The American Journal of Managed Care > February 2019
The American Journal of Managed Care - February 2019
February 07, 2019 – Haley Bush, MSPH; James Paik, PhD; Pegah Golabi, MD; Leyla de Avila, BA; Carey Escheik, BS; and Zobair M. Younossi, MD, MPH
The Medicaid population has significantly higher hepatitis C virus (HCV) prevalence and mortality rates than patients with private insurance. These data must be considered when policy makers assess providing additional support to Medicaid programs for HCV elimination.
February 08, 2019 – Jackson Williams, JD
Cost-benefit analysis for quality measures has emerged as the cornerstone of CMS’ Meaningful Measures initiative.
January 30, 2019 – A. Mark Fendrick, MD; and Darrell George, BA
When it comes to the political iceberg of drug prices, there is more than meets the eye. Policies that reduce prices but do not lower consumers’ out-of-pocket costs will not address the main challenge facing most Americans.
From The Editorial Board
February 14, 2019 – Sachin H. Jain, MD, MBA
February 11, 2019 – Seth A. Seabury, PhD; J. Samantha Dougherty, PhD; and Jeff Sullivan, MS
Physician-level medication adherence is a strong predictor of patient health and should be considered as a measure of physician quality.
February 13, 2019 – Nirosha Mahendraratnam, PhD; Corinna Sorenson, PhD, MHSA, MPH; Elizabeth Richardson, MSc; Gregory W. Daniel, PhD, MPH, RPh; Lisabeth Buelt, MPH; Kimberly Westrich, MA; Jingyuan Qian, MPP; Hilary Campbell, PharmD, JD; Mark McClellan, MD, PhD; and Robert W. Dubois, MD, PhD
We surveyed biopharmaceutical manufacturers and payers to understand the prevalence and characteristics of value-based payment arrangements, as well as their implementation obstacles and success factors.
TRENDS FROM THE FIELD
February 12, 2019 – Anna D. Sinaiko, PhD, MPP; Shehnaz Alidina, SD, MPH; and Ateev Mehrotra, MD, MPH
This qualitative study finds low employer adoption of reference-based pricing (RBP) benefit design and that redesign of RBP may be necessary to overcome barriers to adoption.
January 31, 2019 – Cheryl L. Damberg, PhD; Marissa Silverman, MSPH; Lane Burgette, PhD; Mary E. Vaiana, PhD; and M. Susan Ridgely, JD
Value-based payment is promoting care delivery transformation among California physician organizations, although the initial focus has been on controlling hospital costs and redesigning primary care.
February 01, 2019 – Felix Sebastian Wicke, Dr Med; Anastasiya Glushan, BSc; Ingrid Schubert, Dr Rer Soc; Ingrid Köster, Dipl-Stat; Robert Lübeck, Dr Med; Marc Hammer, MPH; Martin Beyer, MSocSc; and Kateryna Karimova, MSc
We present an International Classification of Diseases, Tenth Revision (ICD-10) translation of the adapted Diabetes Complications Severity Index and show its performance in predicting hospitalizations, mortality, and healthcare-associated costs.
February 04, 2019 – Rebecca A. Gourevitch, MS; Ateev Mehrotra, MD, MPH; Grace Galvin, MPH; Avery C. Plough, BA; and Neel T. Shah, MD, MPP
This randomized controlled trial finds that a hospital cesarean delivery rate comparison tool affects women’s perceptions but not where they choose to deliver.
February 05, 2019 – Thomas E. Kottke, MD, MSPH; Jason M. Gallagher, MBA; Marcia Lowry, MS; Pawan D. Patel, MD; Sachin Rauri, MS; Juliana O. Tillema, MPA; Jeanette Y. Ziegenfuss, PhD; Nicolaas P. Pronk, PhD, MA; and Susan M. Knudson, MA
When we weighted health insurance claims with a disease burden score, we were able to generate valid estimates of disability-adjusted life-years.
February 06, 2019 – Jesús Antonio Álvarez, PhD, MD; Rubén Francisco Flores, PhD; Jaime Álvarez Grau, PhD; and Jesús Matarranz, PhD
Improving efficiency is complex and requires a multimodal approach. Health information systems, patient feedback, and multidisciplinary teams are components that can improve clinical processes.