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Racial and Ethnic Disparities in Prior Authorizations for Patients With CancerThe prior authorization process for patients with cancer demonstrates fewer days until submission and lower denial rates for Asian patients relative to White patients.
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Investigating Real-world Consequences of Biases in Commonly Used Clinical CalculatorsClinical calculators that do not include demographic variables may be biased, and their equity should be understood in the context of clinical guidelines.
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Assessing Surveillance Utilization and Value in Commercially Insured Patients With Colorectal CancerTrends in surveillance testing after treatment for colorectal cancer remained relatively stable recently, and patients who overutilized surveillance measures had quicker recurrence detection but higher costs.
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Key Takeaways for the Management of HIV PrEPA panel of experts share closing thoughts and advice for the management and uptake of HIV PrEP therapy.
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Continuously Updated Forecasting of SARS-CoV-2 in a Regional Health SystemThis study presents a methodology for forecasting demand of COVID-19 on health resources in an integrated health system.
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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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A Scoping Review of US Insurers’ Use of Patient-Reported OutcomesThis scoping review found 350 articles that discuss US health insurance providers’ use of patient-reported outcomes about health-related quality of life.
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Accountable Care Organization Initiatives to Improve the Cost and Outcomes of Specialty CareEngaging specialty physicians is an emerging area of focus for Medicare accountable care organizations. Enhanced data on specialist costs and outcomes are essential to addressing alignment challenges.
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A Kidney Diagnostic’s Impact on Physician Decision-making in Diabetic Kidney DiseaseThe KidneyIntelX test would affect primary care physician (PCP) decision-making, and PCPs would use the results of KidneyIntelX more than albuminuria and estimated glomerular filtration rate when making decisions about diabetic kidney disease management.
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CMS Practice Assessment Tool Validity for Alternative Payment ModelsUsing data from 632 primary care practices, the authors show that the CMS Practice Assessment Tool has adequate predictive validity for participation in alternative payment models.
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Contributor: The Price of Mental WellnessConsidering the personal, societal, and economic toll of treatment-resistant depression, we must make it easier to access medicines and care that provide value, both for the patient and for the health care system.
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Contributor: ACO Success—Driving Better Outcomes and Liberating CliniciansPhysicians have been facing increasing workloads making it difficult to practice medicine as they were trained, but an accountable care organization might provide an opportunity for real change to deliver high-value, compassionate care.
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Provider Barriers in Uptake of Biosimilars: Case Study on FilgrastimPrevious studies have found modest uptake of biosimilars in both commercial and Medicare populations. This study finds that the uptake varies between the rural and urban provider settings.
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Income Differences Between Locations of 340B Entities and Contract PharmaciesThe authors find that 340B-covered hospitals and grantees are contracting mainly with pharmacies in significantly more affluent neighborhoods than their own.
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OneOncology and Its Practice Partners Celebrate 5 Years of Cancer Care Excellence“OneOncology was started by physicians and for physicians,” said Jeff Patton, MD, OneOncology CEO. “As we’ve grown and enhanced world-class cancer care in communities across the country, strengthening practice independence and empowering their decision-making has always been our north star."
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How the Name Change to Myeloproliferative Neoplasms Affected People With the DiseaseA decision to rename myeloproliferative neoplasms led to a plethora of developments in a space where there was once little interest.
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Association Between Low-Income Subsidies and Inequities in Orally Administered Antimyeloma Therapy UseMedicare Part D low-income subsidies alone are insufficient to improve the uptake and equitable use of high-cost, orally administered antimyeloma therapy.
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Using Natural Language Processing to Classify Social Work InterventionsNatural language processing can be used for automated extraction of social work interventions from electronic health records, thereby supporting social work staffing and resource allocation decisions.
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Primary Care Case Conferences to Mitigate Social Determinants of Health: A Case Study From One FQHC SystemThis article describes perceived benefits, facilitators, and challenges of conducting interprofessional team case conferences in primary care settings to address patients’ complex social needs.
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Contributor: COVID-19’s Impact on ACO REACH Deserves CMS' AttentionCMS must account for inclusion of COVID years in 2023 ACO REACH benchmarks to avoid unfairly penalizing REACH ACOs.
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mCRC Treatment Access: IRA Cost Cap Impact and Final InsightsMedical experts discuss how the Inflation Reduction Act’s out-of-pocket prescription drug cost cap, effective in 2025, may impact access to oral chemotherapy options for metastatic colorectal cancer.
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US Cost-effectiveness and Budget Impact of Point-of-Care NAAT for StreptococcusThis study evaluates the cost-effectiveness and budget impact to US payers of point-of-care nucleic acid amplification tests (NAAT) for group A streptococcus.
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Physician Groups Mostly Unhappy With Proposed Medicare Fee ScheduleThe proposed fee schedule for 2024 would reduce payments by 3.4%. Most responses were swift and negative.
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Health Care Resource Utilization, Quality Metrics, and Costs of Bladder Cancer Within the Oncology Care ModelSpending on novel therapies in high-risk bladder cancer had minimal impact on Oncology Care Model payments to practices, according to this cohort study and an average performance estimation.
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Opioid Safety Initiative Associated With Decreased Emergency Department Opioid PrescribingA scalable health system–wide emergency physician education and feedback initiative was associated with decreased opioid prescribing, in excess of background temporal decline.
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Trends in Medicare Part D Coverage of Generics With Equivalent Brand-Name DrugsHigh-tier generic drug placement in Medicare Part D has increased over time, but it may be related to a drug’s clinical profile and availability of substitutes rather than preferred brand-name drug coverage.
