This year, some of the most-read peer-reviewed research published in The American Journal of Managed Care® (AJMC®) explored cost-saving models of care, the benefits and hazards of health information technology, effects of incorporating Choosing Wisely principles into clinical decision support tools, and more.
This year, some of the most-read peer-reviewed research published in The American Journal of Managed Care® (AJMC®) explored cost-saving models of care, the benefits and hazards of health information technology (IT), effects of incorporating Choosing Wisely principles into clinical decision support tools, and more.
Here are the 5 most-read articles published in AJMC® in 2018.
5. Variation in Markups on Outpatient Oncology Services in the United States
Amid rising costs for oncology treatment and the resulting financial burdens on patients, this retrospective analysis in the February 2018 issue found significant variation in the price markup of oncology services by hospitals across oncology specialties. Both for-profit status for medical oncology services and prestige status for radiology and pathology services were associated with higher markups. The study authors suggested that further efforts are needed to insulate patients from the financial impacts of highly variable pricing.
4. High-Touch Care Leads to Better Outcomes and Lower Costs in a Senior Population
Providing “high-touch” care to Medicare Advantage patients was associated with cost savings and improved outcomes compared with usual care, according to the findings of this cohort study from the September 2018 issue. The model, which allows patients to see healthcare providers more frequently and assigns fewer patients to each provider, was associated with more primary care visits, increased use of preventive medications, fewer hospital admissions, and lower monthly healthcare costs. The advantages of strengthening the physician—patient relationship and ensuring easier access to care may be drivers of the model’s success, wrote the authors.
3. A Cost-Effectiveness Analysis of Cardiology eConsults for Medicaid Patients
This article from the annual Health IT special issue of AJMC® published in January 2018 examined the cost-effectiveness of an electronic consultation (eConsult) program for Medicaid patients seeking cardiology care. Six months after the consult, patients in the eConsult group had mean unadjusted total costs that were $655 lower than those in the face-to-face consult arm; they also had $81 lower costs for outpatient cardiac procedures. The results may spur payers to consider eConsult programs as a way to contain costs while maintaining or improving access to care.
2. Data Breach Locations, Types, and Associated Characteristics Among US Hospitals
Data breaches seem to strike all types of hospitals, but are certain hospital qualities associated with higher odds of a breach? This analysis in the February 2018 issue found some characteristics, including type and size, that were associated with breach occurrences, and it also determined that paper and films were the most common location of data breaches, although breaches of network servers affected the most patients. The study authors recommended that hospitals should conduct security audits and prioritize patient privacy to minimize their risk of breaches.
1. Choosing Wisely Clinical Decision Support Adherence and Associated Inpatient Outcomes
When clinicians adhere to clinical decision support alerts based on the principles of Choosing Wisely, patients have reduced costs, shorter lengths of stay, and lower probabilities of being readmitted or experiencing complications, according to this observational study published in the August 2018 issue. By triggering an alert within the electronic health record system when a physician placed a potentially inappropriate order, the initiative prompted providers to reconsider instances of low-value care. Health systems should consider real-time decision support interventions as a way to encourage adoption of evidence-based strategies like Choosing Wisely, the researchers concluded.