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Potential Spillover Effects on Traditional Medicare When Physicians Bear Medicare Advantage RiskMedicare beneficiaries treated by physicians with high levels of Medicare Advantage risk exposure had higher care quality and efficiency outcomes compared with those treated by other physicians.
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Accountable Care Organizations and Use of Surgery Among Patients With Alzheimer Disease and Related DementiasThe decision to pursue surgery in patients with Alzheimer disease and related dementias is challenging. Accountable care organizations may influence decisions to pursue surgery in this population.
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Guideline-Informed Care Among Medicaid-Enrolled Children With Food AllergyThis article describes food allergy–related service utilization and identifies factors associated with guideline-informed care among Medicaid-enrolled US children with food allergy.
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Contributor: Providers and Employers Need to Collaborate More to Avoid a Greater CrisisIt can be hard to think about the bigger picture while in the middle of a crisis, but providers and employers should use this opportunity to work together on new and alternative models of care delivery and financing that directly affect cost, outcomes, and experience.
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Integrating Mental Health Care Services Into HIV Comprehensive CareDistinguishing between need and receipt of integrated services reveals that mental health care improves the likelihood of medication adherence among people living with HIV.
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Medicare Advantage Coverage Restrictions for the Costliest Physician-Administered DrugsFour large Medicare Advantage insurers manage access to expensive physician-administered drugs with a combination of prior authorization, step therapy, and Part D formulary design.
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Chemotherapy-Induced Peripheral Neuropathy in Metastatic Breast Cancer Patients Initiating Intravenous Paclitaxel/nab-PaclitaxelWe examine the incidence and impact of chemotherapy induced peripheral neuropathy on clinical and economic outcomes in women with metastatic breast cancer initiating intravenous paclitaxel/nab-paclitaxel.
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Multimodal Imaging Can Be Used to Manage AMDMultimodal imaging is a useful tool in diagnosing and managing age-related macular degeneration (AMD), according to Julie Rodman, OD, MS, FAAO.
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Modeling the Economic Value of Cardiometabolic Virtual-First Care ProgramsUsing a microsimulation approach, this study modeled the potential multiyear health and economic benefits of participating in cardiometabolic virtual-first care programs.
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Impact of Payment Models on Medical Specialist Physician Practice PatternsThis article explores the impact of payment models (fee for service vs salary based) on practice patterns, including wait times and care for patients with chronic diseases.
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Antihyperglycemic Treatment Patterns for Chronic Kidney Disease and Type 2 DiabetesThis study characterized antihyperglycemic medication use after chronic kidney disease onset among patients with type 2 diabetes to uncover potential unmet needs in clinical practice.
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Combined Effect of Continuous Glucose Monitoring and Semaglutide: Analysis of Administrative ClaimsClaims data reveal larger hemoglobin A1c decreases in people with type 2 diabetes who use continuous glucose monitoring and semaglutide compared with semaglutide alone.
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Patient-Centered Communication and Outcomes in Heart FailureAmong community patients living with heart failure, excellent and good patient-centered communication was associated with a reduced risk of death.
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AI’s Future in Health Care Depends on Data Standardization, Collaboration: Erin Weber, MSErin Weber, MS, CAQH, is hopeful that artificial intelligence (AI) will empower people rather than replace them.
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Changes in Electronic Notification Volume and Primary Care Provider BurnoutPrimary care provider burnout was analyzed before and after a national initiative to optimize the electronic health record inbox notification system at the Veterans Health Administration.
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Community Health Workers’ Critical Role in Trust Building Between the Medical System and Communities of ColorThe authors interrogate elements of routine medical practice in New York City to argue for reforms of hospital culture through relational trust-building capabilities of community health workers.
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Hypoglycemia Upon Hospital Admission From Long-term Care: Health Care Resource UseThis analysis of a hospital billing database describes inpatient length of stay, intensive care unit length of stay, comorbidities, and costs for patients with diabetes after admission with hypoglycemia from long-term care or home.
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Access to Consultative Dermatologic Care via Physician-to-Physician Asynchronous Outpatient TeledermatologyDirect access of primary care physicians to dermatologists via asynchronous teledermatology improves a health system’s ability to increase patient access to dermatologic care.
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Baloxavir vs Oseltamivir: Reduced Utilization and Costs in InfluenzaBaloxavir, compared with oseltamivir, was associated with lower health care resource utilization and costs in patients with influenza, particularly those at high risk of secondary complications.
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Patient Experience in a COVID-19 Patient Home Monitoring ProgramPatients who participated in a COVID-19 patient home monitoring program were satisfied with their care and stated that their participation made them less likely to seek care in the emergency department.
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Predicting Hospitalizations for Patients With Chronic Kidney DiseaseThe authors developed an algorithm that uses medical claims to identify patients with chronic kidney disease who are at greatest risk of being hospitalized within 90 days.
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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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Overdiagnosis of Adult ADHD Is Exacerbating the Stimulant ShortageThe authors argue that the stimulant shortage is being perpetuated by the overdiagnosis of attention-deficit/hyperactivity disorder (ADHD) in adults because executive functioning deficits are not included in diagnostic criteria.
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Small Practice Participation and Performance in Medicare Accountable Care OrganizationsMedicare beneficiaries attributed to small practices in accountable care organizations (ACOs) achieve greater savings than beneficiaries attributed to large practices in ACOs.
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Evaluating Smoking Cessation Service at an Emergency Department Clinical Observation UnitThis study aimed to evaluate the impact of a smoking cessation service in a group of patients admitted to a short-stay unit in the emergency department.
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Actions to Improve Quality: Results From a National Hospital SurveyHospitals reported widespread adoption of quality improvement (QI) changes to improve on CMS quality measures, and QI adoption was associated with improved performance on quality measures.
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Eliminating Defects in Value: Turnaround of an MSSP ACOA health system transformational leadership framework and management system made visible and eliminated defects in value and was associated with reduced annual Medicare expenditures and increased quality between 2017 and 2020.
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2025 GOLD Report: New Insights on COPD Risks, ManagementThe 2025 Global Initiative for Chronic Obstructive Lung Disease (GOLD) report highlighted climate change, cardiovascular risk, and pulmonary hypertension.
