Top 5 Most-Read AJMC® Research Articles of 2019

December 26, 2019

In 2019, the peer-reviewed research published in The American Journal of Managed Care® (AJMC®) that drew the most readers included studies on value-based arrangements, out-of-network payment policies, and more.

In 2019, the peer-reviewed research published in The American Journal of Managed Care® (AJMC®) that drew the most readers included studies on value-based arrangements, out-of-network payment policies, and more.

Here are the 5 most-read articles published in AJMC® in 2019.

5. Patients’ Expectations of Their Anesthesiologists

With the increasing emphasis on patient satisfaction ratings for calculating value-based payment amounts, a group of researchers administered surveys to determine patients’ perceptions and expectations of their anesthesiologists. Although some patients seemed to have an inaccurate perception of the role of the anesthesiologist, 98% of respondents said they were satisfied or very satisfied with their anesthesia care. A takeaway from the article, published in the October 2019 issue, is that anesthesiologists have a responsibility to educate patients about their role, set realistic expectations for postsurgical outcomes, and involve patients in medical decision making.

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4. Value-Based Arrangements May Be More Prevalent Than Assumed

Previous research likely underestimates the prevalence of value-based arrangements between payers and drug makers because the majority of these arrangements are not publicly disclosed, according to the findings of this study from the February 2019 issue that used confidential surveys to collect respondents’ experiences. Manufacturers and payers reported the reasons that their negotiations most frequently broke down, revealing differences in priorities for the stakeholders. Based on the responses, the study authors suggested the development of a guidance document or tool to help ease the path toward successfully agreeing on and implementing value-based arrangements.

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3. Patient and Clinician Experiences With Telehealth for Patient Follow-up Care

A study published in the January 2019 health information technology issue found that patients and clinicians in a busy healthcare system were largely satisfied with the use of telehealth virtual video visits. A majority of both patients and clinicians reported no difference in the overall quality between telehealth and face-to-face visits, and patients in particular reported that virtual visits were more convenient and saved them substantial travel time. While clinicians expressed some worries about feeling a personal connection with patients during virtual visits, the study authors predicted that the use of telemedicine will continue to grow in the coming years.

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2. Influence of Out-of-Network Payment Standards on Insurer—Provider Bargaining: California’s Experience

An August 2019 article reported effects of California’s policy to address surprise medical billing, a top concern of patients and policy makers. Interviewees said that the state’s policy has shifted negotiation leverage in favor of payers, not physicians, as the payers are now incentivized to cancel contracts with high rates. Physicians reported an accelerating trend of provider consolidation due to this change in bargaining dynamics, and the effects of the policy on access to specialists for patients in the safety net are still unclear. Although these findings are early and reflect experiences in a single state, they may inform efforts at the federal level to protect consumers from receiving surprise medical bills.

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1. Medicare Annual Wellness Visit Association With Healthcare Quality and Costs

Findings from this study in the March 2019 issue suggested that the Medicare Annual Wellness Visit (AWV) can help improve healthcare outcomes and reduce costs. Among nearly 9000 Medicare beneficiaries in 2 physician-led accountable care organizations, receiving an AWV was associated with significantly lower spending on hospital acute care and outpatient services, as well as a higher likelihood of receiving preventive care services. The greatest effects on costs were seen for patients in the highest hierarchical condition category risk quartile. If these findings can be replicated in other settings, wrote the authors, the AWV may be key to unlocking the Triple Aim of healthcare.

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