Authors

COVID-19 and MCO-Community Partnerships to Address Enrollee Social Needs

COVID-19 strained already-burdened community partners, affecting service delivery, communication, and partnerships. Managed care organization (MCO) partnerships with these organizations evolved in response to changing needs and resources.

Flash CGM Associated With Event Reduction in Nonintensive Diabetes Therapy

Analysis of the MarketScan database showed a strong association between flash continuous glucose monitoring (CGM) use and significant reductions in diabetes-related events and hospitalizations in a cohort of 10,282 adults with type 2 diabetes.

Novel Blood-Based Early Cancer Detection: Diagnostics in Development

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.

A Kidney Diagnostic’s Impact on Physician Decision-making in Diabetic Kidney Disease

The KidneyIntelX test would affect primary care physician (PCP) decision-making, and PCPs would use the results of KidneyIntelX more than albuminuria and estimated glomerular filtration rate when making decisions about diabetic kidney disease management.

Real-World Users of Triple Therapy for Asthma in the US

This retrospective cohort study evaluated baseline demographics, clinical characteristics, and treatment patterns of US patients with asthma who newly initiated single- or multiple-inhaler triple therapy.

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.

How Value-Based Care With Provider Enablement Improves Maternal and Infant Outcomes in Medicaid

Supported value-based care improves prenatal care while reducing neonatal intensive care unit stays, preterm birth rates, low birth weight rates, and costs for mothers and infants.

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 Patterns and Stress Testing Trends After Implementing High-Sensitivity Troponin Assay

This study found that switching from a conventional troponin assay to a high-sensitivity troponin assay resulted in changes to diagnosis patterns and stress testing trends.

Availability of Off-Marketplace Plans With Lower Premiums for Higher-Income Families

Off-marketplace plans are widely available, and individuals with higher incomes can obtain silver plans with low premiums off-marketplace.

Responsibility for Treating Tobacco Dependence in Health Clinics Serving Medicaid Enrollees

This article describes the implementation of Medicaid smoking cessation guidance in a large, urban federally qualified health center to examine how state-level provisions translated into clinic-level policies.

Trends in Sepsis and Pneumonia During COVID-19: Lessons From BPCIA

The authors analyzed cost and utilization changes for sepsis and pneumonia non–COVID-19 episodes prior to and during the pandemic, and during the pandemic for patients with and without COVID-19.

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.

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.

Real-world Usage of Bevacizumab-bvzr Biosimilar in US Oncology Practice

Real-world adoption of bevacizumab-bvzr biosimilar was retrospectively assessed, revealing switching between biosimilars and the reference product and utilization in extrapolated indications and combination regimens.

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.

Medigap Enrollment Patterns Before and After Ban on New Medigap Plan F Enrollment

Medigap Plan F enrollment has declined since it was closed to new beneficiaries in 2020. The percentage of individual Medigap enrollees relative to non–dually eligible traditional Medicare beneficiaries increased from 2013-2024.

Contributor: Despite Updated NCCC Guidelines, More Action Is Needed to Address Diabetes Care Equity

Experts weigh in on the recently updated National Clinical Care Commission (NCCC) recommendation to improve diabetes prevention and care in the United States.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.