Authors
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Implementing Multistate Behavioral Health Pay-for-Performance Initiatives in Medicaid Managed CareThe authors describe a pay-for-performance initiative targeting behavioral health providers, which was introduced by a large Medicaid managed care organization across multiple states.
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The Relationship Between the Follow-up to Discharge Ratio and Length of StayThe objective was to evaluate the correlation between the follow-up to discharge ratio and average length of stay.
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Value-Based Management of Specialty Drugs: Practical Considerations and Implications for PharmacyPolicy makers and health plans seek value-based management of specialty drugs. This study examines real-world factors that favor some approaches over others and their potential impact.
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Care Coordination Engagement Patterns in Long-Term PatientsCare coordination engagement increases over time in long-term high-cost, high-need patients, with no identifiable data-driven times for when to initiate patient care de-escalation.
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Medicare APMs at a CrossroadsTo be sustainable and successful, Medicare alternative payment models (APMs) have to attract and retain high and low performers. That requires a different approach to pricing and evaluation.
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Telehealth Use in 2022 Among US Adults by Sexual OrientationIn a 2022 survey representative of US adults, sexual minority individuals reported greater rates of telehealth use, especially for mental health visits, than heterosexual individuals.
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Trends in Low-Value Cancer Care During the COVID-19 PandemicAmong adults with newly diagnosed cancer, rates of low-value cancer services persisted throughout the COVID-19 pandemic in areas ranging from peridiagnosis imaging to end-of-life care.
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Charitable Medication Distribution Improves Care for Uninsured Patients With DiabetesThis report illustrates how providing vital diabetes medications to uninsured patients through a charitable medication distributor improves clinical outcomes.
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Chemotherapy-Induced Peripheral Neuropathy in Metastatic Breast Cancer Patients Initiating Intravenous Paclitaxel/nab-PaclitaxelWe examine the incidence and impact of chemotherapy induced peripheral neuropathy on clinical and economic outcomes in women with metastatic breast cancer initiating intravenous paclitaxel/nab-paclitaxel.
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Incorporating Health IT Into Primary Care TransformationLongitudinal evaluation of an advanced primary care reform effort found some improvements in health information technology (IT) offerings and use as well as opportunities to improve future collaboration.
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Care Fragmentation Predicts 90-Day Durable Ventricular Assist Device OutcomesThis analysis evaluates the relationship between hospital care delivery network fragmentation and in-hospital and 90-day outcomes. These networks may be novel targets for improving outcomes.
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Predictors of Discharge From the VA Caregiver Support ProgramThe year of application predicts discharge from the Department of Veterans Affairs (VA) caregiver program. Unexpected, disallowed criteria also predict discharge, with significant others facing higher discharge risk than spouses.
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A Machine Learning Technology for Addressing Medication-Related Risk in Older, Multimorbid PatientsA novel machine learning system effectively stratifies emergency department use and hospitalization risk of older patients with multimorbidity who take multiple medications and provides appropriate medication recommendations.
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A Strategy to Promote Population-Wide Life Satisfaction While Advancing EquityThe authors used health care claims and survey data to identify a strategy that might promote life satisfaction while advancing equity in an insured population.
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Empiric Segmentation of High-risk Patients: A Structured Literature ReviewData-driven segmentation of high-risk patient populations may inform health system interventions, but results are dependent on the data sources and methods applied.
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Differences in Spending for Diabetes and Multiple Chronic Conditions in Michigan Medicare BeneficiariesDiabetes and multiple chronic conditions increase overall Medicare spending, but spending increases even more in minority beneficiaries compared with White beneficiaries with similar comorbidity combinations.
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Mental Health Service Utilization Review Patterns in a Medicaid Managed Care ProgramMedicaid 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.
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Navigation and Clinician Payment Investments Enhance Colorectal Cancer Screening BenefitsInvesting in patient navigation and clinician incentives ensures colorectal cancer screening completion, improves early detection, reduces disparities, achieves cost savings, and advances population health for all stakeholders.
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The PANDEMIC Framework for Encouraging COVID-19 VaccinationsThis commentary offers 8 promising approaches forming a framework known as PANDEMIC to address COVID-19 vaccination hesitancy.
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Health Care Costs Associated With Unrecognized Progression to Late-Stage Kidney DiseaseUnrecognized disease progression is associated with higher health care costs both for patients with end-stage kidney disease and late-stage (stages G4-G5) chronic kidney disease.
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CMS Practice Assessment Tool Validity for Alternative Payment ModelsUsing 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.
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Economic Burden of Nonadherence to Standards of Diabetes CareUsing propensity score matching in a US nationally representative sample, authors found the effect of nonadherence to diabetes guidelines on health care expenditures of patients with diabetes.
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Impact of Including Drug Spending in Oncology Alternative Payment ModelsThis study demonstrates a method for understanding the effects of drug spending in the design of alternative payment models.
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Primary Care Referrals to Nephrology in Patients With Advanced Kidney DiseasePrimary care physicians did not refer the majority of patients with severe nephropathy to specialists; nonreferred patients had fewer comorbidities and might be better kidney transplant candidates.
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Future of PrEPExperts in HIV provide closing thoughts on the future of PrEP, including improvement of uptake and addressing access disparities.
