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Defining Value Among Treatment OptionsPayer decision-makers discuss defining value among agents for unintended pregnancy, uterine fibroids, and endometriosis.
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Contributor: COVID-19 Vaccine May Not Be the Ultimate PanaceaWe should look forward to a safe, effective vaccine for coronavirus disease 2019 (COVID-19) but not expect it to be the ultimate panacea.
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Patient Value Co-creation Behavior Scale Based on the DART ModelThis study aimed to develop and evaluate the psychometric properties of a scale measuring patient value co-creation behavior based on the DART (Dialogue, Access, Risk assessment, Transparency) model.
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Clinical Outcomes in Heart Failure Monitoring: A Pooled Rates AnalysisThis systematic literature review and pooled rates analysis investigated the standard of care for patients with heart failure in the US post hospital discharge.
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The Unintended Consequences of Medicare’s Wage Index Adjustment on Device-Intensive Hospital ProceduresThe authors found an association between Medicare’s wage index adjustment and the differential use of labor-intensive surgical procedures and medical device–intensive minimally invasive clinical procedures across the United States.
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NACT Use Appears to Be Increasing in Less Common Epithelial Ovarian CancersPatients with low-grade serous ovarian cancer appear to have worse survival outcomes following treatment with neoadjuvant chemotherapy (NACT).
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A Machine Learning Technology for Addressing Medication-Related Risk in Older, Multimorbid PatientsA novel machine learning system effectively stratifies emergency department use and hospitalization risk of older patients with multimorbidity who take multiple medications and provides appropriate medication recommendations.
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Guideline-Informed Care Among Medicaid-Enrolled Children With Food AllergyThis article describes food allergy–related service utilization and identifies factors associated with guideline-informed care among Medicaid-enrolled US children with food allergy.
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Reduced Medical Spending Associated With Integrated Pharmacy BenefitsMembers covered by an integrated pharmacy benefit (as opposed to a pharmacy carve-out) experienced slower growth in medical spending.
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Telemedicine Catches On: Changes in the Utilization of Telemedicine Services During the COVID-19 PandemicThis analysis of health insurance claims data demonstrates rapid increase and sustained high utilization of telemedicine services during the COVID-19 pandemic.
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Unmet Needs in the Treatment of Wet AMDNicholas G. Anderson, MD; Philip Niles, MD, MBA; Kevin U. Stephens, Sr., JD, MD; and Jim Kenney, RPh, MBA, provide insight on unmet needs and future directions for the treatment of wet AMD and DME.
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Long-Term Health Care Costs Following COVID-19: Implications for Pandemic PreparednessA difference-in-differences analysis of health care claims data evaluated excess health care costs in the 12 months following COVID-19 diagnosis among the general and older adult populations.
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Contributor: Roadmap to the Quadruple Aim—A Framework for Minimizing Physician Burnout During the Transition to Value-Based CareAs provider and payer organizations pursue the Quadruple Aim, it is important that they take into account not just the contracting but also the transformation in staffing, clinical workflows, and culture as these organizations evolve.
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Modeling of an Alternative Reimbursement Method for Palliative CareThe authors modeled a version of the Patient and Caregiver Support for Serious Illness alternative reimbursement structure for palliative care using data from the Statin Trial.
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Real-World Users of Triple Therapy for Asthma in the USThis retrospective cohort study evaluated baseline demographics, clinical characteristics, and treatment patterns of US patients with asthma who newly initiated single- or multiple-inhaler triple therapy.
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The Price of Progress: Understanding Innovation and Affordability of Prescription DrugsEconomic incentives and patent protections drive development of innovative medications. Drug prices are determined by consumer demand, not production costs. Therefore, governmental regulation risks future investment in research and development.
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Antibiotic Practice Patterns With Procalcitonin Levels in Patients With Acute Lower Respiratory Tract InfectionAlthough clinical trials have demonstrated the utility of procalcitonin (PCT) testing and potential benefit on antibiotic stewardship, findings suggest that clinicians do not order PCT testing with regularity and also prioritize clinical judgment over PCT results.
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Cost-effectiveness of Nivolumab in Patients With NSCLC in the United StatesThis article presents a cost-effectiveness analysis of nivolumab vs docetaxel from the US payer perspective in non–small cell lung cancer (NSCLC) based on randomized phase 3 studies with a minimum 5 years of follow-up.
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A “Sludge Audit” for Health System Colorectal Cancer Screening ServicesA systematic, mixed methods “sludge audit” identified novel health system delivery targets for improving colorectal cancer screening services.
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Pharmacists and Transitions of Care From Emergency Department to HomePharmacists’ roles in transitions of care continue to evolve. Evaluation of pharmacist-led interventions as patients transition from emergency department to home is needed.
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Contributor: Vulnerable Seniors Are at Risk With Looming Medicare Advantage Cuts—Income-Based Programs Can Minimize the DamageIn the wake of the Inflation Reduction Act and other regulatory changes, Medicare Advantage plans have braced for significant cuts that are forcing them to take a hard look at their product offering.
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Impact of Food Affordability on Diabetes-Related Preventable HospitalizationMedicaid enrollees residing in counties with greater food affordability had lower odds of preventable hospitalization related to diabetes.
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Impact of COVID-19 Pandemic on Accessibility of Taiwanese Medical CareThe COVID-19 pandemic disrupted access to routine medical care in community populations in Taiwan. The unmet needs should be emphasized as normal life resumes.
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Reimagining the Inpatient Palliative Care Consult: Lessons From COVID-19Digital innovations in palliative care during COVID-19 have changed how hospitalized patients receive palliative care. We propose an approach to implement new models at scale.
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Collaboration to Transition Members to Preferred Formulary Dipeptidyl-Peptidase-4 InhibitorA collaboration between a drug plan and clinical pharmacists led to nearly 50% of members successfully switching to a preferred dipeptidyl-peptidase-4 inhibitor.
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Adolescent Anterior Cruciate Ligament Reconstruction: A Decade of Rising Surgical CostAdolescent anterior cruciate ligament reconstruction surgery can preserve health and restore function of the knee joint, but the surgical cost has outpaced inflation.
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Out-of-Pocket Spending for Cardiac Rehabilitation and Adherence Among US AdultsAmong commercial and Medicare supplemental beneficiaries with cost sharing, higher out-of-pocket spending for the first cardiac rehabilitation session was associated with lower program adherence.
