Health System

This editorial discusses positions for academic medical centers to consider when designing and implementing artificial intelligence (AI) tools.

A retrospective analysis of 30-day risk-adjusted readmission rates among skilled nursing facilities (SNFs) between 2017 and 2022 compared those that had implemented an interventional analytics platform and other SNFs.

This study quantified the trends over time in utilization of, spending on, and access to CT fractional flow reserve, the first artificial intelligence (AI)–enabled clinical software reimbursed by Medicare.

Compared with usual care, a dementia care management program improved various cost of care and utilization metrics in a Medicare managed care population at 12 months.

A recent study found that screening for hepatocellular carcinoma (HCC) is associated with reduced mortality, highlighting the need to promote HCC screening for patients with known risk factors.

The authors created a machine learning–based model to identify patients with major depressive disorder in the primary care setting at high risk of frequent emergency department visits, enabling prioritization for a care coordination program.

Public hospitals were significantly more likely to sustain access to unprofitable services following 340B Drug Pricing Program participation, while nonprofit hospitals were mostly unaffected, according to a recent study.

Risk assessments of drug-related problems for cardiac surgery patients can be conducted by implementing a framework for patient safety.

Regular users of the emergency department (ED) transiently reduced ED visits when faced with ED access barriers during the COVID-19 pandemic.

Michael Morse, MD, FACP, MHS, medical oncologist at Duke Cancer Center, explained gaps in care access and equity that must be addressed to ensure all patients with liver cancer can get the treatments they need.

On this episode of Managed Care Cast, we're talking with Karen Iapoce, senior director of government products and programs at ZeOmega, about the recent CMS final rule on Medicare Part D and Medicare Advantage.

Stephanie T. Page, MD, PhD, UW Medicine Diabetes Institute, presented on ongoing research and growing interest in new male contraceptive options, such as an oral pill and a hormonal transdermal gel, at the American Urological Association 2024 Annual Meeting.

In 2024, the Asembia Specialty Pharmacy Summit celebrated 20 years and speakers highlighted the conversations around improving access and affordability taking place at the meeting.

The novel intravesical drug delivery system releases erdafitinib locally within the bladder while limiting systemic toxicities.

Quoc-Dien Trinh, MD, MBA, chief of urology at Brigham & Women's Faulkner Hospital, highlighted successful efforts to improve prostate cancer care access for underserved communities in Massachusetts.

Leaders at 49 accountable care organizations (ACOs) shared their perspectives on the Medicare Shared Savings Program, as well as a range of strategies for success and ongoing challenges.

Type 1 diabetes (T1D), which once predominantly affected children, is increasingly affecting older adults in the US, with prevalence rates peaking in those aged 45 to 64, according to recent research.

The health-system specialty pharmacy has the unique ability to coordinate better with the provider and take a team approach that reduces the chances of dropping the ball on the patient’s care.

Researchers also estimated that more than 700,000 Americans with diabetes could lose insurance coverage if these proposed retractions are put into place, with some new policies already in effect.

The 340B hospitals not receiving an offsetting lump-sum payment from CMS following 2018-2022 cuts later ruled unlawful are disproportionately rural, publicly owned, and nonacademic, according to a new study.

The findings suggest there are ongoing disparities between Black and White patients with hepatocellular carcinoma (HCC) in terms of both outcomes and health care resource utilization.

Leslie Fish, PharmD, senior vice president of pharmacy at IDP Analytics, LLC, reflects on the future of biosimilars and the impact they will have on managed care pharmacy settings to improve patient access to medications.

Prices for care at hospital trauma centers vary across hospitals; drug shortages reached a record high during the first quarter of 2024; although 3 of the biggest makers of asthma inhalers pledged to cap out-of-pocket costs for some US patients at $35, these do not apply to daily inhalers used by the youngest kids with asthma.

By prioritizing well-being, both the public and private sectors can come together in partnerships to address social needs and social determinants of health.

The new playbook details voluntary best practices for value-based care (VBC) payment arrangements and is part of an effort to increase VBC adoption in the private sector.