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Impact of the Patient-Centered Medical Home on Consistently High-Cost Patients

Patient-centered medical homes in Maryland’s multipayer demonstration disrupted the pattern of recurrently high expenditure among the costliest patients and improved continuity of care.

Medical Costs for Managing Chronic Kidney Disease and Related Complications in Patients With Chronic Kidney Disease and Type 2 Diabetes

Psoriatic Arthritis Treatment Patterns and Costs Among Pharmacologic Treatment–Naïve Patients

We present results of an analysis of IBM MarketScan databases that evaluates treatment patterns and health care costs for treatment-naïve patients with psoriatic arthritis.

PQA Annual Meeting: Quality Emerges From the Pandemic, Focused on Access and Equity

The Pharmacy Quality Alliance's 2022 annual meeting will return to an in-person format after 2 years. The meeting with include timely topics: quality beyond the pandemic, health equity, and remote care

A Learning Health Care Community: Integrating Research and Practice at Scale

This article presents a case study of how stakeholders in one state came together to integrate practice and research that is a step beyond a learning health care system.

Out-of-Pocket Costs for Diabetes Medications in Employer-Sponsored Health Insurance Plans

Out-of-pocket costs of diabetes medications other than insulin can be quite high for individuals with employer-sponsored health insurance.

Understanding Insurance Coverage Policies for Incretin Mimetics for Weight Management

The high cost of incretin mimetics for weight management limits insurance coverage and potentiates variation in utilization management strategies to control near-term spending.

Remote Monitoring Saves Costs in Outpatient Negative Pressure Wound Therapy

Health insurance records of patients using negative pressure wound therapy (NPWT) revealed lower adjusted 90-day wound-related costs with remote therapy monitoring vs NPWT alone.

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.

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.

Utilization Management and Physician Burnout

This survey assesses physician experiences with utilization management and burnout and investigates whether there is a link between them.

Challenges of Fracture Risk Assessment in Asian and Black Women

Differences in bone density and FRAX fracture risk scores among Black and Asian women yield greater discordance in fracture risk estimation compared with White women.

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.

Impact of Delayed Adoption of Novel Atrial Fibrillation Treatments

Using direct oral anticoagulants as a case study, the authors examined how delayed adoption of novel treatments could impact patient health outcomes and cost.

Approaches for Overcoming Barriers to Cross-Sector Data Sharing

The authors identified challenges to cross-sector data sharing and the approaches used to overcome these challenges in the Mid-Ohio Farmacy, a partnership to address food insecurity.

Hospital Outcomes of Male Breast Cancer in the United States

This is the first study to estimate the hospital lengths of stay and costs of male breast cancer at the US population level.

Medicare Advantage Coverage Restrictions for the Costliest Physician-Administered Drugs

Four large Medicare Advantage insurers manage access to expensive physician-administered drugs with a combination of prior authorization, step therapy, and Part D formulary design.

Behavior-Based Diabetes Management: Impact on Care, Hospitalizations, and Costs

The Diabetes Care Rewards program offers a business case for health plans to promote engagement through use of contingent incentives, thus improving health outcomes and lowering costs.

Association Between Interhospital Care Fragmentation, Readmission Diagnosis, and Outcomes

In this analysis of the National Readmissions Database, the authors investigated the association between interhospital fragmentation of care, reason for readmission, and patient outcomes.

Potential Health Literacy Resources for Health Plans: A Narrative Review

Several evidence-based health literacy resources may be beneficial in health plan settings to improve organizational health literacy, personal health literacy, and health equity.

Making Obesity Care Affordable: Patient Views on Deprescribing GLP-1 RAs

Most surveyed individuals with obesity support lower-cost options for weight maintenance, which would allow better coverage for injectable incretin mimetics for weight management during active weight loss.

Inappropriate Wrist MRI: Did Guidelines Have an Impact?

This article analyzes the use of MRI in a national sample of patients with wrist pain before and after consensus guideline publication.

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.

Contributor: Addressing Physician Burnout—Work-Life Balance and Traditional Workplace Improvement Interventions

Initiatives to address physician burnout should be prioritized in a post-pandemic world, with physician shortages affecting the country.

Covishield India: Demystifying Myths Through an Early Multicenter Safety Study

This was a multicenter study carried out in India to study the adverse and systemic effects of the indigenously developed Covishield vaccine.

Telehealth User Experiences During COVID-19: A Case Study of Outpatient Cardiovascular Clinics Affiliated With a Large Academic Practice

In cardiovascular clinics during COVID-19, notable barriers to successful telehealth use included obtaining diagnostic information needed to deliver high-quality care and technology-related challenges for patients.

Managing Total Knee Replacement Under Value-Based Payments

This article describes the approach that a large primary care group at risk for value-based payments chose to deploy in managing clinical and financial outcomes of knee osteoarthritis jointly with orthopedic surgeons.

Value Realization: An Unattained Challenge for Integrated Practice Units

As value realization eludes integrated practice units (IPUs), the authors examine 6 key value drivers for IPU teams to competitively drive volumes and hone their multidisciplinary competencies.

Subjective and Objective Impacts of Ambulatory AI Scribes

Although the vast majority of physicians using an artificial intelligence (AI) scribe perceived a reduction in documentation time, those with the most actual time savings had higher relative baseline levels of documentation time.

Reply to “Industry-Informed Perspectives on the Benefits of Rideshare-Based Medical Transportation”

The authors of “Rideshare Transportation to Health Care: Evidence From a Medicaid Implementation” respond to a letter to the editor.