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Do Patient or Provider Characteristics Impact Management of Diabetes?Many more patient than provider characteristics are associated with optimal or poor glycemic control and treatment intensification when glycemic control is initially lost.
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CHAPTER 5. Clinical Guideline for Pharmacological Management of Adults With Type 2 DiabetesFrom the Adult Diabetes and Clinical Research Sections, Joslin Diabetes Center, Harvard Medical School. Approved May 10, 2016; updated April 24, 2018. For the Figure and Tables, download the PDF at the end of the chapter.
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A Multimodal Blood Pressure Control Intervention in 3 Healthcare SystemsA multisite multimodal intervention of patient education, home monitoring, measurement reporting to an IVR system, and pharmacist follow-up achieved greater BP reductions vs usual care.
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Patient Assignment and Quality Performance: A Misaligned SystemThis article explores the congruence between payer patient assignment and quality performance and the implications for incentive payments in alternative payment models.
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Performance Measurement for People With Multiple Chronic Conditions: Conceptual ModelThe Performance Measurement for People with Multiple Chronic Conditions conceptual model can facilitate development and refinement of quality measures for a medically complex population.
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Lessons From CareMore: A Stepping Stone to Stronger Primary Care of Frail Elderly PatientsCareMore, an insurance plan based in southern California, has reduced costs and improved outcomes by providing direct care for its frailest elderly patients.
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Oral Anticoagulant Discontinuation in Patients With Nonvalvular Atrial FibrillationThe risk of discontinuation of oral anticoagulant therapy (both warfarin and direct oral anticoagulant therapies [DOACs]) among nonvalvular atrial fibrillation patients was high. Although the hazard ratio for discontinuation favors DOACs, it is unlikely that the small difference in discontinuation relative to warfarin is clinically meaningful.
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Delivering on the Value Proposition of Precision Medicine: The View From Healthcare PayersGenomics-based precision medicine has the potential to transform healthcare delivery. However, effective collaborations among scientists, clinicians, and payers are needed to accelerate the translation of precision medicine to clinical practice and ensure its sustainability.
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Costs and Spillover Effects of Private Insurers' Coverage of Hepatitis C TreatmentExpanding private-payer coverage of hepatitis C treatment may yield significant long-term cost savings for private payers, reduced costs to Medicare, and increased social value.
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Measuring Patient-Centered Medical Home Access and Continuity in Clinics With Part-Time CliniciansCommonly used measures of performance for assessing patient access do not reflect PCMH-encouraged strategies to improve access that may be preferentially used by part-time physicians.
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Insomnia Risks and Costs: Health, Safety, and Quality of LifeThis review article discusses the issues surrounding the risks and costs of sleep disturbance as they relate to society and the individual.
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Have Prescription Drug Brand Names Become Generic?Prescription drug brand names no longer function as trademarks. They have become the common names of generic versions of the medicine.
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Care Coordination for Children With Special Needs in Medicaid: Lessons From MedicareAs increasing numbers of children with special healthcare needs move into Medicaid managed care, health plans can improve care coordination using evidence from Medicare.
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Molecular Testing Patterns in Metastatic Non—Small Cell Lung CancerAssessment of the timing of histologic and molecular testing indicates that testing occurred prior to treatment initiation for most patients with metastatic non—small cell lung cancer.
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Office Manager and Nurse Perspectives on Facilitators of Adult ImmunizationFactors significantly associated with adult vaccination rates in primary care practices were patients’ age, race, scheduled well-visit length, and nurses’ vaccination status.
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The Duration of Office Visits in the United States, 1993 to 2010Nationally representative data show that outpatient office visits to both primary care physicians and specialists grew longer over the period from 1993 to 2010.
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Three Proposals to Reform the 340B Drug Discount ProgramThe 340B Drug Discount Program has rapidly expanded over the last few years and may be missing its original intent. Here are 3 possible steps that could enhance the program’s function and mirror Congress’ original intent to enhance access for the poor to essential medical services.
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Cost Sharing, Adherence, and Health Outcomes in Patients With DiabetesHigher cost-sharing levels reduced adherence to antidiabetic medications in patients with type 2 diabetes.
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Electronic Consults for Improving Specialty Care Access for VeteransThe combination of electronic consultations and active triage of specialty care consults effectively reduces wait times for outpatient clinics.
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Are Benefits From Diabetes Self-Management Education Sustained?Conventional individualized diabetes self-management education resulted in sustained improvement in self-efficacy and diabetes distress. Short-term improvements in A1C, nutrition, and physical activity were not sustained.
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Cost-Effectiveness of Laparoscopic Gastric Banding and Bypass for Morbid ObesityLaparoscopic adjustable gastric banding and gastric bypass are cost-effective treatments for morbid obesity compared with no treatment.
