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Lessons Learned in Implementing Behavioral Screening and InterventionThis article describes lessons learned over the past 10 years while helping several dozen primary care settings implement evidence-based, cost-saving behavioral screening and intervention.
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Flunking Asthma? When HEDIS Takes the ACTAsthma control, rather than compliance with the HEDIS asthma measure, is the most useful quality indicator of asthma care.
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Comparative Efficacy of Ezetimibe/Simvastatin, Rosuvastatin, and Atorvastatin in Uncontrolled Hyperlipidemia PatientsEfficacy of switching statin therapy from generic simvastatin was examined in a VA population. Ezetimibe/simvastatin was more potent than atorvastatin or rosuvastatin in lowering LDL.
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ED-Based Care Coordination Reduces Costs for Frequent ED UsersResults of our pilot randomized controlled intervention involving emergency department (ED)-based care coordination and community health workers demonstrated a trend toward fewer ED visits, fewer hospitalizations, and lower costs among intervention patients.
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Out-of-Plan Pharmacy Use: Insights Into Patient BehaviorPrescription cost and pharmacy convenience were identified as the most significant drivers of out-of-plan pharmacy use.
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The Value of Ambulatory Care Measures: A Review of Clinical and Financial Impact from an Employer/Payer PerspectiveThis review suggests that only a few primary care quality measures, which usually are not found in claims data, have significant clinical and financial impact.
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E-Consult Implementation: Lessons Learned Using Consolidated Framework for Implementation ResearchThis paper identified 4 factors associated with implementation success of e-consults in 8 VA medical centers, with implications for implementing similar health IT initiatives elsewhere.
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Primary Care Diabetes Bundle Management: 3-Year Outcomes for Microvascular and Macrovascular EventsUsing a system for primary care management of patients with diabetes may reduce the risk of myocardial infarction, stroke, and retinopathy over a 3-year period.
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The Value of Ambulatory Care Measures: A Review of Clinical and Financial Impact from an Employer/Payer PerspectiveThis review suggests that only a few primary care quality measures, which usually are not found in claims data, have significant clinical and financial impact.
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Hospital Responses to DSRIP Program Reforms in New JerseyThis study examines the New Jersey Delivery System Reform Incentive Payment (DSRIP) program using hospital web surveys and key informant interviews and finds progress toward data-driven population health management for low-income patients.
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Analysis of Venous Thromboprophylaxis Duration and Outcomes in Orthopedic PatientsExtended-duration thromboprophylaxis (>14 days) for total hip replacement/total knee replacement was associated with significantly lower risk for thromboembolic and bleeding events than short-duration thromboprophylaxis.
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Cost Per Response Analysis of Strategies for Chronic Immune ThrombocytopeniaThis decision tree model estimates the cost per response and incremental cost per additional responder for romiplostim, eltrombopag, and “watch and rescue” for immune thrombocytopenia.
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Can Primary Care Physicians Accurately Predict the Likelihood of Hospitalization in Their Patients?This study demonstrates that the predictive accuracy of primary care physicians’ assessment of future hospitalization risk is comparable to commonly used quantitative risk stratification instruments.
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Estimating the Staffing Infrastructure for a Patient-Centered Medical HomeThis study suggests that implementing a patient-centered medical home requires additional staff with specific expertise based on the needs of the practice and its population.
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The Vermedx® Diabetes Information System Reduces Healthcare UtilizationThis analysis of paid claims from a physician hospital organization demonstrates that the Vermedx Diabetes Information System improves healthcare costs for adults with diabetes.
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Technology-Driven Intervention to Improve Hypertension Outcomes in Community Health CentersHealth information technology that is implemented as part of a multifaceted quality improvement initiative can lead to improvements in hypertension care and outcomes.
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Why Palliative Care Is the Answer to the Serious Illness Question in Payment ReformWhether it is through enlisting primary providers, building a champion workforce, or hiring more specialist consultants, there is no question that palliative programming must be at the heart of our healthcare system’s quality transformation.
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Treatment Modification After Initiating Second-Line Medication for Type 2 DiabetesAmong adults with type 2 diabetes who started noninsulin second-line therapy, most modified treatment within 1 year. Discontinuation was by far the most common modification.
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Mental Health in ACOs: Missed Opportunities and Low-Hanging FruitThis paper describes the rationale and benefits of incorporating mental health into accountable care organizations using the Chronic Care Model.
