Live Webinar

A Look at PBM Reform and Transparency: Payer, Provider and Patient Impact

Hosted by AJMC, Managed Healthcare Executive, Pharmacy Times and PBMI

-- Days : -- HRS : -- MIN : -- SEC
Register Now →
Logo Image
  • News
  • Watch
  • Journals
  • Conferences
  • Events
  • Resources
  • CE
  • About AJMC
  • Subscribe

Authors

Stephanie Franklin, MPS, PMP
Latest Article

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.

Aqsa Mugal, BA
Latest Article

A Machine Learning Technology for Addressing Medication-Related Risk in Older, Multimorbid Patients

A 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.

Dilek Kiliç, PhD, RN
Latest Article

Effect of Home Care After Cardiac Surgery

A multidisciplinary approach and symptom management are both vital components of home care to provide continuity of care after cardiac surgery because they decrease symptoms and readmissions to the hospital and increase self-efficacy.

Kimberly Rath, PharmD

Kimberly Rath, PharmD, is a freelance health writer who previously worked as a clinical pharmacist with Elevance Health for a decade. She has also worked for Amerigroup and Sentara Group.

Latest Article

Meta-Analysis Supports RSV Vaccine Efficacy and Safety in Older Adults

New research highlights the effectiveness of RSV preF vaccines in preventing severe respiratory infections in older adults.

Carolyn B. Jasik, MD
Latest Article

The Value of Virtual Physical Therapy for Musculoskeletal Care

This counterfactual simulation study on a nationally representative sample of the working population with musculoskeletal conditions estimated the value of patient-initiated virtual physical therapy.

Lauren M. Zhao, BA
Latest Article

Two Steps Forward, One Step Back: 50 Years of Societal Value From LDL-C–Lowering Therapies

Low-density lipoprotein cholesterol (LDL-C)–lowering therapies have yielded significant value to society through reduced costs for both fatal and nonfatal cardiovascular disease events. The vast majority of this value has accrued to patients.

Michele Heisler, MD, MPH
Latest Article

Patient and Supporter Factors Affecting Engagement With Diabetes Telehealth

Family support with medication management and recent urgent self-management concerns are 2 novel factors, among others, that predict completion of diabetes telehealth calls.

Samyukta Singh, MHA
Latest Article

Assessing New York’s Health Care Disparities Using Health Plan Quality Data

Utilizing the Health Insurance Disparities Index for assessment, the authors found that New York’s Medicaid health maintenance organizations (HMOs) outperformed Medicaid HMOs nationally in addressing health care disparities from 2019 to 2023.

Colleen T. LaBelle, MSN, RN-BC
Latest Article

The Cost of Implementing and Sustaining the Massachusetts Model

This article presents a microcosting analysis of resources needed for the implementation and sustainment of the Massachusetts model evaluated in the PROUD trial.

Elizabeth A. Phelan, MD, MS
Latest Article

Utilization of Low- and High-Value Health Care by Individuals With and Without Cognitive Impairment

Low-value service utilization is common among all older adults, and utilization of some high-value services decreases after the onset of cognitive decline.

Ankita Kaushik, PhD
Latest Article

Real-World Value of Direct-Acting Antivirals for Hepatitis C at Kaiser Permanente Southern California

This analysis demonstrates value and innovation of direct-acting antivirals for the treatment of chronic hepatitis C in the US Kaiser Permanente health system.

Matthew A. Pappas, MD, MPH
Latest Article

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.

Lusine Poghosyan, PhD, MPH, RN
Latest Article

Primary Care Practice Structural Capabilities in Health Professional Shortage Areas

Nurse practitioners are increasingly meeting primary care demands in underserved areas and are more likely to deliver structural capabilities related to chronic disease management.

Lisa Tran, BS
Latest Article

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.

Charles D. Phillips, PhD, MPH
Latest Article

Longer Appointment Duration Reduces Future Missed Appointments in Safety-Net Clinics

Longer appointment duration was associated with lower likelihood of missed appointments for patients receiving care at a federally qualified health center network.

Catherine Madaffari, MD
Latest Article

Impact of Advance Care Planning Consults on Advance Directives Completion

Implementing advance care planning consults can increase advance directive completion rates. The authors demonstrate the impact of consults on completed advance directives in the medical record.

Emi Terasawa, PhD
Latest Article

Journey to Anticoagulant Access Following Payer Rejection of Apixaban

Formulary restrictions can create treatment barriers for patients with atrial fibrillation, including unnecessary delays in treatment and prescription abandonment, with vulnerable populations at greater risk.

Benjamin L. Castleman, EdD
Latest Article

A “Sludge Audit” for Health System Colorectal Cancer Screening Services

A systematic, mixed methods “sludge audit” identified novel health system delivery targets for improving colorectal cancer screening services.

Yasmeen Qahwash
Latest Article

From CAR T-Cell Therapy to ADCs: Tackling Oncology Access Gaps

Experts discussed innovations in oncology care, treatment access, pharmacy workflows, and patient outcomes.

Jianbo Li, PhD
Latest Article

Dialysis Costs for a Health System Participating in Value-Based Care

In a large, integrated health system participating in value-based care, higher costs and utilization were observed before and after unplanned dialysis initiation.

Thomas Lehmann, PhD
Latest Article

Clinical and Economic Outcomes of a Collaborative Cardiology Care Program

Patients with chronic cardiac conditions benefited from a health care program that strengthened collaboration between general practitioners and cardiology specialists in Baden-Wuerttemberg, Germany.

Milton Eder, PhD
Latest Article

Diabetes Care Quality: Do Large Medical Groups Perform Better?

Large medical groups perform better than medium- or small-sized groups on diabetes quality measures, perhaps because they have more care management processes in place.

Molly Candon, PhD
Latest Article

Trends in Acupuncture Billing by a Large Commercial Insurer

A large commercial insurer is increasingly covering acupuncture, which is a safe and effective alternative to opioids, for multiple pain conditions.

Devon M. Zoller, MD
Latest Article

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.

Reed Melton, MBA
Latest Article

Value-Based Management of Specialty Drugs: Practical Considerations and Implications for Pharmacy

Policy 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.

Ann E. Erwin, MMHS
Latest Article

Utilization by High-Cost, High-Need Medicaid Patients Receiving Social Worker Care Coordination

Complex Medicaid patients randomly assigned to receive outpatient social worker care coordination services experienced increased hospitalizations but no differences in emergency department visits or costs.

Valinda Rutledge, MBA
Latest Article

Medicare APMs at a Crossroads

To 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.

Elise Atkinson, BS
Latest Article

Telehealth Use in 2022 Among US Adults by Sexual Orientation

In a 2022 survey representative of US adults, sexual minority individuals reported greater rates of telehealth use, especially for mental health visits, than heterosexual individuals.

Justin E. Bekelman, MD
Latest Article

Trends in Low-Value Cancer Care During the COVID-19 Pandemic

Among 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.

Priscilla Smith, PharmD, BS, BCPPS
Latest Article

Charitable Medication Distribution Improves Care for Uninsured Patients With Diabetes

This report illustrates how providing vital diabetes medications to uninsured patients through a charitable medication distributor improves clinical outcomes.