A Case of Congestive Heart Failure -- The Managed Care Perspective

This article examines the prevalence of pay-for-performance incentives to promote human papillomavirus vaccination and other quality metrics as reported by frontline clinical staff.

Patients who experienced a formulary-related rejection of cariprazine for adjunctive treatment of major depressive disorder had significantly higher hospitalization rates than those with approved claims.

Assertive community treatment, a strongly evidence-based practice for delivering care to individuals with schizophrenia and low health care engagement, is applicable to disengaged, medically complex patients.

In Massachusetts’ largest Medicaid accountable care organization (ACO), high-risk care management significantly reduced spending, emergency department visits, and hospitalizations, demonstrating that targeted strategies can manage health care costs amid budget constraints.

Accountable care organization (ACO) participation was associated with an increase in hospitals’ mean market share and with additional market share gains in more concentrated markets.

Although use of corticosteroid premedication prior to infliximab infusions is declining, it remains unnecessarily high despite limited benefit and the risk of serious adverse events from corticosteroids.