Health System

The newly appointed president and CEO of the National Alliance of Healthcare Purchaser Coalitions discussed timely issues where we may see progress in 2024.

UnitedHealthcare is incorporating real-world evidence into pathways design and policy formulation, leveraging its members' data to evaluate the impact of different regimens on health resource utilization and costs, explains Lucy Langer, MD, MSHS, national medical director of oncology and genomics at UnitedHealthcare.

UnitedHealthcare's oncology payment mode initially involved a pay-for-performance program based on pathways adherence, and will be transitioning in 2024 to a broader system with graded quartiles to incentivize greater participation and pathway adherence.

While the clinic did not significantly reduce hospital readmission rates for patients with diabetes, it was able to decrease the time to follow-up and improve long-term diabetes outcomes following hospitalization.

A recent study found that use of optimal guideline-directed medical therapies after heart failure with reduced ejection fraction (HFrEF) diagnosis is low overall, but especially among female patients compared with male patients.

The Thyme Care virtual navigation program demonstrated a $594 reduction in total costs per member per month for navigated cancer patients compared with a control group, emphasizing the scalability of the independent virtual navigation model across various contracts, with opportunities to adapt to different populations and needs in the evolving landscape of value-based care arrangements.

Most patients in the cohort received rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone for first-line therapy; hospitalization was prevalent; and average medical and pharmacy costs were more than $140,000 per patient per year.

Molly Mendenhall, BSN, RN, director of quality and compliance at Oncology Hematology Care, Inc (OHC), discussed a 1-year quality improvement project implemented by OHC to standardize comprehensive biomarker testing in patients with non–small cell lung cancer (NSCLC).

Especially during shortages, Kirollos S. Hanna, PharmD, BCPS, BCOP, FACCC, director of pharmacy services at Minnesota Oncology, says practices should carve out areas where going to a different therapeutic approach isn't considered off-pathway.

A real-world study found that patients treated with Bruton tyrosine kinase inhibitors had lower rates of treatment discontinuation and health care resource utilization compared with other first- and second-line treatment regimens.

Edward "Ted" Arrowsmith, MD, MPH, medical director for pathways at OneOncology and managing partner at Tennessee Oncology, talks about challenges and changes in clinical pathways and the importance of keeping them updated.

Four years after the publication of data showing that the Camden Coalition’s “hotspotting” care management program did not reduce hospital readmissions, the investigators have published new work delving into the mechanisms behind the null findings.

Margaret Liang, MD, MSHPM, gynecologic oncologist and health services researcher and director, Gynecologic Oncology Fellowship Program, Cedars-Sinai Cancer Center, discusses financial toxicity in cancer care and how institutions can help alleviate the financial burden for patients.

Employers, recognized as pivotal contributors to health equity, are urged to prioritize equitable benefits, address the complexity of health plans, and engage in education, data-driven interventions, and systematic measurements to comprehensively improve outcomes for diverse employee populations.

An in-depth look into what the drug is being used for and what has contributed to the shortage.

Advanced care at home (otherwise known as hospital at home) can be scaled and provide care for a sizable portion of a hospital’s inpatient census, creating hospital capacity in an integrated delivery system.

David Fajgenbaum, MD, MBA, MSc, cofounder of Every Cure, shared that the organization is able to reduce clinical trial costs to $1 to $5 million per drug trial, and that clinical trials are not always necessary to expand a drug's indication.

A new report from AHIP shows that Medicare Advantage outperformed traditional Medicare on several clinical quality measures, including preventive screenings. However, debate continues over these plans’ cost efficiency and impact on the financial sustainability of rural hospitals.

This editorial provides suggestions for improving the process of e-consults, which are a promising method of expanding access to specialty care.

US Department of Veterans Affairs (VA) clinicians’ perspectives on what constitutes a good e-consult and why suboptimal e-consult requests occur contain broadly applicable lessons for other health systems.

Cardiologists need skills in risk assessment, contraception counseling, and hypertension management for pregnant patients, according to Kathryn Lindley, MD, FACC, Vanderbilt University Medical Center.

Overall, the number of patients discharged from hospitals with an ulcerative colitis diagnosis increased between 2009 and 2018, but the number of patients opting for ileal pouch–anal anastomosis (IPAA) decreased.

Pharmacists’ roles in transitions of care continue to evolve. Evaluation of pharmacist-led interventions as patients transition from emergency department to home is needed.

Kathryn Lindley, MD, FACC, Vanderbilt University Medical Center, talks about why it’s important to incorporate cardio-obstetrics training into cardiovascular disease fellowship programs.

Incident reporting systems, which are often computer based and require no in-person interactions, can enable health care staff who perceive low psychological safety to speak up.