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September 2019
The Sociobehavioral Phenotype: Applying a Precision Medicine Framework to Social Determinants of Health
September 06, 2019
Article
COMMENTARY
Sociobehavioral phenotypes are actionable risk profiles based on empirically derived social, economic, and behavioral factors that, if applied appropriately, can help healthcare organizations address social determinants of health.
VA Geriatric Scholars Program’s Impact on Prescribing Potentially Inappropriate Medications
September 09, 2019
Article
CLINICAL
Primary care teams reduced their prescribing of potentially inappropriate medications to older veterans after participation in the Veterans Affairs (VA) Geriatric Scholars Program.
Physician-Initiated Payment Reform: A New Path Toward Value
September 10, 2019
Article
POLICY
Physician groups have begun designing alternative payment models for their own specialties, proposing that CMS include financial risk, funding for new technologies, and legal waivers.
Managed Care for Long-Stay Nursing Home Residents: An Evaluation of Institutional Special Needs Plans
September 12, 2019
Article
POLICY
This study examines UnitedHealthcare’s Institutional Special Needs Plans and their association with hospital and skilled nursing facility use.
Medicaid Managed Care: Issues for Enrollees With Serious Mental Illness
September 11, 2019
Article
MANAGERIAL
The authors studied Kansas Medicaid enrollees with serious mental illness and their experiences with integrated managed care and unmet needs.
Multi-Payer Advanced Primary Care Practice Demonstration on Quality of Care
September 13, 2019
Article
MANAGERIAL
An evaluation of the Multi-Payer Advanced Primary Care Practice Demonstration found mixed results in terms of quality of care provided to Medicare and Medicaid beneficiaries.
Changes in Ambulatory Utilization After Switching From Medicaid Fee-for-Service to Managed Care
September 04, 2019
Article
WEB EXCLUSIVE
Transitioning from Medicaid fee-for-service to Medicaid managed care was associated with a significant decrease in ambulatory utilization, especially among beneficiaries with 5 or more chronic conditions.
Did Medicare Advantage Payment Cuts Affect Beneficiary Access and Affordability?
August 30, 2019
Article
WEB EXCLUSIVE
The Affordable Care Act’s reductions to Medicare Advantage plan payments were not significantly associated with healthcare access or affordability for enrollees.
Medicare Shared Savings Program ACO Network Comprehensiveness and Patient Panel Stability
August 29, 2019
Article
WEB EXCLUSIVE
Medicare Shared Savings Program accountable care organization (ACO) network comprehensiveness is associated with stable patient assignment year to year. Panel stability was significantly associated with improved diabetes and hypertension control in the short term.
Which Patients Are Persistently High-Risk for Hospitalization?
September 12, 2019
Article
WEB EXCLUSIVE
Most patients in a large integrated healthcare system who were high-risk for hospitalization were at substantially lower risk within 2 years.
Call Center Performance Affects Patient Perceptions of Access and Satisfaction
September 02, 2019
Article
WEB EXCLUSIVE
Greater telephone wait times, but not abandonment rates, were associated with lower patient perceptions of their ability to obtain urgent care in a timely manner.