March 2020

Care management was effective at reducing infant mortality among the most vulnerable infants enrolled in an Ohio Medicaid managed care organization.

Out-of-pocket costs required by Medicare prescription drug plans for drugs available through Walmart’s generic drug discount program have decreased from 2009 to 2017.

To mark the 25th anniversary of the journal, each issue in 2020 will include an interview with a healthcare thought leader. For the March issue, which marks the 10th anniversary of the Affordable Care Act being signed into law, we turned to Representative Frank Pallone Jr, D-New Jersey, who played a key role in the law’s writing and passage.

A survey of veterans leaving the military in 2016 found that women may be underserved by the Veterans Health Administration and may need housing assistance.

Correction to the Original Research article “Impact of Complex Care Management on Spending and Utilization for High-Need, High-Cost Medicaid Patients” published in the February 2020 issue of The American Journal of Managed Care®.

An updated emergency visit classification tool enables managers to make valid inferences about levels of appropriateness of emergency department utilization and healthcare needs within a population.

This study assesses the cost-effectiveness of adding a sodium-glucose cotransporter 2 inhibitor versus switching to a glucagon-like peptide-1 receptor agonist in patients with diabetes on metformin and a dipeptidyl peptidase-4 inhibitor.

Patients with intellectual disabilities who were cared for in hospitals without programs tailored to intellectual disabilities had 6% higher costs, and those with extreme admission severity had 42% higher costs.

We examine the effects of MD–Value in Prevention (MDVIP) enrollment on Medicare expenditures and utilization among fee-for-service beneficiaries with diabetes over a 5-year period.

Nonadherence to essential chronic medications and mental health diagnosis were associated with higher hospitalizations and emergency department use among Medicare super-utilizers.

This study provides proof of concept that imminent risk of fracture can be assessed by evaluating recent fracture, age, sex, race, medically significant falls, and psychoactive medications.

We find that under current regulatory and market conditions, demand for hospital-based emergency services is highly inelastic with respect to price, giving hospitals substantial pricing power over out-of-network emergency services.