Authors

Review Finds Poor Outcomes, Limited Predictive Tools in MASH Cirrhosis

MASH cirrhosis carries high risks of death, decompensation, and liver cancer—especially with type 2 diabetes—while predictive tools remain limited.

Insurer Costs of COVID-19 by Disease Severity and Duration

Payer costs for COVID-19 ranged from a mean of $505 for asymptomatic cases to $126,094 for severe cases with post–COVID-19 condition.

Cost-effectiveness of a 3-Year Tele-Messaging Intervention for Positive Airway Pressure Use

Long-term tele-messaging was more effective than no messaging and short-term messaging for positive airway pressure use, and it was highly likely to be cost-effective with an acceptable willingness-to-pay threshold.

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.

Medicare Advantage–Pharmacy Partnership Improves Influenza and Pneumococcal Vaccination Rates

Patients whose pharmacy receives notification of their immunization gap have twice the odds of receiving immunizations compared with those whose pharmacy does not receive the notification.

Predicting Drug-Drug and Drug-Gene Interactions in a Community Pharmacy Population

The probability of drug interactions increases when genetic polymorphisms are considered, indicating that pharmacogenetic assessment may be useful in predicting the presence and severity of interactions.

Pharmacist-Driven SMART Formulary Improves Pharmacoequity

A large academic medical center implemented a charitable care formulary with clinical pharmacist oversight, which resulted in more efficient usage of funds and fewer readmissions.

Machine Intelligence for Early Targeted Precision Management and Response to Outbreaks of Respiratory Infections

This paper evaluates novel machine intelligence to predict patients at risk of severe respiratory infections and recommend postacute care providers likely to reduce infection risk.

Evaluating Alternative Methods of Comparing Antihypertensive Treatment Intensity

Medication dose captures modification of hypertension treatment intensity more precisely than medication count, and this measure should be preferred in studies that aim to improve hypertension management.

Transition-to-Dialysis Planning, Health Care Use, and Mortality in End-Stage Renal Disease

A planned transition to dialysis was associated with improved outcomes and lower mortality. These findings may inform care coordination policies for end-stage renal disease.

Using Natural Language Processing to Classify Social Work Interventions

Natural language processing can be used for automated extraction of social work interventions from electronic health records, thereby supporting social work staffing and resource allocation decisions.

Billing for Tobacco Cessation: Enhancing Data Quality and Revenue Capture

Outpatient electronic health records at an academic medical center showed that only 1% of visits by tobacco users were associated with a bill for cessation counseling.

Contributor: Value-Based Care Isn’t Broken. Its Structure Is.

Experts outline 4 roles within the value-based care ecosystem that will make it more cohesive and effective for patients.

Evaluation of Institutional Practices for Medication Access for Uninsured Patients

The authors assessed charitable care spending for a 1-month supply of medications at discharge. One-third of the cost was spent on medications for which a more sustainable coverage method exists.

Financial Navigation: Lessons From a Program in Practice

Increased Payments to Medicare Advantage Plans for Dually Eligible Beneficiaries

Increasing Medicare Advantage payments for full Medicaid enrollees was not associated with meaningful changes in inpatient or nursing home use.

Biosimilar Interchangeability and Substitution in the US: What Comes Next?

Changing the FDA biosimilar interchangeability standards is a necessary but likely insufficient step to improve biosimilar competition in the US.

Timely Preterm-Birth Prediction Among Pregnant Women in Medicaid Without Preterm-Birth History

A novel prediction model is developed that accurately predicts preterm birth in a timely manner among pregnant women in Medicaid without preterm-birth history.

The “New” New Normal: Changes in Telemedicine Utilization Since COVID-19

Telemedicine utilization has declined since the peak of the COVID-19 pandemic, but non–primary care specialties continue to see an increase in moderate- and high-complexity telemedicine visits.

Biosimilar Adoption and Provider Performance in Medicare Value-Based Payment Models

Evidence suggests that adoption of oncology biosimilars in Medicare value-based payment models has produced substantial cost savings and improved provider financial performance.

Teamwork Enhances Patient Experience: Linking TEAM and Net Promoter Scores

In 1386 providers, better teamwork related to higher patient Net Promoter Score (NPS), and the relationship between provider experience and NPS was mediated by teamwork.

Hospital Discharge Diagnosis Position: Impact on Adult Pneumonia Burden Estimates

Disease burden estimates of pneumonia-associated hospitalizations are more sensitive when including pneumonia coded in any diagnosis field vs in only the first discharge diagnosis field.

Providing Patients With Cancer Access to Affordable Housing During Treatment

Patients traveling for cancer treatment often incur financial burdens. The members of the Alliance of Dedicated Cancer Centers should play a role in mitigating housing-associated costs for patients during cancer treatment.

Impact of Including Drug Spending in Oncology Alternative Payment Models

This study demonstrates a method for understanding the effects of drug spending in the design of alternative payment models.

Challenges Faced by Medicaid Managed Care Coordinators Working With Members With Substance Use Disorder

Accessing medical and social resources for patients, heavy administrative burden, and lack of data integration are barriers to Medicaid managed care organization care coordinators’ job performance.

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.

Exploratory Study of Selected Stakeholder Insights Into Continuous Glucose Monitoring in T2D With Risk-Sharing Agreements

A small expert panel was selected to share professional experiences with risk-sharing agreements and advance the cost-effective utilization of continuous glucose monitoring–centered care in type 2 diabetes (T2D).

Impact of Food Affordability on Diabetes-Related Preventable Hospitalization

Medicaid enrollees residing in counties with greater food affordability had lower odds of preventable hospitalization related to diabetes.

Prevalence, Resource Utilization, and Economic Impact of Kidney Function and Proteinuria in Patients With Focal Segmental Glomerulosclerosis

CMS Practice Assessment Tool Validity for Alternative Payment Models

Using data from 632 primary care practices, the authors show that the CMS Practice Assessment Tool has adequate predictive validity for participation in alternative payment models.