strengthen health system resiliency, and support financial recovery during and beyond coronavirus disease 2019 (COVID-19).
The incidence of respiratory syncytial virus (RSV)–positive acute respiratory infection (ARI) was found to be significant in the period prior to the COVID-19 pandemic in older adults.
The risk-adjusted 1-year mortality rate was not different between Medicare Advantage and traditional Medicare beneficiaries with kidney failure who initiated dialysis.
This article proposes a new model, Public-Primary ACP, that leverages coordination between primary care and public health workforces to improve delivery of advance care planning.
This review describes the impact of nonmedical switching of biologic therapies on US patients and providers, with a focus on switching to in-class alternatives.
Our hospital is a primary hospital in Chengdu, China. Since February 5, our hospital has been listed as the primary designated medical unit for treating new patients with coronavirus disease 2019 (COVID-19) in Jinniu District. In this letter, we share our COVID-19 experience with readers.
Small practices reduced their use of telemedicine during early stages of the COVID-19 pandemic. Technical support may help expand and maintain telemedicine in small practices.
Coronavirus disease 2019 (COVID-19) was associated with immediate weekly visit trend decreases for overall, primary care, and specialty care with long-term recovery trends; transformation to virtual visits; and increasing long-term trends for meeting patient scheduling and visit needs.
This study describes determinants affecting disease control and inhaled glucocorticosteroid therapy adherence for patients with asthma in western China.
Large medical groups perform better than medium- or small-sized groups on diabetes quality measures, perhaps because they have more care management processes in place.
Inspira Care Connect, LLC, an accountable care organization, incorporated transitional care management services into its postdischarge follow-up process to prevent avoidable utilization of health care services and costs.
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.
With a rapid shift to telehealth during the coronavirus disease 2019 (COVID-19) pandemic, clinicians, health care organizations, and policy makers must consider and address patients’ evolving needs, concerns, and expectations.
Medicaid managed care network adequacy standards exhibit significant heterogeneity across regions and specialties, potentially creating large variations in health care access and quality.
In cardiovascular clinics during COVID-19, notable barriers to successful telehealth use included obtaining diagnostic information needed to deliver high-quality care and technology-related challenges for patients.