April 2021

Patients enrolled in Medicare Advantage had better outcomes and lower cost following skilled nursing facility (SNF) discharge than patients enrolled in traditional fee-for-service Medicare.

A Medicaid managed care organization developed a machine learning model to identify opioid use disorder (OUD) risk factors and predict OUD incidence in its multistate population.

Low-density lipoprotein cholesterol (LDL-C)–lowering therapies have yielded significant value to society through reduced costs for both fatal and nonfatal cardiovascular disease events. The vast majority of this value has accrued to patients.

Inspira Care Connect, LLC, an accountable care organization, incorporated transitional care management services into its postdischarge follow-up process to prevent avoidable utilization of health care services and costs.

Treatment patterns and overall survival were similar regardless of site of care between patients receiving anticancer therapy in the hospital outpatient vs physician office setting.

Patients with chronic cardiac conditions benefited from a health care program that strengthened collaboration between general practitioners and cardiology specialists in Baden-Wuerttemberg, Germany.

Prioritization, interunit collaboration, esprit de corps, and health workers’ adaptability are key factors in providing a coherent response to the coronavirus disease 2019 pandemic.

In the debate of administrative expenses for public and private Medicare, we show incompatibility and extend the analysis to income, benefits, and loss ratio comparisons.

The authors describe federal and state provider network adequacy standards and discuss how regulators should adapt these standards and accompanying monitoring processes in response to coronavirus disease 2019 (COVID-19).

Clinician-, patient-, and research-focused initiatives are needed to reduce the delivery of low-value care services that contribute to financial, clinical, and psychological harm for patients.

Although shortfalls in continuity were well described prior to coronavirus disease 2019 (COVID-19), the pandemic has created an opportunity to augment this critical component of care delivery, with the potential to improve patient-centered outcomes and enhance spending efficiency.

Having highly fragmented ambulatory care and a usual provider of care outside the Veterans Health Administration increased the odds of hospitalization among veterans with diabetes.