Authors
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Outcomes Trends for Acute Myocardial Infarction, Congestive Heart Failure, and Pneumonia, 2005-2009The 3 core measures of acute myocardial infarction, congestive heart failure, and pneumonia are the leading causes of hospital admissions and expenditures. Our study sets the benchmark foundation for outcome evaluations of CMS’s value-based purchasing program and the Affordable Care Act.
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Health Plan—Provider Accountable Care Partnerships: How Have They Evolved?Although health plan accountable care models have evolved provider readiness, data, analytics, and the use of performance measurement are important components of plan-provider partnerships.
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Finding Solutions for Cancer Patients: The American Cancer Society's Health Insurance Assistance ServiceSince 2005, American Cancer Society has sponsored the Health Insurance Assistance Service, a unique initiative to help cancer patients navigate the private coverage system and to educate policy makers about how coverage works for patients with this serious and chronic condition.
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Effective Implementation of Collaborative Care for Depression: What Is Needed?Factors most important for successful implementation of collaborative care for depression differ for patient activation versus achieving remission; both are critical to program success.
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Gatekeeping and Patterns of Outpatient Care Post Healthcare ReformIs specialist “gatekeeping” in modern health maintenance organization (HMO) insurance associated with differences in outpatient care? The study finds that HMO gatekeeping may meaningfully reduce specialist utilization.
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Shifting Cardiovascular Care to Nurses Results in Structured Chronic CareThis study sought to explore if shifting care to nurses in cardiovascular risk management in primary care is a key to more structured chronic care.
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Ambulatory Care–Sensitive Emergency Visits Among Patients With Medical Home AccessPatients often self-refer to the emergency department (ED) for management of an ambulatory care–sensitive condition, and the ED may be the most appropriate care location.
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A Restricted Look at CRC Screening: Not Considering Annual Stool Testing as an OptionThis is a letter clarifying some points in an article published in the February 2016 issue of AJMC by Berger et al on colorectal cancer screening guidelines.
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Access to Primary and Dental Care Among Adults Newly Enrolled in MedicaidNearby provider supply did not affect identification of usual sources of primary or dental care among new Medicaid enrollees. Strategies to improve access are needed.
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Improving Quality of Care in Oncology Through Healthcare Payment ReformOverview of alternative payment models and how leading national organizations are involved with linking quality improvement initiatives and payment reform.
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Large Self-insured Employers Lack Power to Effectively Negotiate Hospital PricesThis study examines the ability of self-insured employers to negotiate hospital prices and the relationship between hospital prices and employer market power in the United States.
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Recommendations for the Role of Clinical Pathways in an Era of Personalized MedicineWe offer recommendations for the development and design of clinical pathways in an effort to establish a set of normative criteria that creates trust and transparency.
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Clinical Outcomes and Healthcare Use Associated With Optimal ESRD StartsOptimal end-stage renal disease (ESRD) starts were associated with lower 12-month morbidity, mortality, and inpatient and outpatient utilization in an integrated healthcare delivery system.
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Anticonvulsant Use After Formulary Status Change for Brand-Name Second-Generation AnticonvulsantsThe utilization pattern of anticonvulsants after a change in preferred-formulary coverage resulted in health plan savings of $0.16 per member per month.
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Cognitive Impairment and Reduced Early Readmissions in Congestive Heart Failure?Proactive identification of cognitive impairment and compensatory destigmatized patient/familial psychoeducation regarding “forgetfulness” in hospitalized patients with congestive heart failure may reduce readmission rates substantially.
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Does Opioid Therapy Affect Quality of Care for Diabetes Mellitus?Within the Veterans Affairs system, diabetes performance measures were similar in patients who received chronic opioid therapy and in those who did not.
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Clinical and Economic Outcomes Associated With Potentially Inappropriate Prescribing in the ElderlyClinical and economic outcomes associated with the use of specific potentially inappropriate medications in the elderly were evaluated.
