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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.

Patient Perceptions of In-home Urgent Care via Mobile Integrated Health

Comparing patients’ experiences with in-home urgent care from community paramedics vs urgent care provided in emergency departments, we found higher satisfaction among patients receiving in-home treatment.

Changes in Marketplace Competition and Television Advertising by Insurers

This study provides the first evidence on how Marketplace insurers are altering their marketing in response to changes in competitive pressure over time.

Reducing Medical Costs Through Innovative Treatment for Chronic Kidney Disease

Food Insecurity, Neighborhood, and Health Care Utilization in Health System Adults

This retrospective study examined food insecurity and neighborhood disadvantage in health system patients as predictors of acute health care utilization.

Efficacy of Oral Semaglutide: Overview of the PIONEER Clinical Trial Program and Implications for Managed Care

Primary Care Case Conferences to Mitigate Social Determinants of Health: A Case Study From One FQHC System

This article describes perceived benefits, facilitators, and challenges of conducting interprofessional team case conferences in primary care settings to address patients’ complex social needs.

Prevention and Management of COVID-19 in Hemodialysis Centers

This article gives recommendations for individual hemodialysis centers worldwide to ensure the safety and effectiveness of patients receiving maintenance hemodialysis based on the experience of such a patient with coronavirus disease 2019 (COVID-19) in the Sichuan province of China.

Overdiagnosis of Adult ADHD Is Exacerbating the Stimulant Shortage

The authors argue that the stimulant shortage is being perpetuated by the overdiagnosis of attention-deficit/hyperactivity disorder (ADHD) in adults because executive functioning deficits are not included in diagnostic criteria.

Impact of the Collaborative Care Model on Medical Spending

Modest spending on integrated mental health services in primary care, facilitated by use of new collaborative care billing codes, did not increase overall health care costs.

AHA Telemetry Guidelines Improve Telemetry Utilization in the Inpatient Setting

Using Plan-Do-Study-Act cycles, the studied intervention reduced hospital inpatient telemetry time by 51.25% while increasing American Heart Association (AHA) guideline–based usage.

A Comparison of Administrative Claims–Based Risk Predictors for Pediatric Asthma

A comparison of claims-based asthma risk predictors in a national sample of children with Medicaid determines accuracy and informs risk predictor choice.

Decreasing Primary Care Use and Blood Pressure Monitoring During COVID-19

Among a group of primary care accountable care organizations, patients with hypertension were 50% less likely to have a blood pressure recorded in April compared with February.

Economic Burden of Osteoporotic Fractures: The Tip of the Iceberg?

The economic burden of osteoporotic fractures may be much higher than estimated: just the tip of the iceberg. In this letter, we suggest that the cost of these fractures might be underestimated by considering only direct medical cost.

Practice Radiation Patterns Among Oncologists in the Oncology Care Model

Despite the potential incentives for medical oncologists to reduce radiation therapy utilization under the Oncology Care Model, we find no evidence that such reduction occurred.

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.

Provider Capacity During Medicaid Expansion and a Public Health Emergency

This survey study finds that most Missouri Medicaid providers had capacity for new patients, even during a period of unprecedented Medicaid enrollment growth.

The Relationship Between the Follow-up to Discharge Ratio and Length of Stay

The objective was to evaluate the correlation between the follow-up to discharge ratio and average length of stay.

Actions to Improve Quality: Results From a National Hospital Survey

Hospitals reported widespread adoption of quality improvement (QI) changes to improve on CMS quality measures, and QI adoption was associated with improved performance on quality measures.

Care Coordination in Primary Care: Mapping the Territory

A survey completed by 100% of leaders of diverse care systems in Minnesota participating in an observational study showed little difference in approach to care coordination.

Antihyperglycemic Treatment Patterns for Chronic Kidney Disease and Type 2 Diabetes

This study characterized antihyperglycemic medication use after chronic kidney disease onset among patients with type 2 diabetes to uncover potential unmet needs in clinical practice.

Discharge Before Noon: Is the Sun Half Up or Half Down?

Discharge before noon was associated with longer length of stay in patients with medical diagnoses and shorter length of stay in surgical patients.

Characterizing Obesity in a Large Health Care Delivery System.

The prevalence of obesity in the Sutter Health system between 2015 and 2020 was 35%. Differences by race/ethnicity, health insurance, smoking status, and comorbidities were examined.

Medication Adherence Star Ratings Measures, Health Care Resource Utilization, and Cost

For patients prescribed diabetes, hypertension, and hyperlipidemia medications, nonadherence to CMS Star Ratings quality measures of medication adherence was associated with increased health care resource utilization and costs.

Study Details Prediabetes, MACE Link

Patients with prediabetes are at significantly higher risk of major cardiovascular events than those who have never had high blood sugar.

Contributor: Solving the US Physician Diversity Problem

The representation of Black physicians is alarmingly low, but the opportunities for change are possible and urgent. Health care leaders and human resource departments need to address these disparities, and increasing diversity among their workforce is an excellent place to begin.

Time to Publication of Cost-effectiveness Analyses for Medical Devices

This study examines the availability of cost-effectiveness analyses for medical devices, both in terms of the number of studies and when studies are published.

Predictors of and Barriers to Receipt of Advance Premium Tax Credits

Few eligible individuals apply for the Advance Premium Tax Credit due to knowledge barriers. Additionally, specific sociodemographic characteristics appear to predict applying status.

Impact of Medical Care Coordination Intervention on Patient Activation

This observational evaluation compared an adult medical care coordination intervention with usual care and found that the intervention was associated with significant improvements in patient activation.

Development of a Medicare Plan Dashboard to Promote Health Equity

Health plans use data to decide on quality improvement initiatives. Having a dashboard that characterizes how equitably plans are serving their enrollees would promote health equity.