Fairness and Rationing Implications of Medical Necessity Decisions

Physician groups under 2-sided risk–based Medicare Advantage provide care associated with higher quality and efficiency compared with care by these same groups under fee-for-service Medicare.

This study compared 6 algorithmic fairness–improving approaches for low-birth-weight predictive models and found that they improved accuracy but decreased sensitivity for Black populations.

Primary care nurse practitioners were found to use low-value care at lower or relatively similar rates compared with the general clinician population.

Laundromats offer a promising outreach setting for Medicaid payers because Medicaid enrollees represent a majority of laundromat users and have disproportionately high levels of unmet needs.

Enrollment in Medicare coverage without out-of-pocket protections was associated with a higher likelihood of reporting cost and access barriers to care.

A community-based remote patient monitoring (RPM) program was associated with significant reduction in blood pressure in Medicare patients with stage 2 hypertension, highlighting the potential benefits of RPM with care coaching.