December 2019

Rates of hepatitis C virus (HCV) treatment in a commercially insured population doubled after availability of new direct-acting antivirals. Member out-of-pocket spending was kept low while the health plan bore 99% of spending on HCV medications.

Higher intensity of care management in an all-condition program addressing care coordination and care barriers was associated with increased healthcare utilization among Medicaid and Medicare patients.

Among outpatients who were screened for alcohol use, those with unhealthy alcohol use, women, and those who were older, white, and of lower socioeconomic status were more likely to use benzodiazepines.

Implementing a claims-based algorithm and disease management program may be an effective strategy to reduce relapse and cost among patients with schizophrenia.

This study of claims among adults covered by employer-sponsored plans revealed substantial variations in out-of-network cost-sharing payments. The growth of cost sharing for nonemergent hospitalizations is concerning.

This review presents a set of evidence-based outcome measures for oncology alternative payment models, drawing on evidence from existing and proposed quality measures.

It is important to take into account individual complexities such as comorbidities and pill burden when selecting antiretroviral therapy regimens for individuals living with HIV.

Patients have an incomplete understanding of what constitutes no-cost preventive care services. Ease of obtaining information from insurance companies can significantly affect whether patients are charged correctly.

Health systems will improve postacute outcomes when CMS begins sharing its performance data on nursing facility chains.

This manuscript synthesizes findings from a multidisciplinary panel following the RAND/UCLA Appropriateness Method to guide standardization of urinary catheter use after transurethral prostate surgery.

One delivery system’s healthcare utilization in its Medicare Advantage product was notably less than in its Pioneer accountable care organization or in a traditional Medicare comparison group.