December 2022

Curative direct-acting antivirals for chronic hepatitis C provide a net economic benefit to Medicaid in less than 1 year. Cumulative savings to date have exceeded $15 billion.

A national survey demonstrated differences in organizational capacity between hospitals participating in Medicare bundled payment programs and those coparticipating in both Medicare and commercial bundled payment programs.

This analysis evaluates the relationship between hospital care delivery network fragmentation and in-hospital and 90-day outcomes. These networks may be novel targets for improving outcomes.

Health plan dissatisfaction was higher among Medicaid managed long-term services and supports (MLTSS) beneficiaries who did not follow through with an intention to change health plans.

Care coaching and behavioral health provider referral programs produce long-term savings, reductions in avoidable utilization, and increases in targeted services to treat behavioral health conditions.

Predictive analytics–driven disease management outperforms standard of care among patients with chronic heart failure.

Health plans can gain efficiencies and improve quality by connecting to health information networks and incentivizing hospital and provider participation as part of pay-for-performance programs.

Interviews with chief financial officers of rural hospitals revealed that they perceived telehealth to have some financial advantages; however, they did not believe that telehealth improved their hospitals’ financial situations.

Because of its often slowly progressive nature, dementia is often included among chronic disease management programs. Yet, for many reasons, its management demands different approaches.

As Medicare Advantage increasingly becomes the dominant form of Medicare coverage, Congress must improve transparency of programmatic costs and benefits to promote beneficiary choice.

The KidneyIntelX test would affect primary care physician (PCP) decision-making, and PCPs would use the results of KidneyIntelX more than albuminuria and estimated glomerular filtration rate when making decisions about diabetic kidney disease management.