Authors

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.

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.

Contributor: Medicare’s ACO Model Begins, Kidney Care Cannot Be Left Behind

As CKCC nears its sunset, kidney care leaders urge CMS to preserve a dedicated, nephrologist-led accountable care model for advanced kidney disease.

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.