Authors
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Session 3: DiscussantJan Berger, MD, MJ, The American Journal of Pharmacy Benefits editor-in-chief, follows Rebecca Killon's remarks with her own insight on the importance of diabetes medication adherence.
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Physician Satisfaction With Health Plans: Results From a National SurveySeveral physician and payer characteristics are associated with physician satisfaction with health plans. There is opportunity to improve physician satisfaction with payers, specifically in pharmacy.
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Implementing Team-Based Telemedicine Workflows in Safety-Net Primary CareTelemedicine in safety-net primary care faces particular challenges. Consistent, team-based workflows can support video visit implementation and health care maintenance in telemedicine visits.
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Adherence to Medication Under Mandatory and Voluntary Mail Benefit DesignsPharmacy benefit designs that mandate mail pharmacy use interfere with prescription drug access, particularly for individuals without previous mail pharmacy experience.
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Caregiver Presence and Patient Completion of a Transitional Care InterventionCaregivers' presence during patient recruitment is associated with a greater rate of completion of a post hospital transitional care coaching intervention, particularly among men.
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Impact of the Patient-Centered Medical Home on Consistently High-Cost PatientsPatient-centered medical homes in Maryland’s multipayer demonstration disrupted the pattern of recurrently high expenditure among the costliest patients and improved continuity of care.
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Are Work Relative Value Units Correlated With Operative Duration of Common Surgical Procedures?Work relative value units (wRVUs) correlate with operative duration of common surgical procedures. Reimbursement for physicians depending on wRVUs is fair for commonly performed surgeries.
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Value and the Medical Home: Effects of Transformed Primary CareA patient-centered medical home with intensive case management and a payer partner can significantly improve hospital utilization and may decrease total medical costs for a Medicare population.
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Risk Stratification for Return Emergency Department Visits Among High-Risk PatientsThe authors examined 2 high-risk classification methods to compare and contrast the patient populations, and to identify the preferred method for predicting subsequent emergency department visits.
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Community Navigators Reduce Hospital Utilization in Super-UtilizersSuper-utilizers place a significant clinical and financial burden on the healthcare system. The authors investigated the effectiveness of community navigators in reducing hospital utilization and costs.
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Alternative Payment Models: Paving the Way or Building a Wall for Personalized Medicine?As personalized medicine rapidly becomes an effective tool for combating cancer, payers are exploring new, value-based payment paradigms. These trends will soon intersect, and depending on how they are structured, the new payment models could accelerate or stifle personalized medicine's progress.
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Value-Based Insurance Design: Benefits Beyond Cost and UtilizationThe authors provide a framework to capture additional benefits that may result from VBID programs, extending beyond utilization and outcomes to productivity, engagement, and talent.
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Active Pharmacovigilance and Healthcare UtilizationThis study highlights the potential value of innovative ways of collecting information about adverse drug events directly from patients.
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Association of Care Management Intensity With Healthcare Utilization in an All-Condition Care Management ProgramHigher intensity of care management in an all-condition program addressing care coordination and care barriers was associated with increased healthcare utilization among Medicaid and Medicare patients.
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Medication Utilization and Adherence in a Health Savings Account-Eligible PlanA consumer-directed health plan with a health savings account was associated with reduced adherence for 4 of 5 conditions.
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Oncology Practice Transformation Helps Deliver Patient-Centered Cancer Care in a Community Oncology PracticeOne possible way to reduce overall cost, improve patient experience, and improve outcomes in cancer care is to shift the focus of healthcare delivery away from volume and toward value. Patient-centered cancer care holds the promise of addressing these issues.
