June 2020

What We Talk About When We Talk About Care Management

June 17, 2020


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.

Hopes, Worries for US Health Care in Wake of COVID-19: A Q&A With Donald M. Berwick, MD, MPP

June 15, 2020


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.

General Medical Claims for Behavioral Health Patients in Japan

June 15, 2020


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.

Claims Identification of Patients With Severe Cancer-Related Symptoms

June 11, 2020


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.

FASStR: A Framework for Ensuring High-Quality Operational Metrics in Health Care

June 11, 2020


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.