Medicare Coverage of Buprenorphine-Naloxone Film Surrounding Generic Entry
Medicare plans are replacing brand-name buprenorphine-naloxone film with its generic equivalents, resulting in a decrease in out-of-pocket cost faced by enrollees with opioid use disorder.
Hospital Performance in a Statewide Commercial Insurer Episode-Based Incentive Program
Some hospitals were able to outperform others in a commercial insurer episode-based incentive program, but there was little evidence of global reductions in episode spending.
Reexamining the Association of Care Continuity and Health Care Outcomes
Claims-based and patient-reported continuity measures have distinct effects on subjective and objective outcomes. A claims-based continuity indicator may be a unique dimension of care continuity.
Dialysis Costs for a Health System Participating in Value-Based Care
In a large, integrated health system participating in value-based care, higher costs and utilization were observed before and after unplanned dialysis initiation.
Predicting Hospital Readmission in Medicaid Patients With Diabetes Using Administrative and Claims Data
A statistical model based entirely on claims data can accurately predict 30-day hospital readmission in Medicaid patients with diabetes.
Pharmacist-Led Review of Empagliflozin and Ertugliflozin Following Formulary Update
Management of empagliflozin and ertugliflozin may be suboptimal following an insurance carrier’s formulary updates. Pharmacists may improve the management.
Non–Face-to-Face Care Management and Service Utilization in Patients With Diabetes
CMS began reimbursement for non–face-to-face chronic care management in 2015, and results from Louisiana show that it increases outpatient visits but decreases inpatient and emergency department encounters.
Statin Prescribing Patterns in Patient-Centered Medical Home Patients With NAFLD
In this study, authors assessed the proportion of patients with nonalcoholic fatty liver disease (NAFLD) receiving prescriptions for statins in primary care.
Social Determinants of Health: Are Colonoscopies Always Fit for Duty?
Social determinants of health are associated with colonoscopy noncompletion in a Medicaid patient population at the Providence Community Health Centers.
Does Missing Trust Lead to Overuse or Underuse of Health Care Services?
Most trust literature investigates missing trust and health care underuse. The authors show that mistrust also leads to health care overuse, a rapidly growing problem in the United States.
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