Payers

Dr Milena Murray on How Insurance Status Plays Into Uptake of Care for HIV

December 13th 2020, 1:00pm

Video

Insurance status can influence an individual’s ability to access care, stated Milena Murray, PharmD, MSc, BCIDP, AAHIVP, associate professor at Midwestern University College of Pharmacy.

Medicaid Expansion May Result in Earlier Colon Cancer Diagnosis, Study Says

December 13th 2020, 12:00am

Article

The authors wrote that in states that expanded Medicaid health insurance coverage in 2014, there was an increase of early-stage colon cancer diagnoses compared with states that did not implement expansion.

Study Shows Effect of COVID-19 on Hospitalization Risk in CKD

December 12th 2020, 9:45pm

Article

Patients with COVID-19 and end-stage renal disease were 11 times more likely to be admitted to the hospital than patients without kidney disease.

Implementing a Targeted Approach to Social Determinants of Health Interventions

December 10th 2020, 8:00pm

Article

We must rethink our one-size-fits-all approach to social determinants of health interventions and instead target patients who truly need and would benefit from these interventions.

Payment Incentives and the Use of Higher-Cost Drugs: A Retrospective Cohort Analysis of Intravenous Iron in the Medicare Population

December 9th 2020, 8:00pm

Article

During a period of rapid fluctuation in the intravenous iron market, there was increased use of a more expensive drug that afforded providers additional revenue.

Calibrating Medicaid Payment to Need for Long-term Services and Supports

December 9th 2020, 8:00pm

Article

Incorporating data from functional status assessments, we developed a Medicaid payment model for long-term services and supports in a community-dwelling population of older adults.

A Case Report of the Analytic Development of Bundled Payments for the Commercial Market

December 9th 2020, 2:00pm

Article

This case report of a novel methodology for the analytic development of bundled payments addresses statistical analysis, data visualization, and clinical consultation.

Prospective or Retrospective ACO Attribution Matters for Seriously Ill Patients

December 8th 2020, 5:00pm

Article

This study compared beneficiary characteristics and Medicare per capita expenditures among seriously ill Medicare accountable care organization (ACO) populations defined using prospective and retrospective claims-based attribution methods.

Medicare Advantage and Postdischarge Quality: Evidence From Hospital Readmissions

December 8th 2020, 2:00pm

Article

Relative readmission rates, a measure of care coordination, did not change over time for beneficiaries enrolled in Medicare Advantage and traditional Medicare.

Telehealth Claim Lines Rise 2980% in One-Year Period Through September 2020

December 1st 2020, 3:00pm

Article

COVID-19 created a striking rise in telehealth services over the past year, as seen in claims tracked by FAIR Health.