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Population-Based Return on Investment of Deploying Transient ElastographyDeploying vibration-controlled transient elastography/controlled attenuation parameter devices at the population level is a financially advantageous solution to address the epidemic of fatty liver disease.
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Association of Wound Healing With Quality and Continuity of Care and Sociodemographic CharacteristicsBased on the analysis of electronic health records from 480 clinics, we found that better care quality and continuity are associated with better-than-expected wound healing performance.
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Real-World Value of Direct-Acting Antivirals for Hepatitis C at Kaiser Permanente Southern CaliforniaThis analysis demonstrates value and innovation of direct-acting antivirals for the treatment of chronic hepatitis C in the US Kaiser Permanente health system.
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Health Equity Decision-making: A Q&A With Dr N. Benjamin FredrickN. Benjamin Fredrick, MD, of Penn State Hershey Medical Center and Penn State University College of Medicine, speaks on the key themes he presented during his session at the 2023 Health Equity Summit in San Diego, California, as well as topics related to the measurement, creation, and implementation of health equity initiatives.
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Contributor: Engaging With Dual-Eligible Members During a PandemicWhen a crisis hits and members become isolated, how can a health plan continue to play an active role in maintaining their health?
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Evaluating Alternatives to QALYsA better summary measure would be useful, but it is unclear whether there will ever be sufficiently little variation in valuation to design methods in a way that does not require repeated and costly reevaluation of assumptions.
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Physician-Led Tech Firms Use AI to Counter Drug Denials and Augment AppealsAs drug denials increase, experts discuss the importance of optimizing data to keep up with these changes and implementing artificial intelligence (AI) to reduce the burden on providers and ensure patient access to care and treatment.
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Evaluating Smoking Cessation Service at an Emergency Department Clinical Observation UnitThis study aimed to evaluate the impact of a smoking cessation service in a group of patients admitted to a short-stay unit in the emergency department.
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Improving Risk Stratification Using AI and Social Determinants of HealthPrediction models combining claims data with social determinants of health and additional, more-timely data sources using artificial intelligence (AI) can better identify individuals with the highest future medical spending.
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Immunotherapy in the Frontline Management of Advanced and Metastatic NSCLCThe frontline treatment paradigm for patients with advanced or metastatic non−small cell lung cancer (NSCLC) has changed dramatically in the past decade amid efforts to tackle this leading cause of cancer-related mortality. Immune checkpoint inhibitors (ICIs) targeting the programmed cell death protein 1 (PD-1) receptor and its ligand PD-L1 are an important therapeutic option for patients whose tumors lack genetic alterations that dictate response to molecularly targeted therapies. With a growing number of FDA-approved ICI monotherapy and combination therapy options for first-line therapy, the use of biomarkers such as PD-L1 expression has become increasingly important in guiding therapeutic decision making. Presently, PD-L1 expression remains a key biomarker in this setting, in spite of its limitations. This article will evaluate the current and evolving clinical trends in the use of ICIs in the frontline management of metastatic NSCLC, as well as the challenges associated with PD-L1 expression analysis and biomarker implementation.
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Facilitators of and Barriers to Medicaid Investment in Electronic Consultation ServicesIn this qualitative investigation, leaders of Medicaid managed care plans were interviewed to identify facilitators of and barriers to electronic consultation for specialty care delivery.
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Cold Agglutinin Disease: Clinical PearlsTake-aways from a discussion on the management of cold agglutinin disease, with expert insight on navigating the healthcare system to optimize patient care.
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Availability of Prices for Shoppable Services on Hospital Internet SitesOnly 60% of hospitals display their cash prices and 5% display their minimum negotiated charges on their public websites; many hospitals are in violation of new federal legislation.
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Leveraging AI to Reduce Breast Cancer RiskMikael Eriksson, PhD, epidemiologist at Karolinska Institute in Sweden, discusses the development and implementation of an artificial intelligence (AI) model to reduce bias and improve breast cancer prevention.
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What Value Do Teaching Hospitals Provide Commercial Beneficiaries When in an ACO?Accountable care organizations (ACOs) with a major teaching hospital were associated with lower mortality, lower inpatient spending, lower emergency department utilization, and higher overall outpatient spending.
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Population-Based Return on Investment of Deploying Transient ElastographyDeploying vibration-controlled transient elastography/controlled attenuation parameter devices at the population level is a financially advantageous solution to address the epidemic of fatty liver disease.
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Appropriate ED Utilization Leading to Better Care CoordinationAddressing avoidable emergency department (ED) utilization takes interventions in partnership with providers.
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The Persistent Pandemic of Violence Against Health Care WorkersThe problem of violence against health care workers has escalated across the world, and tackling this issue requires the support of administrators.
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Building Research Capacity in Primary Care Practices That Serve Predominantly Racial and Ethnic Minority PopulationsThe successful collaboration between a primary care–based network of practices and academic researchers demonstrates feasibility and the need for more funding for primary care research.
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Stakeholder Analysis: Medicare Diabetes Prevention Program Awareness and ImplementationThis article describes facilitators of and barriers to uptake of the underutilized Medicare Diabetes Prevention Program from the perspectives of health care providers and program suppliers in western Pennsylvania.
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Medication Adherence Star Ratings Measures, Health Care Resource Utilization, and CostFor patients prescribed diabetes, hypertension, and hyperlipidemia medications, nonadherence to CMS Star Ratings quality measures of medication adherence was associated with increased health care resource utilization and costs.
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Estimating the Economic Burden of Migraine on US EmployersThe Migraine Impact Model is an interactive calculator that estimates migraine prevalence within a workforce and the associated economic burden of migraine on the employer.
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Reimbursement for Genetic Variant Reinterpretation: Five Questions Payers Should AskPeriodic reinterpretation of genetic sequencing results presents a challenge for developing transparent and systematic coverage and reimbursement policies.
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Cost of Home vs Clinic Administration of Paclitaxel in Metastatic Breast CancerHome administration of oral paclitaxel and encequidar is associated with potential cost savings for payers compared with clinic administration of intravenous chemotherapy in metastatic breast cancer patients.
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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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Impact of Including Drug Spending in Oncology Alternative Payment ModelsThis study demonstrates a method for understanding the effects of drug spending in the design of alternative payment models.
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Budget Impact Analysis of Biosimilar Natalizumab in the USProjected savings from biosimilar natalizumab were $452,611 over 3 years, driven by decreased drug acquisition costs and a utilization shift from reference to biosimilar natalizumab.
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Accountable Care Organizations and HPV Vaccine Uptake: A Multilevel AnalysisThe authors evaluated whether adolescents receiving care at accountable care organizations (ACOs) vs non-ACOs were more likely to initiate and complete the human papillomavirus (HPV) vaccination series.
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Contributor: Medicare Policy Proposal Jeopardizes Care for Those on DialysisCEOs of 3 kidney care organizations explain flaws in CMS' recent reimbursement proposal.
