Authors

Association of Medicare Enrollment With Increased Inpatient Coding Intensity

Inpatient encounters for Medicare patients 65 years and older are associated with higher coding intensity compared with commercially insured, Medicaid, or self-pay hospitalizations for those same individuals prior to age 65 years.

Classifying Clinical Work Settings Using EHR Audit Logs: A Machine Learning Approach

An automated pipeline of frequency representation and machine learning models on raw electronic health record (EHR) audit logs can classify work settings based on clinical work activities.

Assessment of Structured Data Elements for Social Risk Factors

An expert panel identified and assessed electronic health record and health information exchange structured data elements to support future development of social risk factor computable phenotyping.

Does Missing Trust Lead to Overuse or Underuse of Health Care Services?

Most trust literature investigates missing trust and health care underuse. The authors show that mistrust also leads to health care overuse, a rapidly growing problem in the United States.

Oncology Alternative Payment Models: Lessons From Commercial Insurance

Developing alternative payment models for commercial populations in specialties such as oncology is rife with practical challenges. Leading payers and practices share lessons to date.

Geographical Access to Preferred Pharmacies in Medicare Part D

Many rural and urban areas lack preferred pharmacies. Where preferred pharmacies were available, distances were generally minimal relative to the cost savings; however, rural-urban disparities persist.

Access Denied: CMS’ Action Hurts Patients With Cancer in Rural America

CMS rules hindered the access of rural patients with cancer to medically integrated pharmacies in 2023. The authors discuss the impact on equity in health care, emphasizing the need for regulatory change.

Health Care Costs Associated With Unrecognized Progression to Late-Stage Kidney Disease

Unrecognized disease progression is associated with higher health care costs both for patients with end-stage kidney disease and late-stage (stages G4-G5) chronic kidney disease.

Comparing Breast Cancer Treatment Outcomes Between Fee-for-Service and Medicare Advantage

This study examined postdiagnosis breast cancer treatment outcomes for Medicare Advantage vs fee-for-service (FFS) Medicare in Ohio and found no significant differences overall but disparities for Black patients with FFS Medicare.

Service Line Care Delivery Model for COVID-19 Patient-Centric Care

The authors provide steps hospitals can take to align their care delivery model to effectively meet the demands of a public health crisis such as the current pandemic.

Older Adults’ Perspectives on Emergency Department Costs During COVID-19

Most older US adults have concerns about emergency department visit affordability. Lower income, being uninsured, poor or fair physical/mental health, and younger age were associated with increased concerns.

Preappointment Surveys and Reminder Calls to Improve Show Rate

Patients who completed a preappointment survey were significantly more likely to attend their clinic appointment than noncompleters and spent significantly less time in their appointment.

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.

Predicting Hospitalizations for Patients With Chronic Kidney Disease

The authors developed an algorithm that uses medical claims to identify patients with chronic kidney disease who are at greatest risk of being hospitalized within 90 days.

Cost-Benefit Analysis of Sacubitril/Valsartan in a Medicaid Population

The cost avoidance of heart failure–related hospitalizations and emergency department visits may outweigh the additional drug cost in Medicaid members adherent to sacubitril/valsartan.

Medicare Advantage Customer Service Is Used Most by Higher-Need Patients

Medicare Advantage customer service supports a less healthy, higher-need population, indicating that it should be designed and staffed to effectively serve complex, high-need patients.

Exploratory Study of Selected Stakeholder Insights Into Continuous Glucose Monitoring in T2D With Risk-Sharing Agreements

A small expert panel was selected to share professional experiences with risk-sharing agreements and advance the cost-effective utilization of continuous glucose monitoring–centered care in type 2 diabetes (T2D).

Out-of-Pocket Spending for Health Care After COVID-19 Hospitalization

For most patients who survive COVID-19 hospitalization, out-of-pocket spending within 180 days of discharge is modest. However, 1 in 10 have out-of-pocket spending exceeding $2000.

Why EOM Participation Was Extremely Low—and How to Fix It

Association of 340B Contract Pharmacy Growth With County-Level Characteristics

The growth of 340B contract pharmacies since 2010 is unprecedented. This study’s findings suggest that patterns of growth differ between safety-net clinics and hospitals.

Research Will Be Integral in Evaluating the Efficacy of Executive Order Regarding Homelessness: Jack Tsai, PhD, MSCP

Jack Tsai, PhD, MSCP, emphasized that comparing the methods of different jurisdictions can aid decision-making as the new executive order is enacted.

Hospital Stays and Probable Dementia as Predictors of Relocation to Long-Term Care Facilities

This article explores late-life relocations in patients with dementia, hospital stays, and their implications for health care policy, geriatric care, and future research priorities.

Exploratory Study of Selected Stakeholder Insights Into Continuous Glucose Monitoring in T2D With Risk-Sharing Agreements

A small expert panel was selected to share professional experiences with risk-sharing agreements and advance the cost-effective utilization of continuous glucose monitoring–centered care in type 2 diabetes (T2D).

Association of Travel Nursing With Quality Outcomes in Hospitalized Patients

Greater reliance on travel nurses may be associated with more hospital complications.

Have Racial Disparities in Home Dialysis Utilization Changed Over Time?

Medicare prospective payment for dialysis modestly increased availability and use of home-based dialysis treatment but did not affect historic racial disparities in home dialysis.

Care Transitions: Opportunities to Better Serve the Traveling Patient

The authors share a model that facilitates patient-centered care and can be adopted by other health systems to encourage successful care transitions for the traveling patient.

COVID-19 and Clinic Workflow Optimization Using Lean Six Sigma

The authors report an approach of outpatient clinic workflow reorganization utilizing simple, inexpensive measures to improve patient engagement and experience in addition to providing a safe setting for patients for clinic visits in the wake of COVID-19.

Contributor: Companies Can’t Afford a She-cession

As working women have been disproportionately impacted by COVID-19, solutions to address what has been coined a “she-cession” include targeted communications, flexible work schedules, and increased education/tutoring resources.