Authors

Factors That Increase Utilization Management Risk: A Proof of Concept

A score was developed to measure patient risk from payer utilization management policies and its relationship to real-world US commercial payer utilization management policies.

Pharmacist Hypertension Management Using an Electronic Health Record–Based Approach

The authors studied the impact of a pharmacist intervention on blood pressure control compared with usual care.

Implementation and Cost Validation of a Real-time Benefit Tool

This study evaluates impact of a real-time benefit tool on medication access and physician and pharmacy workflows at a large academic medical center.

The Strategic Necessity of Pharma-MedTech Convergence in an Era of Precision Medicine

Better integration of pharma and medical technology is necessary to enhance patient outcomes and drive value-based care.

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.

Patient-Centered Communication and Outcomes in Heart Failure

Among community patients living with heart failure, excellent and good patient-centered communication was associated with a reduced risk of death.

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.

Timely Preterm-Birth Prediction Among Pregnant Women in Medicaid Without Preterm-Birth History

A novel prediction model is developed that accurately predicts preterm birth in a timely manner among pregnant women in Medicaid without preterm-birth history.

Contributor: 5 Lessons on Health Equity From the Fight Against HIV/AIDS in Africa

Abner Mason, CEO and founder of ConsejoSano, highlights how lessons learned from his early days in the fight against HIV and AIDS in Africa can inform improvements in health equity, especially in light of the COVID-19 pandemic.

Optimizing Revisit Intervals: Reducing Variability to Enhance Health Care Efficiency

The authors explore the limitations of the current system of revisit interval assignment and discuss the importance of standardization to optimize patient health care outcomes.

Social Determinants of Health and Emergency Department Utilization in Alabama Children’s Health Insurance Program

Community social determinants of health such as rurality and low socioeconomic status moderate the association between an individual’s race and emergency care use.

Linking Data to Determine Risk for 30-Day Readmissions in Dementia

This study found that certain characteristics in linked electronic health record data across episodes of care can help identify patients with Alzheimer disease and related dementias at high risk of 30-day readmissions.

Bundled Payment Impacts Uptake of Prescribed Home Health Care

The Comprehensive Care for Joint Replacement Model mitigated a trend of lower home health uptake for Black and White patients but not for other populations.

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.

Evolent’s Wonsettler Sees Outcomes-Based Reimbursement as “A Healthy Tool”

Terra Wonsettler, PharmD, MBA, vice president of pharmacy for Evolent, discusses the recent HHS OIG report that stemmed from the 2021 FDA approval of aducanumab (Aduhelm) and use of the accelerated approval pathway.

Telehealth Intervention by Pharmacists Collaboratively Enhances Hypertension Management and Outcomes

Patient interaction and enhanced support with clinical pharmacists significantly improved pass rates for a measure of controlling blood pressure compared with usual care.

Inpatient-Outpatient Shared Electronic Health Records: Telemedicine and Laboratory Follow-up After Hospital Discharge

Using a seamlessly shared inpatient-outpatient electronic health record was associated with greater rates of postdischarge follow-up delivered through telemedicine or laboratory monitoring and without an in-person office visit.

Effective Prevention and Management of COVID-19 in Outpatient Hemodialysis Patients

The authors introduce a mobile phone app that may effectively prevent and manage coronavirus disease 2019 (COVID-19) in outpatient hemodialysis patients in Sichuan Province, China.

Linking Data to Determine Risk for 30-Day Readmissions in Dementia

This study found that certain characteristics in linked electronic health record data across episodes of care can help identify patients with Alzheimer disease and related dementias at high risk of 30-day readmissions.

Impact of Medicaid Institution for Mental Diseases Exclusion on Serious Mental Illness Outcomes

Medicaid’s Institution for Mental Diseases (IMD) rule bars federal funding for psychiatric facilities with more than 16 beds, but findings indicate that state waivers allowing treatment of serious mental illness in IMDs do not increase overall psychiatric hospitalizations.

Why ASCO Is a Must-Attend Event for Oncologists Worldwide

Leaders in oncology share why the American Society of Clinical Oncology (ASCO) meeting remains a top global gathering for breakthroughs, networking, and lifelong learning.

Impacts of Community-Based Care Program on Health Care Utilization and Cost

A community-based care management program in Rhode Island reduced hospitalizations and inpatient costs. There were stark differences across subgroups based on intensity of care.

Local Implementation of the National Opioid Settlements: Challenges and Opportunities

The authors examined experiences with Pennsylvania’s implementation of opioid settlement funds, identifying 7 themes and highlighting opportunities to improve administration and ensure effective fund distribution.

Collaborative Innovation: Flatiron Health and Canopy Partner to Streamline Continuous Care for Oncology Practices

Navigating Compounded Semaglutide: What Health Care Providers Need to Know

This article reviews the safety, efficacy, and regulatory concerns related to compounded semaglutide, with a focus on how health care providers can offer guidance and education to patients.

Collaborative Innovation: Flatiron Health and Canopy Partner to Streamline Continuous Care for Oncology Practices

Continuity of Opioid Prescribing Among Older Adults on Long-term Opioids

Among older adults with chronic noncancer pain on long-term opioid therapy, greater continuity of opioid prescribing was significantly associated with fewer opioid-related adverse outcomes.

Increased Likelihood of Psychiatric Readmission With Medicaid Expansion vs Legacy Coverage

Individuals who became eligible for Medicaid through Medicaid expansion have an increased likelihood of psychiatric readmission compared with their legacy-enrolled counterparts.

Patient and Physician Perceptions of a Hypercholesterolemia Safety-Net Program

Patients’ misperceptions of statins and physicians’ limited knowledge of a hypercholesterolemia safety-net program warrant additional interventions to reduce barriers and improve care.

The Lost Decade: Clinical Trials Data Access After Seife v HHS

Seife v HHS is, at the very least, a symbolically important decision, but its practical impact will be dampened if the government does not take steps to enforce it.