Authors
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Overuse and Insurance Plan Type in a Privately Insured PopulationHealth insurance plan type may be an important lever for reducing low-value healthcare use among patients with commercial insurance.
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Factors Associated With Timeliness in Academic General Surgery Clinics: A Prospective Quality AssessmentThe participation of residents and physician assistants significantly increased patient wait time without reducing the attending surgeon’s consultation length in outpatient surgery clinics.
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“Lean” Improvement in the Quality of Patient Care in the Hospital Admissions ProcessThe objective of this work is to improve the quality of patient care in the admission office service of the University Hospital Virgen del Rocío (HUVR) by standardizing and systematizing its procedures using Lean methodology. The results have allowed HUVR to achieve continuous improvement in the process, eliminating the elements that do not add value.
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The Impact of Patient Assistance Programs and the 340B Drug Pricing Program on Medication CostExamining the financial impact that patient assistance programs and the 340B Drug Pricing Program have on improving medication cost.
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Physicians Respond to Pay-for-Performance Incentives: Larger Incentives Yield Greater ParticipationPhysician participation rates in a pay-for-performance program are related to the amount of rewards offered.
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Resource Utilization With Insulin Pump Therapy for Type 2 Diabetes MellitusA retrospective claims analysis of managed care enrollees with type 2 diabetes mellitus showed that insulin pump therapy reduced antidiabetic drug and healthcare resource use.
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One Size Does Not Always Fit All in Value AssessmentLaying a clear path for incorporating reliable evidence on heterogeneity in value assessments could improve their applicability for healthcare decision making.
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Spending Variation Among ACOs in the Medicare Shared Savings ProgramAnalysis of spending differences among accountable care organizations (ACOs) may help identify cost savings opportunities. We examined the magnitude and sources of spending variation among ACOs over 4 years.
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Impact of a Value-Based Formulary in Three Chronic Disease CohortsA value-based formulary was implemented that used cost-effectiveness analysis to inform medication co-payments. Diabetes cohort expenditures decreased by $9 per member per month.
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Bending the Curve Through Health Reform ImplementationAuthors from The Brookings Institution update their recommendations by focusing on 3 concrete objectives to slow spending and improve quality of care within the next 5 years.
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The Utility of Cost Discussions Between Patients With Cancer and OncologistsMany patients with cancer desire cost discussions with doctors, but those discussions are rare. Nevertheless, cost discussions may lower patient costs-usually without altering treatment.
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Measures of ED Utilization in a National Cohort of ChildrenThrough analysis of multistate Medicaid data, this study identifies differences in 2 commonly used measures of emergency department (ED) utilization, ED visit count and ED reliance.
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Patient Safety Intervention to Reduce Unnecessary Red Blood Cell UtilizationThis study evaluated the impact of a patient safety intervention and national guideline to reduce unnecessary red blood cell transfusions in a large, urban academic medical center.
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Distal Upper and Lower Limb Fractures Associated With Thiazolidinedione UseThis study demonstrates that patients with diabetes taking thiazolidinediones have higher proportions of distal upper and lower limb fractures than those not taking the drug.
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Collaborative DTM Reduces Hospitalization and Healthcare Costs in Patients With Diabetes Treated With PolypharmacyDrug therapy management implementation in 2 health plans resulted in significant cost savings and modest to significant reductions in emergency department visits and inpatient admissions among patients with diabetes.
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A Claims-Based Algorithm to Reduce Relapse and Cost in SchizophreniaImplementing a claims-based algorithm and disease management program may be an effective strategy to reduce relapse and cost among patients with schizophrenia.
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Pragmatic Clinical Trials: US Payers' Views on Their ValuePayers like key traits of pragmatic clinical trials, but are wary of pharmaceutical companies and plan to carefully scrutinize this new, appealing type of evidence.
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Prescription Opioid Abuse: Challenges and Opportunities for PayersThis article outlines strategies insurers can use to mitigate their risks related to prescription opioid abuse by members, while addressing this serious public health problem.
