June 2020

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.

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.

The objective of this research was to identify strategies that significantly lower unnecessary inpatient utilization among Medicare beneficiaries with chronic disease.

High-deductible health plan members with bipolar disorder experienced a reduction in nonpsychiatrist mental health provider visits but no changes in other utilization.

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.

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.

Despite the Medicare Diabetes Prevention Program now being a covered benefit, there is inadequate availability of suppliers to reach Medicare beneficiaries with prediabetes.

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.

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.

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.

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.

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.

Big data could help identify potential clues about the immediate (and future) impact of coronavirus disease 2019, but it is in short supply.