April 2023

Increases in Medicare Advantage market share over the past 10 years are largely caused by an increased preference for managed care among Medicare beneficiaries.

This quantitative and qualitative analysis highlights differences in prior authorization requirements for migraine drugs from nearly 50 managed care organizations and summarizes broad types of criteria used.

Construction of a composite measure, use of a summary disparity statistic, and measure selection are key considerations in the design of equity-focused payment programs.

A multidisciplinary approach and symptom management are both vital components of home care to provide continuity of care after cardiac surgery because they decrease symptoms and readmissions to the hospital and increase self-efficacy.

Payment models that align financial incentives of payers, providers, and patients can mitigate spending growth in thoughtful ways, but the details of the models matter.

This retrospective study examined food insecurity and neighborhood disadvantage in health system patients as predictors of acute health care utilization.

Health systems may be better able to support adoption of chronic care management processes, which have a strong evidence base for practice implementation, compared with patient engagement strategies, which have less evidence to guide effective implementation.

Insured lower-wage employees had lower prevalence of mental health conditions but greater severity, with more hospital admissions and emergency department visits than high-wage employees.

Under preferred pharmacy networks, unsubsidized Part D beneficiaries faced substantial incentives and moderately switched toward preferred pharmacies, whereas subsidized beneficiaries were insulated and demonstrated little switching.

Most older US adults have concerns about emergency department visit affordability. Lower income, being uninsured, poor or fair physical/mental health, and younger age were associated with increased concerns.