The American Journal of Managed Care > May 2015
The American Journal of Managed Care - May 2015
May 21, 2015 – Ann M. Annis, MPH, RN; Jodi Summers Holtrop, PhD, MCHES; Min Tao, PhD; Hsiu-Ching Chang, PhD; and Zhehui Luo, PhD
The authors compared targeting strategies and characteristics of chronic disease care management programs delivered by primary care practices with one administered by a large health plan.
May 22, 2015 – Christine K. Cassel, MD, President and CEO, National Quality Forum
A discussion on meaningful measurement and driving greater value in healthcare, and the role of the National Quality Forum.
May 14, 2015 – Brigham R. Frandsen, PhD; Karen E. Joynt, MD, MPH; James B. Rebitzer, PhD; and Ashish K. Jha, MD, MPH
Increased care fragmentation among chronically ill, commercially insured patients is associated with higher costs and lower quality of care.
May 21, 2015 – Rainu Kaushal, MD, MPH; Alison Edwards, MStat; and Lisa M. Kern, MD, MPH
Use of specialist visits decreased by patients whose primary care physicians transformed their practices into patient-centered medical homes, 1 year after medical home implementation.
May 21, 2015 – Soeren Mattke, MD, DSc; Aparna Higgins, MA; and Robert Brook, MD, ScD
This study shows that health plans use chronic care management programs as standard components of the overall approach to manage the health of their members.
TRENDS FROM THE FIELD
May 18, 2015 – Kavita Patel, MD, MS; Andrea Thoumi, MSc; Jeffrey Nadel, BA; John O'Shea, MD, MPA; and Mark McClellan, MD, PhD
The authors examine 4 alternative payment models for oncology care that shift away from fee-for-service and move progressively toward greater bundling, either across providers or across payments.
June 03, 2015 – Heather Black, PhD; Rodalyn Gonzalez, BA; Chantel Priolo, MPH; Marilyn M. Schapira, MD, MPH; Seema S. Sonnad, PhD; C. William Hanson III, MD; Curtis P. Langlotz, MD, PhD; John T. Howell, MD; and Andrea J. Apter, MD, MSc
A qualitative study of patient and provider perspectives regarding the after-visit summary and the patient portal features of the electronic health record.
Innovative Care Models for High-Cost Medicare Beneficiaries: Delivery System and Payment Reform to Accelerate Adoption
June 05, 2015 – Karen Davis, PhD, APN; Christine Buttorff, PhD; Bruce Leff, MD; Quincy M. Samus, PhD; Sarah Szanton, PhD, APN; Jennifer L. Wolff, PhD; and Farhan Bandeali, MSPH
This paper illustrates how Medicare Advantage plans and accountable care organizations could benefit from adopting innovative care delivery models, and suggests policy changes to accelerate spread.
June 06, 2015 – Elham Hatef, MD, MPH; Bruce G. Vanderver, MD, MPH; Peter Fagan, PhD; Michael Albert, MD; and Miriam Alexander, MD, MPH
We assessed challenges and barriers to annual diabetic eye examinations for a managed care Medicaid population and make recommendations to improve population-level screening.
June 16, 2015 – Oluwatobi Awele Ogbechie, MD, MBA; and John Hsu, MD, MBA, MSCE
A systematic review of insurance benefit designs with differential cost sharing for substitute prescription drugs.
June 17, 2015 – Rozalina G. McCoy, MD; Yuanhui Zhang, PhD; Jeph Herrin, PhD; Brian T. Denton, PhD; Jennifer E. Mason, PhD; Victor M. Montori, MD; Steven A. Smith, MD; Nilay D. Shah, PhD
Glycemic control can lower the risk of diabetes-related complications, and delayed treatment intensification can impede optimal diabetes care.This study examines trends in hyperglycemia treatment intensification between 2002 and 2010.
June 17, 2015 – Monica A. Fisher, PhD, DDS, MPH, MS; and Zhen-qiang Ma, MD, MPH, MS
Medicaid-insured type 2 diabetes mellitus patients, just like the uninsured, are more likely to be hospitalized through emergency/urgent admissions.
June 23, 2015 – Chapin White, PhD; Suthira Taychakhoonavudh, PhD; Rohan Parikh, MS; and Luisa Franzini, PhD
Variation in private spending reflects the ability of the local population to pay for healthcare, whereas variation in Medicare is more driven by health status.
June 26, 2015 – Ann-Marie Rosland, MD, MS; Sarah L. Krein, PhD, RN; Hyungjin Myra Kim, ScD; Clinton L. Greenstone, MD; Adam Tremblay, MD; David Ratz, MS; Darcy Saffar, MPH; and Eve A. Kerr, MD, MPH
Commonly used measures of performance for assessing patient access do not reflect PCMH-encouraged strategies to improve access that may be preferentially used by part-time physicians.