The American Journal of Managed Care > July 2018
The American Journal of Managed Care - July 2018
July 19, 2018 – Yamini Kalidindi, MHA; Jeah Jung, PhD; and Roger Feldman, PhD
Spending on chemotherapy drugs was lower among Medicare beneficiaries who received chemotherapy in hospital outpatient departments than among comparable beneficiaries receiving chemotherapy in physician offices.
July 20, 2018 – Kateryna Karimova, MSc; Lorenz Uhlmann, MSc; Marc Hammer, MPH; Corina Guethlin, PhD; Ferdinand M. Gerlach, MD, MPH; and Martin Beyer, MSc
This study compared general practitioner–centered healthcare (Hausarztzentrierte Versorgung [HZV]) with non-HZV healthcare in Germany regarding the development of diabetes complications. HZV is associated with reduced risk of diabetes complications.
July 18, 2018 – Bruce W. Sherman, MD, and Carol Addy, MD, MMSc
Socioeconomic status may significantly influence enrollee response to value-based benefit design approaches. Evaluating the association of wage status with claims experience may yield actionable insights.
Insights on Site-of-Care Cancer Research: Both Quality and Cost Information Are Necessary to Guide Policy
July 19, 2018 – Kavita Patel, MD, MPH, and A. Mark Fendrick, MD
The implementation of alternative payment models that successfully capture clinical heterogeneity—without adding unacceptable levels of administrative complexity—may be equally (if not more) important than site-neutral payment policies.
July 19, 2018 – Ammarah Mahmud, MPH; Justin W. Timbie, PhD; Rosalie Malsberger, MS; Claude M. Setodji, PhD; Amii Kress, PhD; Liisa Hiatt, MS; Peter Mendel, PhD; and Katherine L. Kahn, MD
We examine utilization, quality, and expenditures among Medicare beneficiaries receiving care at federally qualified health centers and compare outcomes among those attributed to 1 of 3 recognition programs versus none.
TRENDS FROM THE FIELD
July 20, 2018 – Julius L. Chen, PhD; Andrew L. Hicks, MS; and Michael E. Chernew, PhD
For a set of common physician services, employer-sponsored Medicare Advantage plans are found to pay prices that are similar to traditional Medicare rates.
July 16, 2018 – Mariétou H. Ouayogodé, PhD; Ellen Meara, PhD; Chiang-Hua Chang, PhD; Stephanie R. Raymond, BA; Julie P.W. Bynum, MD, MPH; Valerie A. Lewis, PhD; and Carrie H. Colla, PhD
This article compares clinical and utilization profiles of Medicare patients who are attributed to provider groups with those of patients unattributed to any provider group in accountable care organization models.
July 16, 2018 – Wanzhen Gao, PhD; David Keleti, PhD; Thomas P. Donia, RPh; Jim Jones, MBA; Karen E. Michael, MSN, MBA, RN; and Andrea D. Gelzer, MD, MS, FACP
Postdischarge engagement of at-risk Medicaid beneficiaries in 6 health plans resulted in significant reductions in hospital readmissions at rates proportional to the frequency of engagement.
July 17, 2018 – Margje H. Haverkamp, MD, PhD; David Peiris, MD, PhD; Alexander J. Mainor, JD, MPH; Gert P. Westert, PhD; Meredith B. Rosenthal, PhD; Thomas D. Sequist, MD, MPH; and Carrie H. Colla, PhD
Experience with risk-based contracting best predicts active engagement of accountable care organizations in reducing low-value medical services, mainly through physician education and encouraging shared decision making.
July 17, 2018 – Ann M. Annis, PhD, RN; Marcelline Harris, PhD, RN; Hyungjin Myra Kim, ScD; Ann-Marie Rosland, MD, MS; and Sarah L. Krein, PhD, RN
A metric of primary care delivery by non–primary care provider clinicians demonstrated increasing trends in patient encounters by nurses and social workers and was responsive to patient-centered medical home implementation.
July 18, 2018 – Daniel A. Handel, MD, MBA, MPH; Zemin Su, MS; Nancy Hendry, MSN; and Patrick Mauldin, PhD
Placement of patients in an inpatient hospital setting is associated with lower length of stay and mortality at the expense of higher costs.