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Contributor: Navigating Health Equity in 2024: The Evolution of Accountability, Part 2

The article emphasizes the significance of accreditations in addressing health disparities and promoting health equity, highlighting programs for achieving accreditation and advocating for the integration of social determinants of health (SDOH) and health equity practices within pharmacy and health care.

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.

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.

Long-term Medication Adherence and Preventive vs Reactive Care Utilization Among Older Adults With Diabetes

This study using Medical Expenditure Panel Survey data found greater health care utilization and expenditure among adults 65 years and older who were adherent to oral hypoglycemic agents.

Impact of Primary Care Intensive Management on Medication Adherence and Adjustments

The Veterans Health Administration implemented primary care intensive management for high-risk patients. Impacts of this program on patients’ medication adherence and adjustments were modest.

Applying Upstream Problem-Solving to Value-Based Payment Reform in Specialty Care: Blue Cross Blue Shield of North Carolina’s Approach

Effectively designing and implementing value-based payment reform for specialty care is challenging. The authors describe a commercial payer’s strategic approach to specialty value transformation.

Legal Issues in Value-Based Care Contracts for Self-Insured Employers

Self-insured employers face regulatory challenges when adopting value-based contracts, requiring careful data governance, standardized metrics, and legal frameworks to align with federal value-based care models.

Mental Health Diagnoses and Services Utilization Vary by Wage Level

Insured lower-wage employees had lower prevalence of mental health conditions but greater severity, with more hospital admissions and emergency department visits than high-wage employees.

The Extent and Growth of Prior Authorization in Medicare Advantage

Prior authorization is a common utilization-management tool among Medicare Advantage plans. However, service-, area-, and carrier-level patterns suggest variation in how plans use prior authorization.

A Scoping Review of US Insurers’ Use of Patient-Reported Outcomes

This scoping review found 350 articles that discuss US health insurance providers’ use of patient-reported outcomes about health-related quality of life.

Avoiding Surgical Resection of Recurrent BRAF V600E–Mutated Iodine-Refractory Papillary Thyroid Cancer Involving Trachea/Thyroid Cartilage via Resensitization With Dabrafenib and Trametinib: Report of 3 Cases

Physician Prices and Low-Value Services: Evidence From General Internal Medicine

This study found extensive variation in general internal medicine physician prices and that high-priced physicians provided fewer low-value services but had higher spending on these services.

The Impact of HDHPs on Service Use and Spending for Substance Use Disorders

Offering a high-deductible health plan (HDHP) led to a 6.6% reduction in the probability of using substance use disorder services and a shift in spending from the plan to the enrollee.

The Relationship Between Preventive Dental Care and Overall Medical Expenditures

Using an instrumental variable approach, this study is the first to present causal estimates of the effect of preventive dental visits on overall medical expenditures.

Potential Impact of Loss of Coverage for Health Care Screenings: Constance Blunt, MD

Constance Blunt, MD, medical oncologist, Mary Bird Perkins Cancer Center, discusses the potential consequences of losing free health care screening coverage.

At-Home Hemoglobin A1c Testing During COVID-19 Improved Glycemic Control

Providing at-home hemoglobin A1c test kits increases testing rates and facilitates hemoglobin A1c reduction over time among members of a large commercial health plan with diabetes.

Participating Faculty: Rethinking Heart Failure: Patient Classification and Treatment

Investigating Real-world Consequences of Biases in Commonly Used Clinical Calculators

Clinical calculators that do not include demographic variables may be biased, and their equity should be understood in the context of clinical guidelines.

Assessing Opportunities to Advance Quality Measures in Adult Obesity

Obesity is a serious chronic disease and risk factor for a broad range of outcomes. This study identifies opportunities for improving quality in obesity care.

Implementing Clinical Informatics Tools for Primary Care–Based Diabetic Retinopathy Screening

The authors describe a primary care–based diabetic retinopathy screening program incorporating telemedicine, strong health information technology engagement, and development of clinical informatics tools.

Contributor: Maintaining the Doctor-Patient Connection During the COVID-19 Pandemic

Christine Ko, MD, professor of dermatology and pathology at Yale University, reflects on her use of telehealth and how it allowed her to establish and maintain emotional connections with her patients, all at high risk of skin cancer.

Limited English Proficiency, Cardiovascular Risk Factors, Cardiovascular Disease, and In-Hospital COVID-19 Outcomes

This study evaluated whether limited English proficiency modifies the association between cardiovascular risk factors or cardiovascular disease and outcomes in patients hospitalized with COVID-19.

Factors Associated With Persistent High Health Care Utilization in Managed Medicaid

Schizophrenia, chronic pain, and multiple medical diagnoses at enrollment into a large managed Medicaid system are associated with long-term high health care utilization.

Access to Consultative Dermatologic Care via Physician-to-Physician Asynchronous Outpatient Teledermatology

Direct access of primary care physicians to dermatologists via asynchronous teledermatology improves a health system’s ability to increase patient access to dermatologic care.

Noninvasive Ventilation at Home Reduces Mortality in COPD With CRF

This study explores the association between receiving noninvasive ventilation at home and mortality, hospitalizations, and emergency department visits in patients with chronic obstructive pulmonary disease (COPD) with chronic respiratory failure (CRF).

Chronic Overlapping Pain Conditions and Long-term Opioid Treatment

Little is known about opioid prescribing patterns in patients with chronic overlapping pain conditions. This study suggests target populations for interventions to manage chronic pain.

Impact of COVID-19 Pandemic on Accessibility of Taiwanese Medical Care

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.

Treatment Patterns for Patients With Advanced/Metastatic Cancers by Site of Care

Treatment patterns and overall survival were similar regardless of site of care between patients receiving anticancer therapy in the hospital outpatient vs physician office setting.

Care Management Improves Total Cost of Care for Patients With Dementia

Compared with usual care, a dementia care management program improved various cost of care and utilization metrics in a Medicare managed care population at 12 months.

Impact of the Patient-Centered Medical Home on Consistently High-Cost Patients

Patient-centered medical homes in Maryland’s multipayer demonstration disrupted the pattern of recurrently high expenditure among the costliest patients and improved continuity of care.