July 18, 2019
Article
WEB EXCLUSIVE
This article describes perspectives of Medicare Advantage (MA) insurers about participating in the CMS value-based insurance design model test launched in 2017.
July 18, 2019
Article
WEB EXCLUSIVE
Several physician and payer characteristics are associated with physician satisfaction with health plans. There is opportunity to improve physician satisfaction with payers, specifically in pharmacy.
July 17, 2019
Article
EDITORIAL
The competing strategies of patient assistance programs and co-pay accumulator adjustment programs create confusion and administrative burden for clinicians and patients, potentially reducing adherence to clinically indicated services and worsening patient outcomes.
July 17, 2019
Article
MANAGERIAL
Commercial health plan initiation of a co-pay accumulator adjustment program for specialty medications treating autoimmune diseases was associated with significant reductions in medication adherence and persistence.
July 16, 2019
Article
WEB EXCLUSIVE
An interdisciplinary transitions of care service composed of nurse navigators, pharmacists, and medical providers reduced 30-day hospital readmissions among patients who received all components of the intervention.
July 16, 2019
Article
LETTERS TO THE EDITORS
An artificial intelligence–enabled video fall detection system using visual science reduced emergency department visits by 80% in 6 communities over 3 months.
July 15, 2019
Article
POLICY
Hospital participation in Medicare’s Bundled Payments for Care Improvement model was not associated with changes in number of skilled nursing facility (SNF) partners or in SNF discharge concentration.
July 15, 2019
Article
TRENDS FROM THE FIELD
Regardless of the number of manufacturers, generic drug prices presented double-digit average increases from 2012 to 2015.
July 12, 2019
Article
CLINICAL
From 2013 to 2017, the population of US patients prescribed treatment for chronic hepatitis C virus (HCV) changed, becoming predominantly treatment-naïve and having received care in nonacademic centers.
July 12, 2019
Article
METHODS
An analysis of administrative claims showed increasing rates of heroin overdose among an insured population and opportunities for interventions during healthcare encounters before overdose.
July 11, 2019
Article
WEB EXCLUSIVE
Steering patients who visit providers with above-median prices to their market’s median-priced provider would save 42%, 45%, and 15% of laboratory, imaging, and durable medical equipment spending, respectively.
July 10, 2019
Article
WEB EXCLUSIVE
Network analyses of patients with diabetes in Hawaii illustrate structures and links that health plans could leverage to strengthen quality improvement and disease management programs.