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Integrating Predictive Models Into Care: Facilitating Informed Decision-Making and Communicating Equity IssuesAs predictive models proliferate, providers and decision makers require accessible information to guide their use. Preventing and combating bias must also be priorities in model development and in communication with providers and decision makers.
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An Outpatient Critical Care Transition Clinic Model Reduces Admissions/Readmissions in Medically Complex PatientsCritical care transition clinic patients with chronic conditions had a 31% reduction in relative risk for inpatient admissions, and the clinic reduced cost by more than $1 million.
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Managing Total Knee Replacement Under Value-Based PaymentsThis 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.
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Enhanced Prophylactic Regimen Reduces Skin AEs With Amivantamab-Lazertinib: Byoung Chul Cho, MD, PhDByoung Chul Cho, MD, PhD, of the Yonsei University College of Medicine, discussed outcomes in the COCOON trial of an enhanced dermatologic regimen with amivantamab-lazertinib treatment.
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Medication Persistence and Its Impact on Type 2 DiabetesMost newly treated patients with type 2 diabetes exhibit suboptimal medication persistence, which is associated with higher risk of hospitalization and increased medical costs.
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Long-Term Health Care Costs Following COVID-19: Implications for Pandemic PreparednessA difference-in-differences analysis of health care claims data evaluated excess health care costs in the 12 months following COVID-19 diagnosis among the general and older adult populations.
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Reducing Delays in Breast Cancer Care Using an Innovative Digital Health PlatformThe use of a novel digital health platform achieved a 55% reduction in time to treatment among women with a new diagnosis of breast cancer.
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Contributor: Medicare Policy Proposal Jeopardizes Care for Those on DialysisCEOs of 3 kidney care organizations explain flaws in CMS' recent reimbursement proposal.
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Insurer Costs of COVID-19 by Disease Severity and DurationPayer costs for COVID-19 ranged from a mean of $505 for asymptomatic cases to $126,094 for severe cases with post–COVID-19 condition.
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Modeling Financial Outcomes and Quantifying Risk in Episode-Based Payment ModelsThis article provides a description of prospective financial simulation methodology and use cases with empirical data for episode-based bundled payments, including implications for contract negotiations and value-based care redesign.
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COVID-19 Vaccine Hesitancy and Health Literacy in US Southern StatesCOVID-19 vaccine hesitancy is not associated with health literacy. Personal perception of threat was associated with reduced vaccine hesitancy.
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Kansas City’s TB Outbreak Can Be Contained With the Lessons From COVID-19In this final interview clip, Michael A. Bernstein, MD, stresses the need for effective communication and proactive screening to contain the ongoing tuberculosis (TB) outbreak in Kansas City.
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Follow-Up and Monitoring: Proactive Strategies for Long-Term Patient Engagement After Hidradenitis Suppurativa DiagnosisPanelists discuss the critical role of effective follow-up and multidisciplinary care in managing hidradenitis suppurativa, emphasizing ongoing patient education, coordinated referrals, and personalized treatment plans to improve adherence and long-term outcomes.
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Provider Capacity During Medicaid Expansion and a Public Health EmergencyThis survey study finds that most Missouri Medicaid providers had capacity for new patients, even during a period of unprecedented Medicaid enrollment growth.
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Contributor: Roadmap to the Quadruple Aim—A Framework for Minimizing Physician Burnout During the Transition to Value-Based CareAs provider and payer organizations pursue the Quadruple Aim, it is important that they take into account not just the contracting but also the transformation in staffing, clinical workflows, and culture as these organizations evolve.
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Affordable Care Act Enrollment in Texas After Rating Area AdjustmentsRural marketplace rating area change in Texas did not increase enrollment but increased share of enrollment in gold plans.
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ASCO 2024 and Beyond: Addressing NSCLC Unmet Needs and Future Research DirectionsJason Porter, MD, provides concluding insights on the LAURA phase 3 trial, CHRYSALIS-2 study, TROPION-Lung05 trial, and CheckMate 9LA study, along with other notable findings from the ASCO 2024 conference.
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Understanding the Complexities of Equity Within the Emergence and Utilization of AI in Academic Medical CentersThis editorial discusses positions for academic medical centers to consider when designing and implementing artificial intelligence (AI) tools.
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Reimbursement for Genetic Variant Reinterpretation: Five Questions Payers Should AskPeriodic reinterpretation of genetic sequencing results presents a challenge for developing transparent and systematic coverage and reimbursement policies.
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Glucose-Lowering Treatment Patterns in Patients With Diabetic Kidney DiseaseReal-world treatment of diabetic kidney disease in the United States, based on national-level health care claims and electronic health records data, is inconsistent with the current guidelines.
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Actions to Improve Quality: Results From a National Hospital SurveyHospitals reported widespread adoption of quality improvement (QI) changes to improve on CMS quality measures, and QI adoption was associated with improved performance on quality measures.
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Characterizing Telehealth Use in the US: Analysis of the 2022 Health Information National Trends SurveyPatients’ motivations for telehealth use require further investigation to develop appropriate policies.
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Q&A: Dr Michael Ashley Stein Speaks on How Natural Disasters Can Affect Disabled IndividualsMichael Ashley Stein, PhD, JD, speaks about how disabled individuals are at a disadvantage when it comes to preparing for natural disasters, specifically during wildfires.
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Adherence Patterns 1 Year After Initiation of SGLT2 Inhibitors: Results of a National Cohort StudyThis article describes the trajectory of adherence patterns among users of sodium-glucose cotransporter 2 (SGLT2) inhibitors. The authors found that baseline factors were unable to predict the adherence trajectory groups.
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Organizational Factors Associated With Variation in Primary Care Providers in ACOsA higher percentage of accountable care organization (ACO) primary care providers was associated with physician leadership, upside financial risk, and financial compensation of physicians tied to performance measures.
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Real-World Value of Direct-Acting Antivirals for Hepatitis C at Kaiser Permanente Southern CaliforniaThis analysis demonstrates value and innovation of direct-acting antivirals for the treatment of chronic hepatitis C in the US Kaiser Permanente health system.
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Telehealth User Experiences During COVID-19: A Case Study of Outpatient Cardiovascular Clinics Affiliated With a Large Academic PracticeIn 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.
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Budget Impact Analysis of Biosimilar Natalizumab in the USProjected savings from biosimilar natalizumab were $452,611 over 3 years, driven by decreased drug acquisition costs and a utilization shift from reference to biosimilar natalizumab.
