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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.

Cardiovascular Disease Risk Management During COVID-19: In-Person vs Virtual Visits

This article compares cardiovascular disease risk management in community clinics during the COVID-19 pandemic among patients for whom primary care was delivered mostly in person vs mostly virtually.

Knowledge, Attitude, and Practices Regarding ChatGPT Among Health Care Professionals

This web-based cross-sectional study indicated that health care professionals in China had poor knowledge, positive attitudes, and proactive practices in regard to ChatGPT.

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.

Features of Health Care Interventions Associated With Reduced Services and Spending

This study identifies several factors shared by locally defined delivery system innovations that have been shown to reduce service use and lower health care spending.

An Accelerated Hospital Observation Pathway to Reduce Length of Stay for Patients With COVID-19

For select patients hospitalized due to COVID-19, an academic urban hospital implemented an observation pathway that incorporated mobile health technology, reducing hospital length of stay by more than 2 days.

Non–Face-to-Face Care Management and Service Utilization in Patients With Diabetes

CMS began reimbursement for non–face-to-face chronic care management in 2015, and results from Louisiana show that it increases outpatient visits but decreases inpatient and emergency department encounters.

Health Plan Switching and Satisfaction in a Medicaid MLTSS Program

Health plan dissatisfaction was higher among Medicaid managed long-term services and supports (MLTSS) beneficiaries who did not follow through with an intention to change health plans.

Hypoglycemia Upon Hospital Admission From Long-term Care: Health Care Resource Use

This analysis of a hospital billing database describes inpatient length of stay, intensive care unit length of stay, comorbidities, and costs for patients with diabetes after admission with hypoglycemia from long-term care or home.

CMS Needs to Rethink How Medicare Assesses Quality

Late 2020 changes make accountable care organizations a canary in the coal mine.

Using Telemedicine Interventions During COVID-19 to Expand Care Post COVID-19

The Patient-Centered Rheumatology Collaborative identified several critical areas for further intervention to improve the delivery of high-quality, patient-centered care during the COVID-19 pandemic and beyond.

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.

Health Care Utilization in Veterans With Alzheimer Disease

Veterans with Alzheimer disease (AD), identified using clinical notes, have higher health care utilization than veterans without AD.

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

Association Between 340B Contract Pharmacy Growth and Payer-Specific Drug Coverage

340B covered entities are expanding contracts with retail pharmacies that are increasingly located in counties with high rates of Medicare and Medicaid insurance coverage.

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.

Cost of Behavioral Messaging Interventions for Cardiovascular Medication Adherence

This article evaluates the programmatic cost of 3 behavioral mobile messaging interventions aimed at improving cardiovascular medication adherence in The Nudge Study.

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.