The AJMC® Medicare compendium is a comprehensive resource for clinical news and expert insights on issues that affect Medicare beneficiaries with a focus on polypharmacy, reimbursement challenges, and other topics related to seniors.
Updated Clinical Practice Guidelines for CDI Show Improved Outcomes, but Adherence Issues Remain
October 25th 2022Improved outcomes associated with fidaxomicin compared with vancomycin suggest benefits from its greater use in Medicare patients, although uptake remains low despite its recommended use.
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Panel Reviews Health Inequities and Opportunities for Innovation Through Population Health Delivery
September 30th 2022A panel discussion at the 70th Annual Roy A. Bowers Pharmaceutical Conference addressed recent care delivery initiatives in New Jersey that aim to address health inequities and other population health concerns.
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Contributor: How Medication Risk Scores Improve Health for Medicare Beneficiaries
July 27th 2022Medication risk scores analyze an individual’s medication regimen to look for the potential for simultaneous, multi-drug interactions, which can cause adverse drug events and other medication-related harms.
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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.
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Contributor: Technology, Supplemental Services in MA Can Help Improve Participant Health
July 10th 2022Social determinants of health present many health-related challenges for Medicare Advantage (MA) plan members, something these plans are looking to overcome by diversifying their service offerings.
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CMS Announces OCM Successor, but Gap Year Remains for Oncology Practices
June 27th 2022Today, CMS unveiled its plan for a successor to the Oncology Care Model (OCM), its ambitious foray into value-based care delivery that has been credited with changing the landscape for patients with cancer, even if it received mixed reviews on achieving savings in its early years.
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Thyme Care: A Human Touch in Cancer Care, Guided by Technology
June 23rd 2022Oncologist and health tech veteran Bobby Green, MD, who practiced for 17 years in Florida and was previously with Flatiron, is now Thyme Care’s president and chief medical officer. He has relocated to Nashville, Tennessee, to launch Thyme Care.
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Influenza vaccine uptake improved among Medicare Advantage enrollees when influenza vaccination was introduced as a performance metric in Medicare star ratings and accompanying bonus payments.
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Health Care Access, Preventive Care Similar in MA and TM for Low-Income Adults
June 9th 2022The analysis of adults with low income enrolled in Medicare Advantage (MA) or traditional Medicare (TM) indicates that increasing enrollment in MA may not advance health equity in the Medicare program.
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ACO REACH Brings Next Era of Medicare Payment Models
June 9th 2022The Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model provides the next great opportunity in moving a health care payment system toward paying for value and rewarding preventive care and keeping patients healthy.
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Integrating Analytics With High-Touch Pharmacy Care for Vulnerable Beneficiaries
May 8th 2022UPMC Health Plan, RxAnte, and Mosaic Pharmacy Services outlined how they are operating a value-based pharmacy care management program within Community HealthChoices, Pennsylvania’s managed Medicaid long-term services and supports (LTSS) program, at a recent conference.
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Contributor: Reform Medicare’s Payment Policy to Expand Patient Access to Nonopioids
April 17th 2022Addressing the opioid crisis will require a strong, multifaceted approach that includes efforts to prevent addiction before it begins. By passing the NOPAIN Act, Congress can seize the win-win opportunity to reduce unnecessary exposure to opioids, while protecting—and expanding—a patient’s right to choose their own care.
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