"Carving Out" Conditions From Global Capitation Rates: Protecting High-Cost Patients, Physicians, and Health Plans in a Managed Care Environment

This study examined employers’ understanding of rebate guarantees, dependency upon rebate dollars, and the role that pharmaceutical rebates or employer benefits consultants play in their pharmacy benefits manager selection.

Clinicians treating a higher percentage of patients insured by Medicaid and patients younger than 5 years were more likely to apply fluoride varnish.

After evaluating the association between the expanded Medicare Advantage supplemental benefits and plan composition, authors determined that adoption was not associated with large demographic shifts in enrollment.

The degree to which novel value elements such as insurance value impact estimated treatment value for rare, severe genetic diseases such as Duchenne muscular dystrophy is unclear.

Patients were satisfied with receiving their lung cancer screening (LCS) pulmonary nodule results via letter and considered the amount of information provided in the letter appropriate.

Medicare Advantage members referred to home health after acute hospitalization who did not receive home health services had higher mortality at 30, 90, and 180 days.