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Non–Face-to-Face Care Management and Service Utilization in Patients With DiabetesCMS began reimbursement for non–face-to-face chronic care management in 2015, and results from Louisiana show that it increases outpatient visits but decreases inpatient and emergency department encounters.
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Contributor: Leveraging Telehealth to Improve Access to Care for Maternal HealthThis article explores the challenges and highlights actionable telehealth solutions that enhance access to care, particularly for mothers at higher risk of postpartum depression.
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Primary Care Visit Cadence and Hospital Admissions in High-Risk PatientsPatients with congestive heart failure and/or chronic obstructive pulmonary disease who had more quarterly primary care visits had lower rates of hospitalizations during the COVID-19 pandemic.
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Development and Validation of the COVID-19 Hospitalized Patient Deterioration IndexThe authors developed and validated an accurate, well-calibrated, easy-to-implement COVID-19 hospitalized patient deterioration index to identify patients at high or low risk of clinical deterioration.
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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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After Tornado Damages Pfizer Plant, Hospitals Brace for ShortagesAnalysts warned of the potential for some shortages until the company can move production elsewhere. The North Carolina plant produces a quarter of the company’s sterile injectables used in hospitals.
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Improving Care Coordination and Reducing ED Utilization Through Patient NavigationA navigation program demonstrated decreased odds of repeat emergency department (ED) visits in patients with low baseline ED utilization and increased odds of follow-up primary care appointments.
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How Do Primary Hospitals Enact Early Response to the Relaxation of COVID-19 Prevention and Control Measures? The Experience From Chengdu, ChinaThis article examines how primary hospitals in Chengdu, China, responded to the relaxation of COVID-19 prevention and control measures in December 2022.
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Patterns of Opioid Use in Commercially Insured Patients With CancerAmong the fewer than half of patients with cancer who received opioid fills, a relatively small proportion (2.5%) had potentially problematic opioid use.
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Older Adults’ Perspectives on Emergency Department Costs During COVID-19Most older US adults have concerns about emergency department visit affordability. Lower income, being uninsured, poor or fair physical/mental health, and younger age were associated with increased concerns.
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Building Community-Level Solutions to Address Health Disparities: A Q&A With Dr Joneigh KhaldunJoneigh Khaldun, MD, MPH, FACEP, vice president and chief health equity officer for CVS Health, speaks on the launch of her organization’s Community Equity Alliance that aims to address structural barriers to equitable care in underserved communities through partnerships with local academic and health care institutions.
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Comment on COVID-19 Vaccine Hesitancy and Health LiteracyThis letter discusses COVID-19 vaccine hesitancy and health literacy.
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Evaluation of a Pediatric Asthma High-risk Scoring AlgorithmAn asthma risk score using 7 clinically relevant parameters evaluated in a pediatric Medicaid managed care population can stratify risk for following-year asthma hospitalization.
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Implementing Multistate Behavioral Health Pay-for-Performance Initiatives in Medicaid Managed CareThe authors describe a pay-for-performance initiative targeting behavioral health providers, which was introduced by a large Medicaid managed care organization across multiple states.
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Economic Burden of Joint Disease in Psoriasis: US Claims AnalysisThis retrospective claims analysis found that concomitant joint disease in psoriasis is associated with greater health care resource utilization and health care costs than psoriasis alone.
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Impact of Travel Distance on Quality Outcomes in Colorectal CancerThis study identified characteristics of patients with colorectal cancer who traveled farther for surgery and found that those who traveled tended to stay longer at the hospital.
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Contributor: An Urgent Call to Action as Colorectal Cancer Rates Skyrocket Among Young PeopleAs rates of CRC skyrocket in young individuals, means of addressing the growing problem must be considered.
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Continuity of Opioid Prescribing Among Older Adults on Long-term OpioidsAmong older adults with chronic noncancer pain on long-term opioid therapy, greater continuity of opioid prescribing was significantly associated with fewer opioid-related adverse outcomes.
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Mental Health Service Utilization Review Patterns in a Medicaid Managed Care ProgramMedicaid managed care utilization review data for mental health services were analyzed for the calendar years 2017 and 2018. These data indicate low rates of utilization review denials for both inpatient and outpatient mental health services.
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Medicaid ACOs and Managed Care: A Tale of 2 StatesThis article presents a detailed descriptive analysis of how Massachusetts and Minnesota implemented Medicaid accountable care organization (ACO) models for their managed care population.
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Geographic Variability of Medicaid Acceptance Among Allergists in the USThe proportion of allergists accepting Medicaid in the US varied significantly among and within states.
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Payment Incentives and the Use of Higher-Cost Drugs: A Retrospective Cohort Analysis of Intravenous Iron in the Medicare PopulationDuring a period of rapid fluctuation in the intravenous iron market, there was increased use of a more expensive drug that afforded providers additional revenue.
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Differences in Spending for Diabetes and Multiple Chronic Conditions in Michigan Medicare BeneficiariesDiabetes and multiple chronic conditions increase overall Medicare spending, but spending increases even more in minority beneficiaries compared with White beneficiaries with similar comorbidity combinations.
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The Implementation of Opioid Prescribing Report Cards in Medicaid Managed Care: A Community Quality CollaborativeThis article describes the Philadelphia Medicaid Opioid Prescribing Initiative that was launched by a multidisciplinary team and mailed local Medicaid providers individualized prescribing report cards.
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Dosage and Outcomes in a Complex Care InterventionAssociations between intervention dosage and hospital use outcomes were observed among patients enrolled in a care management program serving individuals with complex needs.
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Prolonged Cessation of Chronic Opioid Analgesic Therapy: A Multidisciplinary InterventionThis article evaluates the immediate and long-term efficacy of a group multidisciplinary program for chronic opioid analgesic therapy cessation in the setting of chronic, noncancer pain.
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Safety vs Price in the Generic Drug Market: MetforminThe generic drug market focuses on price. However, multiple generic metformin drugs have been recalled due to poor drug quality. The authors examine price and quality after these recalls.
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Assessing the Impact of Transplant Case Management on Clinical OutcomesThis article examines the effect of a transplant case management program on clinical outcomes following transplant surgery.
