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Intensive Care Management of a Complex Medicaid Population: A Randomized Evaluation

The authors present findings of a randomized evaluation of Medicaid patients at an academic medical center, which found that intensive care management was associated with reduced total medical expense.

How Value-Based Care With Provider Enablement Improves Maternal and Infant Outcomes in Medicaid

Supported value-based care improves prenatal care while reducing neonatal intensive care unit stays, preterm birth rates, low birth weight rates, and costs for mothers and infants.

Variability of COPD Inhaler Coverage in Medicare Part D

Although most Medicare Part D plans cover guideline-recommended outpatient chronic obstructive pulmonary disease (COPD) inhalers, the utilization controls applied to these therapies vary by plan type.

Examining Developments in Multicancer Early Detection: Highlights of New Clinical Data from Recent Conferences

Cancer remains the second leading cause of death in the United States despite decades of treatment advances. While death rates have fallen for breast, cervical, and colorectal cancers, death rates remain high for the majority of malignancies, primarily given the late stage at which they are diagnosed. The US Preventive Services Task Force currently recommends routine screening for just 4 cancers: breast, cervical, colorectal, and lung (for high-risk individuals); for prostate cancer, recommendations support individual decision making. However, cancers without recommended screening tests account for 71% of cancer deaths in the United States. In addition, screening rates remain below national goals, with numerous barriers to population-based screening. Recently, initial results of studies on blood-based multicancer early detection tests, which rely on measurement of a range of analytes, demonstrate the potential to identify multiple cancers in a single blood test and detect many cancers for which no screening tests are currently recommended. Blood-based tests have the potential to be more accessible and easier to disseminate than organ-specific tests. However, it remains unclear if their use can reduce deaths from these cancers. Other issues include cost-effectiveness, the impact of false-positive and false-negative results on patients and costs, and uptake among individuals and clinicians. Research and development of blood-based multicancer early detection tests continue.

Medicare Expenditures in the First Year of Amyotrophic Lateral Sclerosis Diagnosis

Medicare expenditures for patients with amyotrophic lateral sclerosis are more than 3 times those of the average Medicare beneficiary, and drug therapies are an important cost driver.

Older Adults’ Perspectives on Emergency Department Costs During COVID-19

Most older US adults have concerns about emergency department visit affordability. Lower income, being uninsured, poor or fair physical/mental health, and younger age were associated with increased concerns.

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.

Spending Patterns Among Commercially Insured Individuals During the COVID-19 Pandemic

In this analysis of more than 97 million commercially insured individuals, investigators found that the COVID-19 pandemic induced a spending shock in 2020 and that health care spending did not recover to baseline until mid-2021.

Patients’ Needs Following Emergency Care for Ambulatory Care–Sensitive Conditions

To inform intervention development, we assessed for medication changes and patient care needs following treat-and-release Veterans Affairs emergency department visits for chronic ambulatory care–sensitive conditions.

Office Procedures for Older Adults by Physician Associates and Nurse Practitioners

The authors probed Medicare Part B data to explore outpatient clinical procedures performed by physician associates and nurse practitioners and report the trends from 2014 through 2021.

Economics of a Health System’s Direct-to-Consumer Telemedicine for Its Employees

A direct-to-consumer telemedicine service resulted in lower per-episode unit costs for care within 7 days and only marginally increased the use of services overall.

Racial and Ethnic Disparities in Telemental Health Use Among Publicly Insured Children

Among publicly insured children with mental health–related encounters, racial and ethnic disparities in telemental health use widened following the onset of the COVID-19 pandemic.

Predicting Hospital Readmission in Medicaid Patients With Diabetes Using Administrative and Claims Data

A statistical model based entirely on claims data can accurately predict 30-day hospital readmission in Medicaid patients with diabetes.

Impact of COVID-19 Pandemic on Accessibility of Taiwanese Medical Care

The COVID-19 pandemic disrupted access to routine medical care in community populations in Taiwan. The unmet needs should be emphasized as normal life resumes.

Potential Health Literacy Resources for Health Plans: A Narrative Review

Several evidence-based health literacy resources may be beneficial in health plan settings to improve organizational health literacy, personal health literacy, and health equity.

Clinician Characteristics Associated With Fluoride Varnish Applications During Well-Child Visits

Clinicians treating a higher percentage of patients insured by Medicaid and patients younger than 5 years were more likely to apply fluoride varnish.

Primary Care Case Conferences to Mitigate Social Determinants of Health: A Case Study From One FQHC System

This article describes perceived benefits, facilitators, and challenges of conducting interprofessional team case conferences in primary care settings to address patients’ complex social needs.

An Accelerated Hospital Observation Pathway to Reduce Length of Stay for Patients With COVID-19

For 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.

RAISE: Elevating Person-Centered Data for Healthy Communities

The RAISE program provides awareness and shares comprehensive solutions to address the multifaceted reasons for missing and incomplete data across the real-world data continuum.

An Accelerated Hospital Observation Pathway to Reduce Length of Stay for Patients With COVID-19

For 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.

Investigating Real-world Consequences of Biases in Commonly Used Clinical Calculators

Clinical calculators that do not include demographic variables may be biased, and their equity should be understood in the context of clinical guidelines.

Standardized Total Knee Arthroplasty Pathway Improves Outcomes in Minority Patients

In a minority-predominant patient population, a standardized pathway for total knee arthroplasty was associated with improved outcomes with no change in postoperative complication rates.

Real-World Insights on Biomarker Testing Patterns and Implications for mNSCLC Therapy Selection

Exploratory Study of Selected Stakeholder Insights Into Continuous Glucose Monitoring in T2D With Risk-Sharing Agreements

A small expert panel was selected to share professional experiences with risk-sharing agreements and advance the cost-effective utilization of continuous glucose monitoring–centered care in type 2 diabetes (T2D).

A Learning Health Care Community: Integrating Research and Practice at Scale

This article presents a case study of how stakeholders in one state came together to integrate practice and research that is a step beyond a learning health care system.

Patient Perspectives on Technology-Based Approaches to Social Needs Screening

Patients are essential stakeholders in designing systems to capture social needs. The authors present key findings from patient interviews regarding social needs screening through technology-based modalities.

Assessment of Variation in Ambulatory Cardiac Monitoring Among Commercially Insured Patients

Ambulatory cardiac monitors’ clinical and economic outcomes vary; one long-term continuous monitor brand showed greater arrhythmia diagnosis, fewer retests and cardiovascular events, and lower health care resource use and costs.

Assessing the Impact of Transplant Case Management on Clinical Outcomes

This article examines the effect of a transplant case management program on clinical outcomes following transplant surgery.

Contributor: Modern Medicine Meets House Calls—Caring for the Patient With Diabetes in 2020

Physicians agree that telehealth leads to better and more consistent patient care for patients and their families and provides many more touchpoints for patients with diabetes—all of which should continue after the pandemic in order to provide these patients with the best care going forward.

Increasing Clinical Awareness of Obesity as a Serious, Chronic, Relapsing, and Treatable Disease