The American Journal of Managed Care > June 2020

The American Journal of Managed Care - June 2020

June 16, 2020 – J. Frank Wharam, MD, MPH; Alisa B. Busch, MD, MS; Jeanne Madden, PhD; Fang Zhang, PhD; Matthew Callahan, MS; Robert F. LeCates, MA; Phyllis Foxworth, BS; Stephen Soumerai, ScD; Dennis Ross-Degnan, ScD; and Christine Y. Lu, PhD
High-deductible health plan members with bipolar disorder experienced a reduction in nonpsychiatrist mental health provider visits but no changes in other utilization.
April 30, 2020 – Dennis P. Scanlon, PhD, MA; and Mark B. Stephens, MD, MS
Big data could help identify potential clues about the immediate (and future) impact of coronavirus disease 2019, but it is in short supply.
June 17, 2020 – Leah M. Marcotte, MD; and Joshua M. Liao, MD, MSc
To support effective care management programs in the context of value-based care, we propose a framework categorizing care management as disease management, utilization management, and care navigation interventions.
June 15, 2020 – Interview by Allison Inserro
To mark the 25th anniversary of the journal, each issue in 2020 will include an interview with a healthcare thought leader. For the June issue, we turned to Donald M. Berwick, MD, MPP, president emeritus and senior fellow at the Institute for Healthcare Improvement and former administrator of CMS.
June 16, 2020 – Jennifer N. Dunphy, DrPH, MBA, MPH; Morris Weinberger, PhD; and Pam Silberman, JD, DrPH
The objective of this research was to identify strategies that significantly lower unnecessary inpatient utilization among Medicare beneficiaries with chronic disease.
June 17, 2020 – Annie Lintzenich Andrews, MD, MSCR; Jessica Bettenhausen, MD; Erik Hoefgen, MD, MS; Troy Richardson, PhD; Michelle L. Macy, MD, MS; Bonnie T. Zima, MD, MPH; Jeffrey Colvin, MD, JD; Matt Hall, PhD; Samir S. Shah, MD, MSCE; John M. Neff, MD; and Katherine A. Auger, MD, MSc
Through analysis of multistate Medicaid data, this study identifies differences in 2 commonly used measures of emergency department (ED) utilization, ED visit count and ED reliance.
June 15, 2020 – Yasuhiro Kishi, MD, PhD; Roger G. Kathol, MD; and Yasuyuki Okumura, PhD
This Japanese cohort shows that behavioral health service users had health care costs higher than those of individuals who did not use behavioral health services, yet lower than the costs demonstrated by studies in US populations.
June 10, 2020 – Amit Prasad, MD; Theodore J. Cios, MD, MPH; Whitney Staub-Juergens, MSN, RN, CCRN; Carol Dziedzina, BSN, RN, CCRN; Srikantha Rao, MBBS, MS; and Kai Singbartl, MD, MPH
Standardization of operating room to intensive care handoff with a “time-out for sign-out” process for health care providers was beneficial for junior clinicians.
June 10, 2020 – Srinivas Annavarapu, MBBS, PhD; Sabyasachi Ghosh, MS; Yong Li, PhD; Chad Moretz, ScD, MS; Sharashchandra Shetty, PhD; and Todd Prewitt, MD
Among patients with type 2 diabetes (T2D), concurrent cardiovascular-, heart failure–, or renal-related hospitalization presents significant disease burden leading to poor quality of life.
June 11, 2020 – Elham Torabi, PhD, MSIE; Tugba Cayirli, PhD; Craig M. Froehle, PhD; Kenneth J. Klassen, PhD; Michael Magazine, PhD; Denise L. White, PhD, MBA; and Michael J. Ward, MD, PhD, MBA
Through literature review and collaborative design, we propose the Focus, Activity, Statistic, Scale type, and Reference (FASStR) framework to provide a systematic approach to health care operation metric definition and use.
June 11, 2020 – Xiaojing Yuan, MPH; Janet Chaisson, BS; Dawn Cantrell, BA; Brice L. Mohundro, PharmD, BCACP; Mollie Carby, PharmD, MBA; Milam Ford, MPH; Miao Liu, MS; Jason Ouyang, MD; Yuan Zhang, PhD; Heath C. Williams, MBA; Benjamin V. Vicidomina, BS; Vindell Washington, MD, MS; and Somesh C. Nigam, PhD
Enrollment in a value-based insurance design program that eliminated pharmacy co-pays for 4 chronic disease drug classes was associated with a large decline in health care spending.
June 11, 2020 – Richard W. DeClue, PhD, MPH; Dana Drzayich Antol, MS; Adrianne W. Casebeer, PhD, MS, MPP; Todd Michael, PharmD, RPh; Marina Sehman, PharmD; Andrew Renda, MD, MPH; Sarika Ogale, PhD; Stephen Stemkowski, PhD, MHA; and Bryan Loy, MD
The authors established a claims-based mechanism for identifying patients with lung cancer with more severe patient-reported cancer-related symptoms who could benefit from engagement with health care programs.
June 12, 2020 – Natalie D. Ritchie, PhD; Katherine Ann Sauder, PhD; and R. Mark Gritz, PhD
Despite the Medicare Diabetes Prevention Program now being a covered benefit, there is inadequate availability of suppliers to reach Medicare beneficiaries with prediabetes.
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