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Proactive Care Management of AI-Identified At-Risk Patients Decreases Preventable AdmissionsProactive care management for artificial intelligence (AI)–identified at-risk patients reduced potentially preventable hospital admissions.
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Modeling Financial Outcomes and Quantifying Risk in Episode-Based Payment ModelsThis article provides a description of prospective financial simulation methodology and use cases with empirical data for episode-based bundled payments, including implications for contract negotiations and value-based care redesign.
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Association of Physician Specialty With Psoriatic Arthritis Treatment and CostsIn this retrospective cohort study of patients with newly diagnosed psoriatic arthritis, the authors examine the association of treatment selection and costs with physician specialty.
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Equity and AI Governance at Academic Medical CentersThis study identifies limited engagement with equity among academic medical centers as they develop governance processes for artificial intelligence (AI)/machine learning and predictive technologies.
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Emergency Department Risk Model: Timely Identification of Patients for Outpatient Care CoordinationThe authors created a machine learning–based model to identify patients with major depressive disorder in the primary care setting at high risk of frequent emergency department visits, enabling prioritization for a care coordination program.
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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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Patient Education, Provider Education, and Overall Final ThoughtsIn this discussion, panelists offer their final thoughts.
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Approaches for Overcoming Barriers to Cross-Sector Data SharingThe authors identified challenges to cross-sector data sharing and the approaches used to overcome these challenges in the Mid-Ohio Farmacy, a partnership to address food insecurity.
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An Evaluation of a Care Coaching and Provider Referral Intervention for Behavioral Health NeedsCare coaching and behavioral health provider referral programs produce long-term savings, reductions in avoidable utilization, and increases in targeted services to treat behavioral health conditions.
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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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Impact of the COVID-19 Pandemic on Regular Emergency Department UsersRegular users of the emergency department (ED) transiently reduced ED visits when faced with ED access barriers during the COVID-19 pandemic.
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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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Journey to Anticoagulant Access Following Payer Rejection of ApixabanFormulary restrictions can create treatment barriers for patients with atrial fibrillation, including unnecessary delays in treatment and prescription abandonment, with vulnerable populations at greater risk.
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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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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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Enhance Care Continuity Post COVID-19Although shortfalls in continuity were well described prior to coronavirus disease 2019 (COVID-19), the pandemic has created an opportunity to augment this critical component of care delivery, with the potential to improve patient-centered outcomes and enhance spending efficiency.
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Hospital Partnership and Patient Outcomes Among Postacute Patients With StrokeThis article explores the patient-sharing relationships between acute hospitals and postacute hospitals and how these relationships influence patient discharge outcomes.
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Preferences for and Experiences With Pill Appearance Changes: National Surveys of Patients and PharmacistsChanges in generic drug appearance occur often. Patients’ and pharmacists’ responses to those changes vary, with some patients stopping their medication or using it less.
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Economic Burden of Nonadherence to Standards of Diabetes CareUsing propensity score matching in a US nationally representative sample, authors found the effect of nonadherence to diabetes guidelines on health care expenditures of patients with diabetes.
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Utilization of Low- and High-Value Health Care by Individuals With and Without Cognitive ImpairmentLow-value service utilization is common among all older adults, and utilization of some high-value services decreases after the onset of cognitive decline.
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Clinic Price Reductions in a Tiered Total Cost Benefit DesignFindings of this evaluation of primary care clinic responses in a tiered total cost of care benefit design suggest that clinics respond by reducing prices.
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Responsibility for Treating Tobacco Dependence in Health Clinics Serving Medicaid EnrolleesThis article describes the implementation of Medicaid smoking cessation guidance in a large, urban federally qualified health center to examine how state-level provisions translated into clinic-level policies.
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An Accelerated Hospital Observation Pathway to Reduce Length of Stay for Patients With COVID-19For select patients hospitalized due to COVID-19, an academic urban hospital implemented an observation pathway that incorporated mobile health technology, reducing hospital length of stay by more than 2 days.
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FDA Approves Bosutinib for Pediatric Patients With CP-CMLBosutinib has a new indication in leukemia as a well as a newly-approved formulation.
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Advancing Health Equity Through Medication Formulary PolicyMedication formulary policies represent a key determinant of access to medication and can be leveraged to advance pharmacoequity and health equity writ large.
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Using Electronic Health Records and Claims Data to Identify High-risk Patients Likely to Benefit From Palliative CareDeep learning algorithms could improve palliative care by predicting mortality from electronic health records and claims data.
