Coverage of our peer-reviewed research and news reporting in the healthcare and mainstream press.
An article by Skilled Nursing News, titled “Researchers Find ‘Perverse Incentives’ for Skilled Nursing Operators Under PDPM,” cited a study published in the April 2020 issue of The American Journal of Managed Care® (AJMC®) titled “The Patient-Driven Payment Model: Addressing Perverse Incentives, Creating New Ones.” In the study, researchers indicated that although the Patient-Driven Payment Model (PDPM) addresses perverse incentives in Medicare’s previous payment system for skilled nursing facilities (SNFs), it includes new incentives that may be problematic. The study authors recommended that regulators should maintain close oversight of billing by SNFs and patient outcomes as the PDPM takes effect to mitigate potential unintended consequences.
A piece reported by Healio referenced a study published in the November 2019 issue of AJMC®, “CKD Quality Improvement Intervention With PCMH Integration: Health Plan Results.” The study results supported innovation in chronic kidney disease (CKD) by commercial health plans, as a scalable CKD quality improvement intervention demonstrated feasibility, decreased hospitalization, and reduced costs.
Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
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Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
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