Authors

Evaluating Proactive Outreach for Prior Authorization Recertifications in Medicaid Patients

Implementing a proactive provider outreach program resulted in significantly more prior authorization recertifications and a reduction in time to submission.

Hospitalization Patterns Among Older Patients With Cancer With and Without Dementia

Dementia was more prevalent in older patients with some cancer types, and comorbid dementia in this population was associated with unplanned or unnecessary hospitalization.

Whither CAR T? Will the FDA Being Under the Hood and the Availability of Bispecifics Make These Therapies Less Attractive?

Current Status and Influencing Factors of Nursing Interruption Events

This study investigated the current status of nursing interruption events and analyzed the time costs, priority of events, and factors influencing interruptions.

Behavior-Based Diabetes Management: Impact on Care, Hospitalizations, and Costs

The Diabetes Care Rewards program offers a business case for health plans to promote engagement through use of contingent incentives, thus improving health outcomes and lowering costs.

OTC Treatment Options for Pesky Summer Rashes

The American Skin Association estimated that 50 million Americans are exposed to urushiol yearly, the most common contact allergen in the United States.

Impact of Expanded Carrier Screening on Health Care Utilization

This study shows little evidence of harms or increased health care utilization for people receiving negative (normal) results of expanded carrier screening through genome sequencing.

Disparities in Physician Access for Rheumatology, Dermatology, and Gastroenterology: A Systematic Review

This article presents a systematic review of US health care disparities in physician specialist access across rheumatology, dermatology, and gastroenterology and a call to action.

Coverage With Evidence Development Study Shows Benefits in Patients With Migraine Treated With Remote Electrical Neuromodulation

A coverage with evidence development (CED) study demonstrated significant and clinically meaningful benefits in patients with migraine treated with remote electrical neuromodulation (REN). Health plans should support clinicians’ REN prescriptions by ensuring adequate coverage.

Agreement Among Measures Examining Low-Value Imaging for Low Back Pain

This study demonstrates the need for additional consensus surrounding how to translate guideline recommendations to administrative measures assessing imaging overuse for acute low back pain.

Current Status and Influencing Factors of Nursing Interruption Events

This study investigated the current status of nursing interruption events and analyzed the time costs, priority of events, and factors influencing interruptions.

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.

Development and Validation of the COVID-19 Hospitalized Patient Deterioration Index

The authors developed and validated an accurate, well-calibrated, easy-to-implement COVID-19 hospitalized patient deterioration index to identify patients at high or low risk of clinical deterioration.

Contributor: Empowering Endocrinologists With Technology for the Diagnosis, Management, and Treatment of NAFLD

In this column, an endocrinologist discusses the growing problem of liver disease and new options at their disposal, including vibration-controlled transient elastography.

Building Research Capacity in Primary Care Practices That Serve Predominantly Racial and Ethnic Minority Populations

The successful collaboration between a primary care–based network of practices and academic researchers demonstrates feasibility and the need for more funding for primary care research.

Small but Nimble: Measures Taken to Face the COVID-19 Pandemic in Small French Military Hospitals

Prioritization, interunit collaboration, esprit de corps, and health workers’ adaptability are key factors in providing a coherent response to the coronavirus disease 2019 pandemic.

A Kidney Diagnostic’s Impact on Physician Decision-making in Diabetic Kidney Disease

The KidneyIntelX test would affect primary care physician (PCP) decision-making, and PCPs would use the results of KidneyIntelX more than albuminuria and estimated glomerular filtration rate when making decisions about diabetic kidney disease management.

The Biosimilar Shift: Trending Infliximab Biosimilar Utilization and Associated Cost Savings for Commercial Insurance

Infliximab biosimilars created price competition causing insurance claims costs for infliximab originator and infliximab biosimilars to decrease, generating significant savings to the health care system.

Telemedicine Catches On: Changes in the Utilization of Telemedicine Services During the COVID-19 Pandemic

This analysis of health insurance claims data demonstrates rapid increase and sustained high utilization of telemedicine services during the COVID-19 pandemic.

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.

Potential Impact of Hospital at Home on Postoperative Readmissions

Many postoperative readmissions are amenable to diversion to a hospital at home program for surgical patients, representing an opportunity to generate revenue and improve patient experience.

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.

Assessment of Structured Data Elements for Social Risk Factors

An expert panel identified and assessed electronic health record and health information exchange structured data elements to support future development of social risk factor computable phenotyping.

Diabetes Associated With Higher Health Care Utilization and Poor Outcomes After COPD-Related Hospitalizations

Patients with diabetes and chronic obstructive pulmonary disease (COPD) have worse outcomes when hospitalized and appear to be more vulnerable to respiratory and nonrespiratory complications after a COPD exacerbation, which highlights the need for targeted interventions in this population.

Characterizing Telehealth Use in the US: Analysis of the 2022 Health Information National Trends Survey

Patients’ motivations for telehealth use require further investigation to develop appropriate policies.

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.

Patient-Centered Oncology Care: Impact on Utilization, Patient Experiences, and Quality

Practices implementing a patient-centered oncology care pilot had improved quality, but utilization and patient experiences did not differ from comparison practices.

Evaluating Smoking Cessation Service at an Emergency Department Clinical Observation Unit

This study aimed to evaluate the impact of a smoking cessation service in a group of patients admitted to a short-stay unit in the emergency department.

“Can You Hear Me Now?”: Postoperative Patient-Initiated Communication With Providers

Patient-provider communication after surgery is critical for patient safety. The growth of patient-provider communication technologies has created opportunities to study postoperative patient-initiated communication.

Association Between Use of Clinician Performance Information and Patient Experience

High patient experience scores were associated with the collection and use of any clinician performance information, especially with whether the practice shared this information internally to compare.