Coverage Decisions for Medical Technology by Managed Care: Relationship to Organizational and Physician Payment Characteristics

A private oncology shared savings plan reduced colon cancer treatment costs. Results varied by tumor, with none in breast cancer and mixed effects in lung cancer.

Accessing medical and social resources for patients, heavy administrative burden, and lack of data integration are barriers to Medicaid managed care organization care coordinators’ job performance.

Rural marketplace rating area change in Texas did not increase enrollment but increased share of enrollment in gold plans.

A large academic medical center implemented a charitable care formulary with clinical pharmacist oversight, which resulted in more efficient usage of funds and fewer readmissions.

Use of voluntary alignment attribution by Next Generation Accountable Care Organization (ACO) participants was limited. The authors highlight the reasons and describe organizational use cases via a mixed-methods approach.

Specialty televisits remain common in the Veterans Health Administration following the COVID-19 pandemic, suggesting they will remain an important ongoing care modality for many patients.